title: Associations between recent gay-related stressful events, emotional distress, social support and unprotected anal intercourse behavior among Chinese men who have sex with men.
abstract: BACKGROUND
  This study was designed to assess the levels of and associations between gay-related stressful events, social support, emotional distress and the number of unprotected anal intercourse partners among Chinese men who have sex with men.
  
  
  METHODS
  Using a respondent-driven sampling method, 807 men who have sex with men were recruited in urban areas of northeast China and data were collected via face-to-face interviews. Gay-related stressful events were measured using the Gay-Related Stressful Life Events Scale; levels of depression, anxiety symptoms and social support were measured using the Self-Rating Depression Scale, the Self-Rating Anxiety Scale and the Social Support Rating Scale, respectively.
  
  
  RESULTS
  Over a quarter of study participants experienced gay-related stressful events during the preceding 3 months. Their average Self-Rating Depression Scale, Self-Rating Anxiety Scale and Social Support scores differed significantly from the national norm. Gay-related stressful events significantly correlated with anxiety (r = 0.167, p < 0.001), depression (r = 0.165, p < 0.001), social support (r = -0.107, p = 0.002) and number of unprotected anal intercourse partners (r = 0.13, p < 0.001), showing a clear dose-response relationship.
  
  
  CONCLUSIONS
  Gay-related stressful events are common and are significantly associated with emotional distress, lack of social support and high-risk sexual behaviors among Chinese men who have sex with men. Multifaceted approaches are warranted to increase social support and reduce intolerance toward homosexual behaviors and to reduce risky sexual behaviors related to the rapid HIV epidemic among men who have sex with men population in China.
authors.affiliation: Department of Psychiatry, Liaoning Provincial Cancer Hospital, Shenyang, P.R. China.
authors.forename: Liu
authors.initials: L
authors.lastname: Yunyong
authors.affiliation: Department of Psychiatry, China Medical University, Shenyang, P.R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Zhe
authors.affiliation: Department of Psychiatry, Dalian Mental Health Center, Dalian, P.R. China.
authors.forename: Xu
authors.initials: X
authors.lastname: Junting
authors.affiliation: Department of AIDS, Dandong Municipal Center for Disease Control and Prevention, Dandong, P.R. China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of Chronic Disease, Benxi Municipal Center for Disease Control and Prevention, Benxi, P.R. China.
authors.forename: An
authors.initials: A
authors.lastname: Xiaoxia
authors.affiliation: Department of AIDS, Anshan Municipal Center for Disease Control and Prevention, Anshan, P.R. China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of AIDS, Shenyang Municipal Center for Disease Control and Prevention, Shenyang, P.R. China.
authors.forename: Gu
authors.initials: G
authors.lastname: Yuan
authors.affiliation: Department of Psychiatry, Dalian Medical University, Dalian, P.R. China jiangchaowst@hotmail.com panpgw@163.com.
authors.forename: Jiang
authors.initials: J
authors.lastname: Chao
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety; D044466:Asian People; D002681:China; D003863:Depression; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological; D055815:Young Adult
keywords: Men who have sex with men; anxiety; depression; gay-related stressful events; unprotected anal intercourse behavior