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Smoking Syndemics among a Sample of Men Who Have Sex with Men in Shanghai, China

Yu, Fan (2012)
Master's Thesis (39 pages)
Committee Chair / Thesis Advisers: Sullivan, Patrick S; Wong, Frank Y
Committee Members: Nehl, Eric J.
Research Fields: Health Sciences, Public Health; Health Sciences, Epidemiology
Partnering Agencies: Emory University schools, faculty or affiliated programs
Keywords: Smoking; Chinese MSM; Syndemics
Program: Rollins School of Public Health, Epidemiology (Epidemiology)
Permanent url: http://pid.emory.edu/ark:/25593/br0pm

Abstract

Fan Yu Men who have sex with men (MSM) population are considerably at a greater risk for HIV infection in China. Studies in other countries indicated the prevalence of cigarette smoking among MSM is significantly higher than among their heterosexual peers. Western researchers found that MSM, gay, and/or bisexual men tend to experience more psychosocial problems, and have higher rates of substance use and HIV and other STIs. They proposed a syndemic theory to study the concurrent psychosocial conditions and health problems and their effects on HIV and other Sexually Transmitted Infections (STIs). Guided by syndemic theory, we analyzed cigarette smoking in relation to demographics, substance use behaviors and psychosocial conditions among 404 MSM participants in Shanghai, China. We also aimed to explore the syndemic effects of substance use and psychosocial problems on sexual risks. Cross-sectional data were collected as part of larger study examining characteristics of HIV/STIs, sexual risks, and health issues among MSM. Bivariate logistic modeling suggests that MSM have a higher prevalence of smoking than general males in China. The smoking level is associated with alcohol and drug use, depression, intimate partner violence, sexual attitude and gay identity. Linear regression analyses present that substance use and psychosocial conditions could significantly predict sexual risks. These findings are understood as part of a syndemic among MSM, and suggest that smoking prevention and cessation, as well as other substance abuse interventions should be integrated with the prevention of sexual risk behaviors for MSM in order for HIV and STIs prevention efforts to be more effective among MSM.

Table of Contents

i -- TABLE OF CONTENTS -- INTRODUCTION .................................................................................................................. 1 -- METHODS ......................................................................................................................... 6 -- RESULTS .......................................................................................................................... 11 -- DISCUSSION ..................................................................................................................... 14 -- REFERENCE ....................................................................................................................... 19 -- TABLES ............................................................................................................................ 28 -- ii -- LIST OF TABLES -- Table 1: Demographic Characteristics of 404 MSM by Cigarette Smoking Status -- Recruited by Respondent-Driven Sampling Method in Shanghai Mens Study in Shanghai -- China, 2008-2009 .............................................................................................................. 28 -- Table 2. The Association Between Demographic, Behavioral and Psychosocial Predictors -- by Smoker Type among 404 MSM Recruited by Respondent-Driven Sampling Method in -- Shanghai Mens Study, in Shanghai, China, 2008-2009 .............................................................. 30 -- Table 3. Correlation matrix between Sex Risk Behaviors and Factors among 404 MSM -- Recruited by Respondent-Driven Sampling Method in Shanghai Mens Study, in Shanghai, -- China, 2008-2009 .............................................................................................................. 31 -- Table 4. Linear Regression on Sex Risk Behaviors among 404 MSM Recruited by -- Respondent-Driven Sampling Method in Shanghai Mens Study, in Shanghai, China, -- 2008-2009. ...................................................................................................................... 32

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