A Study On Multiple Sexual Partner Behaviors And Related Social And Psychological Factors Of Some Men Who Have Sex With Men In Shanghai

Objective:We aimed to obtain the psychosocial problems and multiple sexual partners(MSP)behaviour among men who have sex with men(MSM)in Shanghai,to apply syndemic theory to verify the association and reinforcing effects between psychosocial problems and MSP,to explore the psychosocial pathway of MSP,and to provide evidence on the development of targeted intervention strategy.Methods: A cross-sectional study was conducted among 547 MSM aged over 18 in Shanghai using snowball sampling techniques from January to June,2017.Content of questionnaire included social-demographic information,multiple sexual partners behavior,self-esteem,anxiety,depression,loneliness,sexual compulsivity,social support and involuntary subordination.Results: In the 6 months prior to the survey,54.3% of the MSM sample had had multiple sexual partners.The prevalence rate of low self-esteem was 6.6%,sexual compulsivity was 42.4%,anxiety was 12.2%,depression was 30.9%,loneliness was 24.2%,involuntary subordination was 25.0%,as well as low social support was 23.6% respectively.Univariate analysis showed that self-esteem,depression,loneliness,sexual compulsivity,and involuntary subordination were associated with multiple sexual partners.Sexual compulsivity(ORm = 2.94,95% CI = 1.76-4.91)and involuntary subordination(ORm = 1.79,95% CI = 1.14-2.81)remained significant in multivariate analysis.MSM with five or more psychosocial problems had greater odds of(AOR = 3.06,95% CI = 1.49-6.25)having multiple sexual partners in the previous 6 months than the non-syndemic group.Psychosocial pathway model of MSP presented good fitting results.Self-esteem,mood state and involuntary subordination have indirect effects on the number of sexual partners of MSM,while sexual compulsivity have a direct effect of 0.249(95% CI = 0.171-0.320).Conclusion: Psychosocial problems are common among MSM.Our findings provide preliminary confirmation of the additive relationship of syndemic psychosocial health conditions and multiple sexual partners among MSM in Shanghai.Sexual compulsivity is an important factor affecting MSP.An integrated intervention from the perspective of psychosocial factors with special focus on sexual compulsivity is needed.