The Impact of Homophobia and HIV Stigma on HIV Testing Uptake Among Chinese Men Who Have Sex With Men: a Mediation Analysis.

摘要: BACKGROUND: Gay and HIV-related stigma discrimination are major barriers to accessing HIV prevention services among Men Who Have Sex with (MSM) worldwide. We aimed identify modifiable factors that mediate the relationships between gay testing uptake Chinese MSM. METHODS: conducted a cross-sectional survey study of 523 HIV-uninfected or unknown status MSM in Jiangsu Province China November 2013 January 2014. Multivariable analyses were examine associations experienced homophobia recent testing. Causal mediation parametric assess whether depression social norms mediated hypothesized associations. RESULTS: Stronger subjective toward was associated higher odds (adjusted ratio [AOR]: 1.10 95% confidence interval [CI]: 1.01 1.21) whereas increasing levels both lower (AOR: 0.96 CI: 0.92 0.99; AOR: 0.91 0.84 0.99 respectively). There an indirect relationship (natural effect [NIE]) on (ORNIE: 0.93 0.98) (35.0%) through depression. Furthermore there 0.98 0.95 0.99) (19.2%) norms. CONCLUSIONS: Depression important mediators stigmatized Therefore addition advocacy efforts policies address social-level programs should also mental health issues incorporate community-based approaches changing