Bisexual Behaviors, HIV Knowledge, and Stigmatizing/Discriminatory Attitudes among Men Who Have Sex with Men

Abstract

ObjectiveTo assess the correlates for bisexual behaviors, HIV knowledge, and HIV/AIDS-related stigmatizing/discriminatory attitudes among men who have sex with men (MSM).MethodsA cross-sectional survey among MSM was conducted in 2011 to provide demographics, sexual behaviors, HIV knowledge, HIV/AIDS-related stigmatizing/discriminatory attitudes, and services in Jinan, Qingdao, and Yantai of Shandong Province of China.ResultsOf 1230 participants, 82.8% were single, 85.7% aged <35 years, and 47.2% received college or higher education. There were 28.6% MSM who reported to be married or cohabitating or ever had sex with woman in the past 6 months (P6M). 74.5% had ≥6 HIV-related knowledge score. The average total score of stigmatizing/discriminatory attitude was 37.4±4.4(standard deviation). Bisexual behavior was independently associated with higher levels of HIV/AIDS-related stigma/discrimination(AOR = 1.1, 95% CI:1.0–1.1), older age(AOR = 1.2, 95%CI:1.1–1.2), and lower HIV-related knowledge score(AOR = 1.6, 95%CI:1.2–2.2). HIV knowledge score ≥6 was independently associated with lower levels of HIV/AIDS-related stigma/discrimination(AOR = 1.3, 95%CI:1.2–1.3), less bisexual behaviors(AOR = 0.6, 95%CI:0.5–0.9), ever received a test for HIV in the past 12 months (P12M)(AOR = 3.2, 95%CI:2.3–4.5), college or higher level education(AOR = 1.9, 95%CI:1.4–2.6), consistent condom use with men in P6M(AOR=6.9, 95%CI:4.6–10.6), recruited from internet or HIV testing sites(AOR = 11.2, 95%CI:8.0–16.1) and bars, night clubs, or tea houses(AOR = 2.5, 95%CI:1.7–4.8). Expressing higher levels of HIV/AIDS-related stigmatizing/discriminatory attitudes was independently associated with bisexual behaviors(Aβ = 0.9, 95%CI:0.4–1.4), lower HIV-related knowledge score(Aβ = 3.6, 95%CI:3.0–4.1), the number of male sex partners in the past week ≥2(Aβ = 1.4, 95%CI:1.0–1.9), unprotected male anal sex in P6M(Aβ = 1.0, 95%CI:0.5–1.6), and inversely associated with ever received HIV test(Aβ = 1.4, 95%CI:0.8–2.0) and peer education in P12M(Aβ = 1.4, 95%CI:0.9–1.9).ConclusionHIV/AIDS-related stigmatizing/discriminatory attitudes were associated with bisexual behaviors, low HIV testing rate, lower HIV-related knowledge and risk behaviors. This study called for innovative programs that would reduce HIV/AIDS-related stigmatizing/discriminatory attitudes and bisexual behaviors and improve the uptake of prevention service among MSM.

HIV/AIDS knowledge among MSM in Brazil: a challenge for public policies

“…In our study, those with better schooling presented greater HIV/AIDS knowledge, in agreement with studies conducted in Brazil and in other countries 19,21,[25][26][27]35 . It is also noteworthy the association between high level of knowledge, being white, and having private health insurance -important proxy variables that indicate belonging to higher social strata.…”

“…Few variables related to health services remained associated with high level of knowledge in the multivariate analysis: previous syphilis testing and having received educational material on STI. In the literature, both, previous HIV testing and having had an STI diagnosis, have been associated with a higher level of knowledge 21,[25][26][27] . STI/HIV testing seems to be an opportunity to disseminate information.…”

“…Another aspect of knowledge is the attenuation of stigma and discrimination against people living with HIV by disseminating specific information on the forms of prevention and transmission of the virus [20][21][22] . Thus, monitoring HIV/AIDS knowledge and its associated factors, is important for the formulation, overseeing, and keeping track of public health policies 23 .…”

“…Socioeconomic (e.g., high schooling and monthly income) and behavioral factors (e.g., number of friends or acquaintances who are gay or bisexual, having sex exclusively with men, homosexual sexual orientation, and consistent use of condom) have been associated with high knowledge 21,[24][25][26] . Factors related to healthcare services, including HIV testing and the diagnosis of sexually transmitted infections (STI), are also associated with better knowledge about HIV/AIDS 21,[25][26][27] .…”

Associated factors of self-reported psychopathology and health related quality of life among men who have sex with men (MSM) with HIV/AIDS in Dalian, China: a pilot study

“…A survey from Jinan, Qingdao, and Yantai of Shandong province in China concluded that the bisexual behaviour is independently associated with higher levels of HIV/AIDS-related discrimination [33]. Social ( P  < 0.001) and spirituality ( P  = 0.049) domains, and total HRQoL ( P  < 0.001) were predicted by perceived discrimination.…”