Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2018

Open Access 01-12-2018 | Research article

A cross-sectional study of the relationship between sexual compulsivity and unprotected anal intercourse among men who have sex with men in shanghai, China

Authors: Xin Wang, Zezhou Wang, Xueqin Jiang, Rui Li, Ying Wang, Gang Xu, Huachun Zou, Yong Cai

Published in: BMC Infectious Diseases | Issue 1/2018

Login to get access

Abstract

Background

HIV prevalence among men who have sex with men (MSM) in China is rising rapidly, and unprotected anal intercourse (UAI) is associated with HIV transmission. Recent research has shown that associations between UAI and other factors can differ according to the type of sex partners, including regular partners and casual partners. This study aimed to explore the relationship between sexual compulsivity and UAI according to partner type among MSM in Shanghai, China.

Methods

A cross-sectional study was conducted among 547 MSM from four districts in Shanghai, China. All participants were recruited using snowball sampling. The Sexual Compulsivity Scale was used to evaluate participants’ sexual compulsivity. Multivariable logistic regression was used to identify factors associated with sexual compulsivity and UAI. The mediation effects of substance use before sex on the relationship between sexual compulsivity and UAI were tested through mediation analyses.

Results

After adjusting for sociodemographic variables, sexual compulsivity was associated with overall UAI (adjusted odds ratios [AOR] = 1.039, 95% confidence intervals [CI] = 1.004–1.075), UAI with non-regular sex partners (AOR = 1.089, 95% CI = 1.033–1.148) and UAI with commercial sex partners (AOR = 1.185, 95% CI = 1.042–1.349). No significant association was found between sexual compulsivity and UAI with regular sex partners (AOR = 1.029, 95% CI = 0.984–1.077). Mediation analyses indicated that the relationship between sexual compulsivity and UAI was not mediated by either alcohol use before sex or drug use before sex.

Conclusions

The association between sexual compulsivity and UAI varies depending on the type of UAI partner. Therefore, individuals may engage in different types of UAI for different reasons, and tailored HIV cognitive–behavioral intervention programs are needed.
Literature
1.
Lu L, Jia M, Ma Y, Yang L, Chen Z, Ho DD, et al. The changing face of HIV in China. Nature. 2008;455(7213):609.PubMed
2.
Ministry of Health of China, UNAIDS, WHO. 2005 HIV/AIDS epidemic and work progress of prevention and control in China. China: Beijing; 2006.
3.
Ministry of Health of China, UNAIDS, WHO. 2009 estimates for the HIV/AIDS epidemic in China. China: Beijing; 2010.
4.
Ministry of Health of China, UNAIDS, WHO. 2011 estimates for the HIV/AIDS epidemic in China. China: Beijing; 2011.
5.
State Council AIDS Working Committee Office. UN theme group on AIDS in China. In: A joint assessment of HIV/AIDS prevention, treatment and care in China (2007). Beijing, China; 2007.
6.
Hei FX, Wang L, Qin QQ, Wang L, Guo W, Li DM, et al. Epidemic characteristics of HIV/AIDS among men who have sex with men from 2006 To 2010 in China. Zhonghua Liu Xing Bing Xue Za Zhi 2012. 33(1):67–70.
7.
Hong S, Xu J, Han X, Li JS, Arledge KC, Zhang L. Bring safe sex to China. Nature. 2012;485(7400):576–7.CrossRef
8.
Zhong F, Lin P, Xu H, Wang Y, Wang M, et al. Possible increase in HIV and syphilis prevalence among men who have sex with men in Guangzhou, China: results from a respondent-driven sampling survey. AIDS Behav. 2011;15:1058–66.CrossRef
9.
Zablotska IB, Prestage G, Middleton M, Wilson D, Grulich AE. Contemporary HIV diagnoses trends in Australia can be predicted by trends in unprotected anal intercourse among gay men. AIDS. 2010;24:1955–8.CrossRef
10.
Hirshfield S, Remien RH, Walavalkar I, Chiasson MA. Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: a nested case-control study. J Med Internet Res. 2004;6:e41.CrossRef
11.
Li HM, Peng RR, Li J, Yin YP, Wang B, et al. HIV incidence among men who have sex with men in China: a meta-analysis of published studies. PLoS One. 2011;6:e23431.CrossRef
12.
Berry M, Wirtz AL, Janayeva A, Ragoza V, Terlikbayeva A, et al. Risk factors for HIV and unprotected anal intercourse among men who have sex with men (MSM) in Almaty, Kazakhstan. PloS One. 2012;7:e43071.CrossRef
13.
Vu L, Andrinopoulos K, Tun W, Adebajo S. High levels of unprotected anal intercourse and never testing for HIV among men who have sex with men in Nigeria: evidence from a cross-sectional survey for the need for innovative approaches to HIV prevention. Sex Transm Infect. 2013;89:659–65.CrossRef
14.
Carey JW, Mejia R, Bingham T, Ciesielski C, Gelaude D, Herbst JH, et al. Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles. AIDS Behav. 2009;13(6):1084–96.CrossRef
15.
Kalichman SC, Johnson JR, Adair V, Rompa D, Multhauf K, Kelly JA. Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men. J Pers Assess. 1994;62(3):385–97.CrossRef
16.
Wim VB, Christiana N, Marie L. Syndemic and other risk factors for unprotected anal intercourse among an online sample of Belgian HIV negative men who have sex with men. AIDS Behav. 2014;18(1):50–8.CrossRef
17.
Lau JTF, Siah PC, Tsui HY. A study of the STD/AIDS related attitudes and behaviors of men who have sex with men in Hong Kong. Arch Sex Behav. 2002;31(4):367–73.CrossRef
18.
Zhao Y, Ma Y, Chen R, Li F, Xia Q, Hu Z. Non-disclosure of sexual orientation to parents associated with sexual risk behaviors among gay and bisexual MSM in China. AIDS Behav. 2016;20(1):193–203.CrossRef
19.
O'Leary A, Wolitski RJ, Remien RH, Woods WJ, Parsons JT, Moss S, et al. Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men. Aids. 2005;19(suppl 1(19 Suppl 1)):S67–75.CrossRef
20.
Xu W, Zheng L, Yong L, Yong Z. Sexual sensation seeking, sexual compulsivity, and high-risk sexual behaviours among gay/bisexual men in Southwest China. AIDS Care. 2016;28(9):1138.CrossRef
21.
Benotsch EG, Kalichman SC, Kelly JA. Sexual compulsivity and substance use in hiv-seropositive men who have sex with men: prevalence and predictors of high-risk behaviors. Addict Behav. 1999;24(6):857.CrossRef
22.
Dodge B, Reece M, Cole SL, Sandfort TG. Sexual compulsivity among heterosexual college students. J Sex Res. 2004;41(4):343–50.CrossRef
23.
Grov C, Parsons JT, Bimbi DS. Sexual compulsivity and sexual risk in gay and bisexual men. Arch Sex Behav. 2010;39(4):940.CrossRef
24.
Kalichman SC, Rompa D. Sexual sensation seeking and sexual compulsivity scales: validity, and predicting HIV risk behavior. J Pers Assess. 1995;65(3):586.CrossRef
25.
Schnarrs PW, Rosenberger JG, Satinsky S, Brinegar E, Stowers J, Dodge B, et al. Sexual compulsivity, the internet, and sexual behaviors among men in a rural area of the United States. Aids Patient Care STDS. 2010;24(9):563–9.CrossRef
26.
Bancroft J. Sexual behavior that is “out of control”: a theoretical conceptual approach. Psychiatr Clin N Am. 2008;31:593–601.CrossRef
27.
Black DW. Compulsive sexual behavior: a review. J Pract Psychol Behav Health. 1998;4:219–29.
28.
Kafka MP, Prentky RA. Preliminary observations of DSM-III-R Axis I comorbidity in men with paraphilias and paraphilias-related disorders. J Clin Psychiatry. 1994;55:481–7.PubMed
29.
Gold SN, Heffner CL. Sexual addiction: many conceptions, minimal data. Clin Psychol Rev. 1998;18(3):367.CrossRef
30.
Quadland MC. Compulsive sexual behavior: definition of a problem and an approach to treatment. J Sex Marital Ther. 1985;11(2):121.CrossRef
31.
Quadland MC, Shattls WD. AIDS, sexuality, and sexual control. J Homosex. 1987;14(1–2):277.CrossRef
32.
Kalichman SC, Rompa D. The Sexual Compulsivity Scale: further development and use with HIV-positive persons. J Personal Assess, 2001. 76(3):379.CrossRef
33.
Kalichman SC, Cain D. The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic. J Sex Res. 2004;41(3):235–41.CrossRef
34.
Kalichman SC, Greenberg J, Abel GG. HIV-seropositive men who engage in high-risk sexual behaviour: psychological characteristics and implications for prevention. AIDS Care. 1997;9(4):441–50.CrossRef
35.
McBride K, Reece M, Sanders SA. Using the sexual compulsivity scale to predict outcomes of sexual behavior in young adults. Sex Addict Compulsivity. 2008;15:97–115.CrossRef
36.
Liao W, Lau JT, Tsui HY, Gu J, Wang Z. Relationship between sexual compulsivity and sexual risk behaviors among Chinese sexually active males. Arch Sex Behav. 2015;44(3):791–8.CrossRef
37.
Parsons JT, Kelly BC, Bimbi DS, et al. Explanations for the origins of sexual compulsivity among gay and bisexual men. Arch Sex Behav. 2008;37(5):817–26.CrossRef
38.
Dodge B, Reece M, Herbenick D, et al. Relations between sexually transmitted infection diagnosis and sexual compulsivity in a community-based sample of men who have sex with men. Sex Transm Infect. 2008;84(84):324–7.CrossRef
39.
Parsons JT, Grov C, Golub SA. Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: further evidence of a syndemic. Am J Public Health. 2011;102(1):156.CrossRef
40.
Coleman E, Horvath KJ, Miner M, et al. Compulsive sexual behavior and risk for unsafe sex among internet using men who have sex with men. Arch Sex Behav. 2010;39(5):1045–53.CrossRef
41.
Wang Z, Wu X, Lau J, et al. Prevalence of and factors associated with unprotected anal intercourse with regular and nonregular male sexual partners among newly diagnosed HIV-positive men who have sex with men in China. HIV Med. 2017;18(9):635–46.CrossRef
42.
Li X, Shi W, Li D, et al. Predictors of unprotected sex among men who have sex with men in Beijing, China. Southeast Asian J Trop Med Public Health. 2008;39(1):99–108.PubMedPubMedCentral
43.
Mor Z, Davidovich U, BessuduManor N, et al. High-risk behaviour in steady and in casual relationships among men who have sex with men in Israel. Sex Transm Infect. 2011;87(87):532–7.CrossRef
44.
Lim SH, Bazazi AR, Sim C, et al. High rates of unprotected anal intercourse with regular and casual partners and associated risk factors in a sample of ethnic Malay men who have sex with men (MSM) in Penang, Malaysia. Sex Transm Infect. 2013;89(8):642.CrossRef
45.
Wu J, Hu Y, Jia Y, et al. Prevalence of unprotected anal intercourse among men who have sex with men in China: an updated meta-analysis. PLoS One. 2014;9(5):e98366.CrossRef
46.
Crawford JM, Kippax SC, Mao L, et al. Number of risk acts by relationship status and partner Serostatus: findings from the HIM cohort of homosexually active men in Sydney, Australia. AIDS Behav. 2006;10(3):325–31.CrossRef
47.
Cai Y, Lau JT. Multi-dimensional factors associated with unprotected anal intercourse with regular partners among Chinese men who have sex with men in Hong Kong: a respondent-driven sampling survey. BMC Infect Dis. 2014;14(1):1–10.CrossRef
48.
Lau JT, Cai W, Tsui HY, Cheng J, Chen L, Choi KC, et al. Prevalence and correlates of unprotected anal intercourse among Hong Kong men who have sex with men traveling to Shenzhen, China. AIDS Behav. 2013;17(4):1395–405.CrossRef
49.
Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. Aids. 2009;23(9):1153–62.CrossRef
50.
Gu J, Bai Y, Lau JT, et al. Social environmental factors and condom use among female injection drug users who are sex workers in China. Aids Behav. 2014;18(2):181–91.CrossRef
51.
Yan J, Lau JT, Tsui HY, Gu J, Wang Z. Prevalence and factors associated with condom use among Chinese monogamous female patients with sexually transmitted infection in Hong Kong. J Sex Med. 2012;9(12):3009–17.CrossRef
52.
Jin X, Smith K, Chen RY, et al. HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China. Jaids. 2010;53(1):131–5.PubMed
53.
Li J, Liu H, Li J, et al. Sexual transmissibility of HIV among opiate users with concurrent sexual partnerships: an egocentric network study in Yunnan, China. Addiction. 2011;106(10):1780–7.CrossRef
54.
Lau JT, Tsui HY, Cheng S, et al. A randomized controlled trial to evaluate the relative efficacy of adding voluntary counseling and testing (VCT) to information dissemination in reducing HIV-related risk behaviors among Hong Kong male cross-border truck drivers. AIDS Care. 2010;22(1):17–28.CrossRef
55.
Iacobucci D. Mediation analysis and categorical variables: the final frontier. J Consum Psychol. 2012;22(4):582–94.CrossRef
56.
Eric G, Benotsch SCK, Steven D. Pinkerton. Sexual compulsivity in HIV-positive men and women: prevalence, predictors, and consequences of high-risk behaviors. Sex Addict Compulsivity. 2001;8(2):83–99.CrossRef
57.
Feng Y, Wu Z, Detels R, et al. HIV/STD prevalence among men who have sex with men in Chengdu, China and associated risk factors for HIV infection. Jaids. 2010;53(1):74–80.
58.
Lau JT, Cai WD, Tsui HY, Chen L, Cheng JQ. Psychosocial factors in association with condom use during commercial sex among migrant male sex workers living in Shenzhen, mainland China who serve cross-border Hong Kong male clients. AIDS Behav. 2009;13(5):939–48.CrossRef
59.
Bancroft J, Janssen E, Strong D, Carnes L, Vukadinovic Z, Long J. Sexual risk-taking in gay men: the relevance of sexual arousability, mood, and sensation seeking. Arch Sex Behav. 2003;32:555–72.CrossRef
60.
Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.CrossRef
61.
Hoff CC, Chakravarty D, Beougher SC, Neilands TB, Darbes LA. Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. Aids Patient Care STDS. 2012;26(12):738.CrossRef
62.
Starks TJ, Tuck AN, Millar BM, Parsons JT. Linking Syndemic stress and behavioral indicators of main partner HIV transmission risk in gay male couples. AIDS Behav. 2016;20(2):439–48.CrossRef
63.
Starks TJ, Millar BM, Parsons JT. Predictors of condom use with main and casual partners among HIV-positive men over 50. Health Psychol. 2015;
64.
Centers for Disease Control (USA). Pre-exposure prophylaxis for the prevention of HIV infection in the United States: A clinical practice guideline. Atlanta: Centers for Disease Control and Prevention; 2014.
65.
Ding Y, Yan H, Ning Z, et al. Low willingness and actual uptake of pre-exposure prophylaxis for HIV-1 prevention among men who have sex with men in shanghai, China. Biosci Trends. 2016;10(2):113.CrossRef
Metadata
Title
A cross-sectional study of the relationship between sexual compulsivity and unprotected anal intercourse among men who have sex with men in shanghai, China
Authors
Xin Wang
Zezhou Wang
Xueqin Jiang
Rui Li
Ying Wang
Gang Xu
Huachun Zou
Yong Cai
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2018
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-018-3360-x

Other articles of this Issue 1/2018

BMC Infectious Diseases 1/2018 Go to the issue

Research article

The epidemiology of Taenia spp. infection and Taenia solium cysticerci exposure in humans in the Central Highlands of Vietnam

Case report

Exceptional association of two species of bacteria causing mediastinitis: Haemophilus influenzae (H. influenzae) and Aggregatibacter aphrophilus (A. aphrophilus)

Research article

Pandemic influenza preparedness in the WHO African region: are we ready yet?

Research article

Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014

Research article

Does discovery of differentially culturable M tuberculosis really demand a new treatment paradigm? Longitudinal analysis of DNA clearance from sputum

Case report

Severe acute pancreatitis with blood infection by Candida glabrata complicated severe agranulocytosis: a case report

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits