HIV risk management among sexual minority men in China: context, lived experience, and implications for pre-exposure prophylaxis implementation

Abstract

This study examined the social context and lived experience of HIV risk management among sexual minority men in China. An interpretative phenomenological analysis of 25 in-depth interviews with participants in five Chinese cities was undertaken. Findings show how men managed HIV risk in the context of high risk perception and anxiety, and strong perceived social discrimination and marginalisation. Men’s choice of risk management strategies was influenced by their often-negative perceptions of gay community, social norms around condom use, and prior lived experience. Results underscore the importance of considering these contexts when planning pre-exposure prophylaxis (PrEP) implementation in China and highlight the need for strategies to address potential PrEP-related stigma among sexual minority men.

Keywords:

• HIV
• risk management
• PrEP
• sexual minority men
• China

Acknowledgements

We thank our local research collaborators: Weibin Cheng, Yuzhou Gu, and Huifang Xu (Guangzhou Center for Disease Control and Prevention, Guangzhou, China), Xiaojie Huang (Beijing You’an Hospital, China), Min Wang (The First Hospital of Changsha, Hunan, China) and Qinghai Hu (China Medical University, Shenyang, China). We also thank the following community-based organisations: the Shanghai CSW&men who have sex with men Center, the Changsha Zonda-sunshine Social Work Center, the QingCai Volunteer Centre, Lingnan Partners, Zhitong and Beijing Tianyuan. We thank Rong Fu, Jianhua Hou and Siyan Meng for their help with data collection and study coordination; and Ben Lane for editing the manuscript. Finally, we thank study participants for their involvement and time.

Disclosure statement

No potential conflict of interest was provided by the author(s).

Data availability statement

The data analysed during the current study are available from the corresponding author on reasonable request.

Notes

1 Chinese slang referring to the insertive partner in anal sex.

2 Chinese slang referring to the receptive partner in anal sex.

Additional information

Funding

The study was funded by GlaxoSmithKline. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. KM and YW’s contributions were additionally supported by US National Institute of Mental Health (grant number: R01MH119884, PI: Meyers). The content is solely the responsibility of the authors and does not necessarily represent the official views of the US National Institutes of Health.