China has a high prevalence of HBV. Despite previous studies, uncertainty remains about the association of HBV with depression. This study explores the strength of the association and the modifying effects of participants' self-awareness of the disease and their socio-economic status. Data from the baseline of a Chinese cohort study of approximately 500 000 adults were analysed. Depression was assessed using the Composite International Diagnostic Inventory. Blood spot tests were conducted to detect hepatitis B surface antigen. Logistic regression was used to assess the association between depression and HBV adjusting for demographic, socio-economic and lifestyle factors of major depression. To understand the effect modifications of disease self-awareness and socio-economic factors, a series of stratified analyses were undertaken. The overall prevalence of HBV is 3.2%, with 2.8% screen-detected and 0.3% self-reported cases. There was an 84% increased odds of depression among self-reported HBV patients (OR=1.84, 95% CI: 1.16-2.90), but no association was found in the screen-detected group (OR=0.98, 95% CI: 0.79-1.23). Male (OR=2.28, 95% CI: 1.30-3.98), younger age (OR=3.57, 95% CI: 1.82-7.00), rural resident (OR=2.31, 95% CI: 1.36-3.94), lower household income (OR=2.38, 95% CI: 1.34-4.25) and agricultural worker (OR=2.92, 95% CI: 1.63-5.77) were found having greater odds of depression in the HBV self-aware group, compared to those without HBV. A strong association between hepatitis B self-awareness and depression was found. Lower socio-economic status could modify the association between hepatitis B status and depression. Further studies are needed to understand the underlying psychosocial mechanisms of the association.

PurposeHigh-risk sexual behaviour is a factor affecting the health of sexual minority students, yet few related studies have been completed among Chinese students. This article explores the distribution of sexual minority groups and its association with high-risk sexual behaviours and symptoms of sexually transmitted infections(STIs) among Chinese college students.MethodsAn internet-based questionnaire was applied, and a sample of 17 966 surveys from 130 Chinese colleges was collected. Based on their self-reports, participants were classified into the following groups: homosexual male or female, heterosexual, bisexual, and sexual orientation unknown. High-risk sexual behaviours were defined as having sexual intercourse before the age of 18 years, having one's sexual debut with a non-regular partner, having had more than four sexual partners before investigation, and having mostly had sexual intercourse without using condoms. Logistic regression models were constructed to analyse the associations.ResultsThe proportions of the homosexual males and females, and the bisexual groups were 1.62%, 0.88% and 5.07%, respectively. Homosexual males were more likely to have their sexual debut with a non-regular partner (OR 4.79, 95% CI 3.38 to 6.78), having more than four sexual partners (OR 5.81, 95% CI 4.06 to 8.32), having their sexual debut before the age of 18 years (OR 1.92, 95% CI 1.34 to 2.76), and not using condoms for most episodes of sexual intercourse (OR 1.47, 95% CI 1.00 to 2.17). Similar associations also existed among homosexual females. A positive association between sexual orientation and having symptoms of STIs (OR 1.49, 95% CI 1.02 to 2.18) was found among homosexual males.ConclusionsSexual minority groups among Chinese college students had a greater risk of engaging in high-risk sexual behaviours and having STI symptoms. Future studies and interventions should focus on this population.