title: Religion and HIV Sexual Risk Among Men Who Have Sex With Men in China.
abstract: BACKGROUND
  Religion can profoundly impact the sociocultural contexts that shape sexual HIV vulnerability among men who have sex with men (MSM). However, the relationship between religion and HIV vulnerability remains poorly understood for MSM in China, where religious affiliations and practices are rapidly increasing.
  
  
  METHODS
  Using cross-sectional survey data collected in Beijing and Tianjin, China, from 2013 to 2014 (n = 400), this study tests 3 hypotheses regarding religion and HIV sexual risk: (1) HIV vulnerabilities and testing patterns among religiously affiliated MSM are lower than for areligious MSM, (2) religiosity is inversely associated with HIV vulnerabilities and testing, and (3) the magnitude of inverse association between religiosity and HIV vulnerabilities/testing will be stronger among Christian and Muslim MSM than Buddhist and areligious MSM.
  
  
  RESULTS
  Compared with areligious participants, Buddhists had higher odds of reporting unprotected anal intercourse [adjusted odds ratio (AOR): 2.06, 95% confidence interval (CI): 1.13 to 3.75] and more male sex partners (AOR: 1.95, 1.16-3.27), whereas Muslims had lower odds of reporting unprotected anal intercourse (AOR: 0.33, 95% CI: 0.15 to 0.73) and higher odds of reporting male circumcision (AOR: 3.04, 95% CI: 1.45 to 6.40). Reporting of forced sex was associated with more frequent participation in social religious activities (AOR: 1.25, 95% CI: 1.02 to 1.52) and private religious activities (AOR: 1.30, 95% CI: 1.04 to 1.61). Among Christians, participation in private religious activities was associated with lower odds of reporting anal intercourse (AOR: 0.49, 95% CI: 0.27 to 0.88).
  
  
  CONCLUSIONS
  The sustained growth of multiple religious traditions in China appears to have important implications for HIV vulnerability among religious minority MSM.
authors.affiliation: *School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; †Liu Institute for Global Issues, Vancouver, British Columbia, Canada; ‡Currently, College of Indigenous Studies, National Dong Hwa University, Hualien, Taiwan; §Chaoyang Centers for Disease Control and Prevention, Beijing, China; ‖Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada; and ¶Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Pan
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Dongliang
authors.initials: D
authors.lastname: Li
authors.forename: Richard M
authors.initials: RM
authors.lastname: Carpiano
authors.forename: Martin T
authors.initials: MT
authors.lastname: Schechter
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Ruan
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Spittal
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011902:Rape; D012067:Religion; D012307:Risk Factors; D047568:Unsafe Sex