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Cigarette Smoking and Its Associations with Substance Use and HIV-Related Sexual Risks among Chinese Men Who Have Sex with Men

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  • Wenjian Xu

    (Department of Sociology & Psychology, School of Public Administration, Sichuan University, Chengdu 610065, China
    Faculty of Psychology, Southwest University, Chongqing 400715, China
    Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
    These authors contributed equally to this manuscript.)

  • Wanjie Tang

    (Center for Educational and Health Psychology, Sichuan University, Chengdu 610065, China
    Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu 610065, China
    Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610065, China
    These authors contributed equally to this manuscript.)

  • Jing Zhang

    (Faculty of Psychology, Southwest University, Chongqing 400715, China)

  • Xin Shi

    (Faculty of Psychology, Southwest University, Chongqing 400715, China)

  • Yong Zheng

    (Faculty of Psychology, Southwest University, Chongqing 400715, China)

  • Michelle R. Kaufman

    (Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA)

Abstract

China has the largest population of male smokers globally. Men who have sex with men (MSM) are at greater risk of cigarette smoking compared to the general population. Limited data are available regarding cigarette smoking and its associations with other health issues among Chinese MSM. Eligible MSM (n = 1100) were recruited from mainland China using an online national cross-sectional survey conducted in 2014–2015. Socio-demographic characteristics, smoking behavior, substance use, homosexual stigma and outness, HIV-related risk behavior, and HIV status were obtained. Logistic regression analyses were performed to evaluate predictors of current cigarette smoking frequency and the co-occurrence of smoking and drug use. Nearly 41% (n = 446) of participants had ever smoked cigarettes; 25% (n = 278) were current frequent smokers; and 13% (n = 138) were current infrequent smokers. Factors associated with a history of smoking included age, employment status, and monthly salary. Risk factors associated with current frequent smoking included self-identification as gay, having female sexual partners, binge drinking, drug use, higher levels of homosexual stigma, and being partially or fully “out” as gay. Adjusted multinomial analysis showed that human immunodeficiency virus (HIV) related risks, including risky sexual behaviors, lack of condom use, and a reported history of sexually transmitted infections (STIs), were associated with co-occurrence of current smoking and drug use. Cigarette smoking rates remain high among MSM in China. Cigarette smoking is associated with binge drinking, drug use, and HIV-related risks in this community. There is a clear opportunity for smoking cessation interventions to be linked with HIV and substance use prevention interventions, thereby addressing multiple health issues simultaneously for the MSM community in China.

Suggested Citation

  • Wenjian Xu & Wanjie Tang & Jing Zhang & Xin Shi & Yong Zheng & Michelle R. Kaufman, 2020. "Cigarette Smoking and Its Associations with Substance Use and HIV-Related Sexual Risks among Chinese Men Who Have Sex with Men," IJERPH, MDPI, vol. 17(5), pages 1-14, March.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1653-:d:328526
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    References listed on IDEAS

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    2. Lifson, A.R. & Neuhaus, J. & Arribas, J.R. & Van Berg-Wolf, M.D. & Labriola, A.M. & Read, T.R.H., 2010. "Smoking-related health risks among persons with HIV in the strategies for management of antiretroviral therapy clinical trial," American Journal of Public Health, American Public Health Association, vol. 100(10), pages 1896-1903.
    3. Gilbert, Paul A. & Zemore, Sarah E., 2016. "Discrimination and drinking: A systematic review of the evidence," Social Science & Medicine, Elsevier, vol. 161(C), pages 178-194.
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