Sexual risk behaviors in the internet age: the case of Chinese men who have sex with men

ABSTRACT

This cross-sectional study examined a sample of sexually active Chinese MSM recruited online (N = 403) to determine the associations of MSM social life (both online and in-person) and sexual identity stigma with three types of sexual risk behaviors in the past 12 months, including condom use %, number of anal intercourse partners, and number of partners engaged in condomless anal intercourse (CAI). Hierarchical regression analyses were conducted. More frequent use of social media was associated with higher numbers of anal intercourse partners as well as more condom use in past 12 months, but not number of CAI partners. More active in-person MSM social life was associated with higher numbers of partners in anal intercourse as well as CAI. Both perceived and enacted sexual identity stigma associated with higher numbers of CAI partners; perceived stigma was also linked to less condom use. In conclusion, social life and minority stress are relevant factors of sexual risk among MSM in China in the uptrend of internet use. The internet may be an important and promising platform for HIV prevention, and intervention efforts should consider online-based designs to promote safe sex and reduce sexual minority stigma.

KEYWORDS:

• Sexual risk behaviors
• MSM
• China
• internet
• stigma

Acknowledgements

We would like to acknowledge Beijing LGBT Center, Division of Psychology for their support.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Shufang Sun http://orcid.org/0000-0001-5215-128X

John E. Pachankis http://orcid.org/0000-0002-2015-9225

Notes

1 The tier system has been used to classify cities in China. The first-tier cities represent most developed, metropolitan areas. The second- and third-tier cities are large, urban cities yet less connected internationally.

Additional information

Funding

This research was supported by a Global Health Institute grant from the University of Wisconsin-Madison awarded to the first author. Work by the first author was in part supported by the National Institute of Mental Health [grant number T32MH078788].