title: A syndemic including cigarette smoking and sexual risk behaviors among a sample of MSM in Shanghai, China.
abstract: OBJECTIVE
  We explored possible correlates of cigarette smoking and their associations with levels of smoking among a sample of Chinese men who have sex with men (MSM). We also explored the syndemic associations of substance use and psychosocial problems on sexual risk behaviors.
  
  
  METHODS
  Cross-sectional data collection from 404 MSM in Shanghai, China.
  
  
  RESULTS
  MSM exhibit a high prevalence of smoking (66.3%). Both light and heavy smoking were associated with alcohol and drug use, depression, intimate partner violence, sexual attitudes, and gay identity (though the associations for light smokers were moderate compared to those for heavy smokers).
  
  
  CONCLUSIONS
  Our findings indicate the presence of a health syndemic among MSM, and suggest that smoking prevention and cessation and other substance abuse interventions should be integrated into efforts preventing sexual risk behaviors among MSM.
authors.affiliation: Department of Behavioral Sciences & Health Education, Emory University's Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, GA 30322, United States.
authors.forename: F
authors.initials: F
authors.lastname: Yu
authors.forename: E J
authors.initials: EJ
authors.lastname: Nehl
authors.forename: T
authors.initials: T
authors.lastname: Zheng
authors.forename: N
authors.initials: N
authors.lastname: He
authors.forename: C J
authors.initials: CJ
authors.lastname: Berg
authors.forename: A F
authors.initials: AF
authors.lastname: Lemieux
authors.forename: L
authors.initials: L
authors.lastname: Lin
authors.forename: A
authors.initials: A
authors.lastname: Tran
authors.forename: P S
authors.initials: PS
authors.lastname: Sullivan
authors.forename: F Y
authors.initials: FY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D001290:Attitude; D002681:China / Q000453:epidemiology; D003863:Depression / Q000523:psychology; D017579:Domestic Violence; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D011477:Sex Work; D012747:Sexual Partners; D012907:Smoking / Q000453:epidemiology*; D012919:Social Behavior; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology*; D055815:Young Adult
keywords: Cessation; Chinese MSM; Health syndemics; Prevention; Smoking