Although the Chinese government provides free-of-charge voluntary HIV counseling and testing, HIV testing rates among men who have sex with men (MSM) are reported to be extremely low. This study examines the association of structural and psychosocial factors and social network characteristics with HIV testing behaviors among "money boys" and general MSM in Shanghai. Overall, 28.5% of "money boys" and 50.5% of general MSM had never tested for HIV despite high rates of reported HIV risk behaviors. Factors associated with not testing for HIV included: not knowing of a testing site, limited HIV knowledge, low perceived HIV risk, concern about HIV testing confidentiality, being a closeted gay, not using the Internet, and having a small social network or network with few members who had tested for HIV. Future efforts to promote HIV testing should focus on outreach to general MSM, confidentiality protection, decreasing the stigma of homosexuality, and encouraging peer education and support through the Internet and social networks.
Objective
Stroke is a leading cause of death and long‐term disability in China. The objective of this study was to examine the relation between alcohol consumption and risk for stroke among Chinese men.
Methods
We conducted a prospective cohort study among 64,338 Chinese men aged ≥40 years who were free of stroke at baseline. Data on frequency and type of alcohol consumed were collected at the baseline examination in 1991 using a standard protocol. Follow‐up evaluation was conducted in 1999 to 2000, which included determining vital status, interviewing participants or proxies, and obtaining hospital and medical records for incident and fatal strokes.
Results
Over the course of 493,351 person‐years of follow‐up, we documented 3,434 incident strokes (1,848 stroke deaths). After adjustment for age, body mass index, physical activity, urbanization (urban vs rural), geographic variation (north vs south), cigarette smoking, history of diabetes, and education, compared with nondrinkers, relative risk (95% confidence interval) of incident stroke was 0.92 (0.80–1.06) for participants consuming 1 to 6 drinks/week, 1.02 (0.93–1.13) for those consuming 7 to 20 drinks/week, 1.22 (1.07–1.38) for those consuming 21 to 34 drinks/week, and 1.22 (1.08–1.37) for those consuming 35 or more drinks per week (p for linear trend < 0.0001). The corresponding relative risks for stroke mortality were 0.93 (0.76–1.14), 0.98 (0.85–1.13), 1.15 (0.95–1.38), and 1.30 (1.11–1.52), respectively (p for linear trend = 0.0004; p for quadratic trend = 0.03).
Interpretation
These results suggest that heavy alcohol drinking may increase the risk for stroke in Chinese men and should be the target of strategies for prevention. Ann Neurol 2007
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