Sexual transmissibility of HIV among opiate users with concurrent sexual partnerships: an egocentric network study in Yunnan, China

Abstract

Aims To investigate the patterns of concurrent sexual partnerships among young opiate users and sexual transmissibility of HIV in concurrent sexual partnerships in drug-use and sexual networks. Design Cross-sectional design. Participants 426 young opiate users in Yunnan, China. Measurement Respondent-driven sampling (RDS) was used to recruit participants. Multiple logistic regressions were performed to analyze the relationships of concurrent sexual partnerships with egocentric social network components, risky sexual behavior for HIV, and drug-use practices. Findings The RDS-adjusted prevalence of concurrent sexual partners was 42.9% among opiate users. Opiate users with concurrent sexual partnerships were more likely to engage in risky HIV-related sexual behavior, compared to those without. Specifically, they were more likely to report having had four or more sexual partners (26.3% vs. 2.0%), having had a spouse or boy/girl friends who also had concurrent sexual partnerships (28.1% vs. 8.2%), having exchanged drug for sex (12.4% vs. 3.8%), having had sexual partners who were non-injection drug users (22.6% vs. 10.1%), having had sexual partners who were injection drug users (25.3% vs. 13.5%), and having used club drugs (26.3% vs. 13.5%). There were no significant differences in consistent condom use between opiate users with sexual concurrency and those without. The same proportion (25.8%) of opiate users in the two groups reported having consistently used condoms when having sex with regular partners, and 46.3% of opiate users with sexual concurrency and 36.4% of those without such concurrency consistently used condoms with non-regular partners. Conclusion The expansion of the HIV epidemic from high risk populations to the general population in China may be driven by concurrent sexual partnerships. Behavioral interventions targeting safer sex should be integrated into harm reduction programmes.

Network stigma towards people living with HIV/AIDS and their caregivers: An egocentric network study

“…In addition, it provides specific future directions for HIV stigma reduction interventions in China's endeavor to improve access to HIV/AIDS related care and treatment, reduce new infections, and enhance PLWHAs and their caregivers' quality of life. Past stigma reduction interventions in China are limited and have mainly focused on the individual level (Lau, Tsui, & Chan, 2005; Li, Liang, Wu, Lin, & Guan, 2013; Li, Lin, Guan, & Wu, 2013) of healthcare providers (Li et al, 2013; Wang et al, 2009; Williams et al, 2006) or students (Lau et al, 2005; Li et al, 2011; Yiu et al, 2010), ignoring critical mechanisms like social relationships (Smith & Baker, 2012). Social network analysis provides a platform for addressing HIV stigma in multiple socio-ecological mechanisms (Kennedy et al, 2012).…”

“…HIV/AIDS knowledge regarding HIV transmission and prevention was measured with an 11-item scale (0-11, where each item was recorded as 1=yes, 0=no or don't know) with a higher composite score (defined as the total number of correctly answered items) indicating better HIV knowledge. We created and successfully used this scale in our previous studies (Li, Liu, Li, Lou, Koram, & Detels, 2011; Liu et al, 2006). …”

Current status of drug use and HIV/AIDS prevention in drug users in China

“…Several domestic studies indicate that drug users often have multiple sexual partners and/or concurrent sexual partners, that their use of condoms is relatively low [14,15], and that more drug users are mixing drugs, especially involving amphetamine-style drugs that stimulate the central nervous system [16,17], leading to the danger of transmission of HIV and other sexually transmitted diseases in drug users.…”

Egocentric Network and Condom Use Among Mid-Age Female Sex Workers in China: A Multilevel Modeling Analysis

“…17,18 Previous research has documented that risk networks become part of the social network since individuals not only engage in risk behavior, but also exchange social support or influence. 15,19 Attitudes and behaviors are reinforced when they are shared with network members, but are more likely to be altered or discouraged when they are discrepant, 20 which may be especially true among individuals with a collectivist culture.…”

“…Based on social network theory, 13 the theory of planned behavior, 46 and our previous social network studies, 19,47 particularly the qualitative studies among mid-age FSWs, 6,48 we conceptualized the following hypotheses that were tested in this study:…”