Association Between Mental Disorders And High Risk Sexual Behaviors Among Men Who Have Sex With Men In Urban Area Of Liaoning Province

Objective: Describe the levels and characteristics of mental disorders and high risk sexual behaviors (HRSB), and assess their associations by interviewing 807 men who have sex with men (MSM) aged 18-70 in 4 cities of Liaoning province, to introduce a synthetic intervention mode and reduce the HIV/AIDI transition among MSM.Methods: 807 MSM sampled from Shenyang, Anshan, Dandong and Benxi were investigated during May 1– July 31 of 2008, the criteria of inclusion were: (1) Aged 18-70; (2) men who have oral or anal sex with men in the past 12 months, including gay, Male sex works, and male bisexual, male heterosexual; (3) Local residents. Respondent driven sampling method (RDS) was used in sampling the subjects, 5-10 key informants were selected as the seeds in each city, 3 partners were recruited to join the investigation by each seed, and another 3 partners were recruited again for each investigated MSM to drive the chain of MSM develop step by step. They were face to face interviewed with Composite International Diagnostic Interview (CIDI-1.0) to make DSMⅢ-R and ICD-10 diagnoses, other questionnaire on the knowledge, attitude, behavior and practice of HIV/AIDS (KABP), high risk sexual behavior, homosexual related stimulating events, social support, homosexual related social influence were also investigated simultaneously.Results: Balance test result shows good representation of the sample selected with RDS method. The lifetime prevalence of any mental disorders, anxiety disorder, mood disorder, alcohol disorder and drug disorders were 35.2%,21.2%,20.7%,11.4% and.4% respectively, which were 3.1, 3.4, 4.7 and 3.1 times the levels of male urban citizen. The incidence of HRSB was 71%, significantly and positively related to all the mental disorders, and shows D-R relationship with the numbers of comorbidity; Correct KAPBP was protective factor of HRSB (OR=0.52 , 95%CI=0.34-0.81. Multiple analyses show that homosexuality, high income level, homosexuality related stimulating events, mood and alcohol disorder are significant risk factors of HRSB. The incidence of HRSB were lowest for the subgroup with correct KAPBP, free condom supply and without any mental disorder; the highest for the subgroup without correct KAPBP, without condom supply and with any mental disorder.Conclusions: RDS sampling method is applicable in the hidden population, such as Chinese MSMs. The prevalence of mental disorders among MSMs is 3.1 times of urban citizen, mood disorder and alcohol disorder are significant risk factors of HRSB of MSM by screening or distorted the intervention effort. Establish a synthesized mode consisting of behavior intervention, mental and psychiatric screening and treatment, and improvement of general social environment for MSMs, will effectively improve the results HRSB intervention..