title: Participation of HIV prevention programs among men who have sex with men in two cities of China--a mixed method study.
abstract: BACKGROUND
  Although various HIV prevention programs targeting men who have sex with men (MSM) are operating in China, whether and how these programs are being utilized is unclear. This study explores participation of HIV prevention programs and influencing factors among MSM in two cities in China.
  
  
  METHODS
  This is a mixed-method study conducted in Beijing and Chongqing. A qualitative study consisting of in-depth interviews with 54 MSM, 11 key informants, and 8 focus group discussions, a cross-sectional survey using respondent-driven sampling among 998 MSM were conducted in 2009 and 2010 respectively to elicit information on MSM's perception and utilization of HIV prevention programs. Qualitative findings were integrated with quantitative multivariate factors to explain the quantitative findings.
  
  
  RESULTS
  Fifty-six percent of MSM in Chongqing and 75.1% in Beijing ever participated in at least one type of HIV prevention program (P=0.001). Factors related to participation in HIV prevention programs included age, ethnicity, income, HIV risk perception, living with boyfriend, living in urban area, size of MSM social network, having talked about HIV status with partners, and knowing someone who is HIV positive. Reasons why MSM did not participate in HIV prevention programs included logistical concerns like limited time for participation and distance to services; program content and delivery issues such as perceived low quality services and distrust of providers; and, cultural issues like HIV-related stigma and low risk perception.
  
  
  CONCLUSIONS
  The study shows that there is much room for improvement in reaching MSM in China. HIV prevention programs targeting MSM in China may need to be more comprehensive and incorporate the cultural, logistic and HIV-related needs of the population in order to effectively reach and affect this population's risk for HIV.
authors.affiliation: Shandong University School of Public Health, Jinan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ma
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.forename: Erin C
authors.initials: EC
authors.lastname: Wilson
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.forename: Hongyan
authors.initials: H
authors.lastname: Lu
authors.forename: Xianbin
authors.initials: X
authors.lastname: Ding
authors.forename: Rongrong
authors.initials: R
authors.lastname: Lu
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Ma
authors.forename: Dongyan
authors.initials: D
authors.lastname: Xia
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.forename: Xiong
authors.initials: X
authors.lastname: He
authors.forename: Liangui
authors.initials: L
authors.lastname: Feng
authors.forename: Song
authors.initials: S
authors.lastname: Fan
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Li
authors.forename: Jiangping
authors.initials: J
authors.lastname: Sun
authors.forename: Yujiang
authors.initials: Y
authors.lastname: Jia
authors.forename: Yiming
authors.initials: Y
authors.lastname: Shao
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Ruan
authors.forename: Yan
authors.initials: Y
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D058992:Social Participation / Q000523:psychology; D012959:Socioeconomic Factors