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Prevalence of Bisexual Behaviors Among Men Who Have Sex With Men (MSM) in China and Associations Between Condom Use in MSM and Heterosexual Behaviors

Lau, Joseph T. F. PhD*; Wang, Ming; Wong, Hong Nei*; Tsui, Hi Yi MPhil*; Jia, Manhong MD; Cheng, Feng PhD§; Zhang, Yun MD, MBA; Su, Xiaoyou MSc*; Wang, Ning PhD

Sexually Transmitted Diseases: April 2008 - Volume 35 - Issue 4 - p 406-413
doi: 10.1097/OLQ.0b013e318164467f
Article

Objectives: This study investigated the prevalence of bisexual behaviors and marital status among Chinese men who have sex with men (MSM) and the associations between MSM’s condom use and their heterosexual behaviors.

Methodology: Eight hundred ninety-six adult males in Yunnan Province, China, who reported to ever have engaged in MSM behaviors were interviewed. Data were acquired through the China-UK HIV/AIDS Prevention and Care Project from 2003 to 2006.

Results: Of all respondents, one-third had ever been married, 59% had ever engaged in bisexual behaviors, and 31% had done so in the past 6 months. High prevalence of inconsistent condom use was reported in heterosexual behaviors (71.9%), as well as with those who had engaged in MSM sexual behaviors in the past 6 months (30.8% with commercial sex workers and 54.7% with noncommercial sex partners) in the past 6 months. Those who did not use condoms with MSM partners were also more likely than others to not use condoms with their female sex partners (FSP). Those who had voluntary counseling and testing services were more likely than others to have used a condom in the last episode of sex with their FSP (multivariate odds ratio = 1.66).

Conclusions: The clustering of unprotected sexual behaviors with male and FSP among bisexual MSM is revealed. The bridging effects of the risk for human immunodeficiency virus transmission from the MSM population to the female population are evident.

Bisexual behaviors are prevalent among men who have sex with other men (MSM). Furthermore, unprotected sex with female partners and unprotected anal sex with MSM are intercorrelated.

From the *Centre for Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong; †Yunnan Health Education Institute, China; ‡Department of HIV/AIDS, Yunnan CDC; §China Country Office of Family Health International; ∥Management Office of China-UK HIV/AIDS Prevention and Care Project, Beijing; ¶National Center for AIDS/STDs Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

The authors thank all staffs of the China-UK HIV/AIDS Prevention and Care Project and CDC of Sichuan. Thanks are extended to Dr. Jean H. Kim and Emilio Dirlikov for their help in editing the early drafts of the manuscript.

The study was supported by the United Kingdom Department for International Development, Family Health International, and the China-UK HIV/AIDS Prevention and Care Project.

Correspondence: Joseph T.F. Lau, PhD, Centre for Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, 5/F., School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong, China. E-mail: jlau@cuhk.edu.hk.

Received for publication March 8, 2007, and accepted November 11, 2007.

© Copyright 2008 American Sexually Transmitted Diseases Association