Egocentric Networks of Chinese Men Who Have Sex with Men: Network Components, Condom Use Norms, and Safer Sex

Abstract

Research on risk behaviors among men who have sex with men (MSM) is often based on individualistic models of health behavior, but sexual behavior is inherently social in nature and often determined by constituents of social networks. The objective of this study was to examine relationships among social networks, network norms of condom use, and safer sex. A respondent-driven sampling study recruited 350 MSM in the Shenzhen region of China between November and December 2007 and collected information on network components (relations, structures, and functions) and HIV risk behavior among egos (those interviewed) and their network alters. A total of 2385 alters were nominated by the 350 egos. Egos reported an average of 4 nonsexual relation alters and 2 sexual-partner alters. Egos perceived receiving more tangible and emotional support from nonsexual relation alters than from sexual-partner alters. Two thirds (69%) of egos consistently used condoms. Sixty-seven percent of egos reported having 1 or more alters who always encouraged egos to use condoms, 84% had 1 or more alters who consistently used condoms, and 55% had 1 or more alters who insisted on condom use. Both subjective and descriptive norms were positively associated with consistent condom use. Network components were associated with the levels of the two norms. These findings suggest that social network components may activate or strengthen condom use norms within networks, which, in turn, determine consistent condom use among MSM. HIV behavioral interventions need to target the promotion of safer sex practices through enhancing peer norms of condom use within networks.

Association Between Social Network Communities and Health Behavior: An Observational Sociocentric Network Study of Latrine Ownership in Rural India

“…Research on condom use, for instance, has found that individuals in more tightly connected networks are less likely to have sexual partners willing to use condoms. 31,32 Potentially, once a critical mass of partners in tightly knit social groups adopted condom use, it would be reinforced rather than inhibited. We conjecture that the network-determined communities we identified in our study actually make up the salient reference groups to which individuals turn for information on normative Note.…”

Correlates of Incident Infections for HIV, Syphilis, and Hepatitis B Virus in A Cohort of Men Who Have Sex with Men in Beijing

“…The findings of this study highlighted that an effective multicomponent biomedical and behavioral intervention strategy is needed urgently, including education about appropriate health-seeking behavior, 55 the promotion of condom use through enhancing peer norms within MSM networks, 56 HIV prevention on the Internet due to China has hundreds of MSM websites, expanded testing for HIV, syphilis and HBV, actively bridging to care and treatment for HIV-infected individuals and HBV vaccination for HIVnegative individuals, along with alcohol control and harm reduction. The innovative prevention measures for HIV transmission reduction, e.g., preexposure prevention (PreP), ART for prevention, should be examined in the context of Chinese MSM.…”

HIV Infection, Sexual Behaviors, Sexual Networks, and Drug Use Among Rural Residents in Yunnan Province, China

“…However, conducting sexual network studies presents challenges with respect to sampling [10,11], subject protection [10], and data collection [10,12]. Previous sexual network studies were primarily limited to high-risk populations such as drug users, men who have sex with men, or individuals infected with HIV/STIs [13][14][15][16]. To fill this significant gap, we designed and conducted a cross-sectional study in a rural community in Yunnan Province to examine HIV prevalence, sexual behaviors, sexual networks, and drug use.…”