title: Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study.
abstract: BACKGROUND
  Recreational drug use has increased considerably among Chinese men who have sex with men (MSM). The phenomenon has the potentially to increase HIV transmission among Chinese MSM. The aims of this study were: 1) to investigate the prevalence of recreational drug use among Chinese MSM, and 2) to explore the correlation between gay smartphone based sex-seeking applications (gay apps), HIV/STIs testing, group sex, commercial sex, sexual roles and poppers use among Chinese MSM.
  
  
  METHODS
  MSM who were born biologically male, were at least 16 years of age and had engaged in anal sex with a man at least once were recruited through a nation-wide online survey in 2014. Information regarding socio-demographics, risk behaviors, recreational drug use, HIV and other STIs testing history and gay app use were collected. Univariate and multivariate analysis were used to determine factors associated with recreational drug use among Chinese MSM.
  
  
  RESULTS
  Among 1424 participating MSM, 1100 (77.3%) reported ever using recreational drugs in their lifetime. In the last 12 months, 303 (21.3%) used poppers, 34 (2.4%) used crystal meth and 15 (1.0%) used ecstasy. The mean age of respondents was 25.6±6.8 years, 72.9% identified as gay, 41.3% were students, and 83.8% had never been married. Multiple logistic regression models revealed that compared with non-popper users, popper users were more likely to have been tested for HIV (adjusted OR (aOR) = 1.50, 95% CI: 1.15-1.96) and other STIs (aOR = 1.65, 95% CI: 1.26-2.17). In addition, popper users were more likely to engage in group sex (aOR = 2.63, 95% CI:1.80-3.86), commercial sex (aOR = 1.86, 95% CI:1.13-3.06) and used gay mobile apps to seek sexual partners (aOR = 2.10, 95% CI:1.58-2.80).
  
  
  CONCLUSIONS
  Chinese MSM has a high rate of recreational drug use, including poppers. Public health programs serving MSM may consider integrating intervention programs to decrease recreational drug use related harms.
authors.affiliation: Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
authors.forename: Peizhen
authors.initials: P
authors.lastname: Zhao
authors.affiliation: University of North Carolina at Chapel Hill Project-China, Guangzhou, China.|SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.|Kunming Medical University, Kunming, China.
authors.forename: Songyuan
authors.initials: S
authors.lastname: Tang
authors.affiliation: Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.affiliation: Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.|University of North Carolina at Chapel Hill Project-China, Guangzhou, China.|SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, United States of America.
authors.forename: John
authors.initials: J
authors.lastname: Best
authors.affiliation: University of North Carolina at Chapel Hill Project-China, Guangzhou, China.|SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.
authors.forename: Thitikarn May
authors.initials: TM
authors.lastname: Tangthanasup
authors.affiliation: Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
authors.forename: Shujie
authors.initials: S
authors.lastname: Huang
authors.affiliation: Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, United States of America.
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
authors.affiliation: University of North Carolina at Chapel Hill Project-China, Guangzhou, China.|SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.|School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, United States of America.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
authors.affiliation: Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.|University of North Carolina at Chapel Hill Project-China, Guangzhou, China.|SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.|School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, United States of America.
authors.forename: Weiming
authors.initials: W
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D063106:Transgender Persons; D055815:Young Adult