title: Factors that influence risky sexual behaviors among men who have sex with men in Liaoning province, China: a structural equation model.
abstract: HIV prevalence among men who have sex with men (MSM) has increased rapidly in China. Behavioral and biologic interventions are the key to control the spreading of HIV in the MSM population and the primary strategy for reducing the spread of AIDS in China. The objective of this study is to explore the relationship among HIV-related knowledge, the basic information of respondents, service utilization and risky sexual behavior. Respondent-driven sampling was used to recruit 225 MSM in Fushun and Huludao in China. The results of univariate analysis showed that condom use in the past 6 months was associated with age, being more knowledgeable about HIV, accepting lubricant distribution, and peer education (p<0.05). The structural equation modeling (SEM) results was as following, χ(2)=863.45 (p<0.01); root mean square error of approximation (RMSEA)=0.04; goodness of fit (GFI)=0.94, which indicated the model fitted the data well. The factor loads of HIV-related knowledge, the basic information of respondents, service utilization and risky sexual behavior was -0.06, 0.07, -0.27, respectively, which indicated that service utilization was likely to be a major factor negatively impacting risky sexual behavior. For service utilization, the greatest item load was for distribution of lubricants and peer education, 0.69, 0.68, respectively. The factor load of HIV-related knowledge and service utilization was 0.15, which suggested that risky sexual behaviors might be indirectly reduced by improving HIV/AIDS knowledge to increase service utilization. Basic information (age, income, marital status, age at first sexual intercourse) had a greater impact on service utilization, with a load factor of 0.26. For basic information, the greatest item load was age (0.96). In terms of the intervention strategies, it is essential that public health education is provided for the young, to ultimately decrease risky behaviors in MSM.
authors.affiliation: School of Public Health, China Medical University, Shenyang.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.forename: Bo
authors.initials: B
authors.lastname: Qu
authors.forename: Hai-Qiang
authors.initials: HQ
authors.lastname: Guo
authors.forename: Gao
authors.initials: G
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D017280:Condoms; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D047568:Unsafe Sex; D055815:Young Adult