Understanding MSM HIV risk in context: mapping social and sexual networks among MSM in a cruising park in Beijing, China
H. Yi1, X. Li2, W. Wang3, R. Guo4, Y. Wan4, T. Sandfort1
1HIV Center for Clinical and Behavioral Studies, Columbia University, Psychiatry, New York, United States, 2Renmin University of China, Psychology, Beijing, China, 3Renmin University of China, Sociology and Population Study, Beijing, China, 4Aizhixing Institute of Health Education, Beijing, China
Background: The HIV epidemic among MSM in China has been concentrated and expanded through sexual networks in urban settings. While individual-level prevention approaches are dominant in China, the urbanized epidemic requires special attention to the ecology of HIV risk and protection, acknowledging the physical and social environments of MSM.
Methods: We conducted a network-mapping study among 350 MSM in a cruising park in Beijing in 2009. The survey domains included sexual identity and practices, social and sexual networks, personal history in the park, and prevention services utilization. Ego-centric network data were collected including up to 5 most recent male sex partners and 5 social ties. We conducted logistic regressions to explore network factors associated with unprotected anal intercourse with men (UAI-M).
Results: More than half of the men (56%) reported UAI-M in the past three months. In multivariate models, after controlling for significant individual-level factors (i.e., unstable housing, no regular job, being married to women, and lack of self-efficacy), UAI-M was independently associated at the p value < .05 with; low level of social capital (e.g., financial, material, health, communication, and problem solving supports; social network), sex in bathhouses/saunas and group sex (sexual partnering), engaging in genital contacts in the park (e.g., petting, oral, and anal sex), density of sexual networks (i.e., number of networks having sex with each other divided by total number of network dyads), and overlap between social and sexual networks in the park.
Conclusions: The findings highlight the importance of expanding our understanding of HIV risk in the context of social and sexual networks within/across MSM venues in China. Current prevention research should examine variability of sex environments in terms of features, networks, socio-cultural capital, and ties to health services in order to develop intensive and sustainable interventions targeting high-risk populations in the MSM community.