Psychosocial characteristics and HIV-related sexual behaviors among cisgender, transgender, and gender non-conforming MSM in China.

BACKGROUND: While a growing number of studies focus on men who have sex with men (MSM), they typically ignore the heterogeneity of gender minorities within the MSM population. The recognition of new sub-groups among gender minorities (i.e., transgender and gender non-conforming), who also identify as MSM, play a considerable role in new HIV infections in China. Information on the psychosocial factors and HIV-related sexual behaviors require further consideration to understand the prevalence of HIV infection among MSM within these gender minority sub-groups. METHODS: From September 2017 to January 2018, MSM without HIV were recruited in Wuhan, Nanchang, and Changsha cities in China. Participants were asked to fill out a structured self-administered questionnaire to assess depression, perceived social support, resilience, identity concealment, and HIV-related risky sexual behaviors. RESULTS: A total of 715 MSM completed the structured questionnaire, the number of MSM identifying as gender minorities were 63 and accounted for 8.8% of the population. Compared to the cisgender MSM population, transgender MSM were more likely to have a one-night stand/occasional partner (AOR = 3.49, 95% CI =1.02-11.98), to have sex after drug use in the past 6 months (AOR = 2.57, 95%CI =1.05-6.29), and to have reported a significantly lower likelihood of identity concealment (mean difference = - 3.30, 95%CI = -5.86, - 0.74, P = 0.01). CONCLUSIONS: The findings highlight the significance of providing targeted interventions for different gender minorities within the MSM population. Research is required to further understand the relationship between gender identity, mental health, and HIV-related sexual behaviors.

Minority stress, depression, and cigarette smoking among Chinese gay versus bisexual men: a two-group structural equation model analyses.

BACKGROUND: Literature in the West suggested that bisexual men have a higher smoking rate compared to gay men. Data on patterns of smoking among gay and bisexual men are limited in Eastern Asian countries like China. This study examined the cigarette smoking prevalence for gay versus bisexual men in China and their unique minority stress - smoking pathways. METHODS: Between September 2017 and November 2018, we surveyed a convenience sample of 538 gay men and 138 bisexual men recruited from local sexual minority organizations in four metropolitan cities in China (i.e., Beijing, Wuhan, Nanchang, and Changsha). Measures included sexual orientation, sociodemographics, theory-based minority stressors, depressive symptoms, and past 30-day cigarette smoking. Two-group (gay men vs. bisexual men) structural equation modeling (SEM) was used to test possible distinct mechanisms between theory-based stressors, depressive symptoms, and cigarette smoking among gay men and bisexual men, respectively. RESULTS: The mean age of participants was 26.51 (SD = 8.41) years old and 76.3% of them had at least a college degree. Bisexual men reported a higher rate of cigarette smoking compared to gay men (39.9% vs. 27.3%). Two-group SEM indicated that the pathways for cigarette smoking were not different between gay and bisexual men. Higher rejection anticipation was associated with greater depressive symptoms (standardized ß = 0.32, p < .001), and depressive symptoms were not associated with cigarette smoking. CONCLUSIONS: Minority stress, specifically rejection anticipation, may be critical considerations in addressing depressive symptoms, but not smoking, among both gay and bisexual men in China.

Spectrum of SLC20A2, PDGFRB, PDGFB, and XPR1 mutations in a large cohort of patients with primary familial brain calcification.

Primary familial brain calcification (PFBC) is a rare neurodegenerative disorder with four causative genes (SLC20A2, PDGFRB, PDGFB, and XPR1) that have been identified. Here, we aim to describe the mutational spectrum of four causative genes in a series of 226 unrelated Chinese PFBC patients. Mutations in four causative genes were detected in 16.8% (38/226) of PFBC patients. SLC20A2 mutations accounted for 14.2% (32/226) of all patients. Mutations in the other three genes were relatively rare, accounting for 0.9% (2/226) of all patients, respectively. Clinically, 44.8% of genetically confirmed patients (probands and relatives) were considered symptomatic. The most frequent symptoms were chronic headache, followed by movement disorders and vertigo. Moreover, the total calcification score was significantly higher in the symptomatic group compared to the asymptomatic group. Functionally, we observed impaired phosphate transport induced by seven novel missense mutations in SLC20A2 and two novel mutations in XPR1. The mutation p.D164Y in XPR1 might result in low protein expression through an enhanced proteasome pathway. In conclusion, our study further confirms that mutations in SLC20A2 are the major cause of PFBC and provides additional evidence for the crucial roles of phosphate transport impairment in the pathogenies of PFBC.

Association of Adverse Childhood Experience and Attention Deficit Hyperactivity Disorder with depressive symptoms among men who have sex with men in China: moderated mediation effect of resilience.

BACKGROUND: Adverse childhood experience (ACE), attention deficit hyperactivity disorder (ADHD), and resilience can all contribute to depressive symptoms. However, little is known regarding the complex relationships between these factors and their joint effects on depressive symptoms. This study aimed to explore the underlying mechanism of ACE, ADHD, and resilience on depressive symptoms among men have sex with men (MSM) in China. METHODS: A total of 714 MSM were recruited from gay/bisexual men-serving venues in Wuhan, Changsha, and Nanchang of China. The data was collected using computer-assisted self-interview. The mediated and moderated mediation models were employed to explore the underlying mechanisms between ACE, ADHD, resilience, and depressive symptoms. RESULTS: Among 714 MSM, 51.4% reported at least one ACE and 13.0% reported three or more. ACE had a direct (ß = 1.01, 95% CI: 0.45-1.57) effect on depressive symptoms. ADHD partially mediated the correlation between ACE and depressive symptoms (indirect effect: 0.55; 95% CI: 0.34-0.79). Additionally, the effect of ACE on depressive symptoms was moderated and buffered by resilience (ß = -0.09, 95% CI: -0.15 - -0.03). CONCLUSION: The findings suggested that, programs and policies that promote resilience and address ADHD might protect Chinese MSM exposed to ACE from depressive symptoms.

Prevalence of condom use and associated factors among Chinese female undergraduate students in Wuhan, China.

With the increasing prevalence of premarital sex among college students in China, our aim was to examine prevalence and determinants of condom use among sexually active female undergraduates at 16 university campuses in Wuhan. Questionnaires were distributed to 5076 unmarried female undergraduates, recruited using randomized cluster sampling by type of university and student major and grade, and anonymously completed questionnaires were received from 4769 (94% of enrollees). The complex samples logistic regression was used to examine factors associated with condom use, yielding odds ratios and 95% confidence intervals. Of 4769 female students, 863 (18.1%) reported ever having sexual intercourse. Of these, 19.8% used a condom in their first sexual encounter, and these students were more likely to age 20 or older at first intercourse, and less likely to live in countryside during middle school period, and majoring in the arts. Fully 30% of those having intercourse reported never or seldom or sometimes using condoms in the past 12 months. Students using condoms consistently in the past 12 months were more likely majoring in science and technology, to believe that condoms are the safest way to prevent STD and unwanted pregnancy, and to have used a condom at first intercourse; they were less likely to live in countryside during middle school period, and to report multiple sexual partners since initiating sexual behavior. These results suggested that a larger subset of Chinese female undergraduates is engaged in unprotected, premarital sex, and interventions provided for them should stress the importance of delaying sexual initiation, using condoms from the very first sexual encounter, and consistently using condoms after initiating sex.

Female undergraduate fine arts students: a high-risk population for multiple sexual partners, unwanted pregnancy and sexually transmitted infections in China.

OBJECTIVES: To compare risky sexual behaviour and risk factors associated with unwanted pregnancy and sexually transmitted infections (STIs) among female fine arts undergraduates and students of other disciplines in China. METHOD: Anonymously completed questionnaires were received from 4769 unmarried female undergraduates, recruited using randomised cluster sampling. Multiple regression analyses were used to examine factors associated with lifetime number of sex partners, self-reported pregnancy, and STIs. RESULTS: The proportion of students who had ever had sex was higher among female fine arts majors (35%) than among other females (15%). Not using a condom at first sex (87%), multiple lifetime partners (44%), and extramarital lover now or ever in lifetime (9%) were more common in sexually experienced fine arts students. Self-reported pregnancy (23%) and STIs (33%) were also more common in fine arts students. Years spent in school, understanding or approval of multiple sex partners, younger age at first sex and coercive first sex were associated with multiple lifetime partners, which was a risk factor for both unintended pregnancy and STIs. CONCLUSIONS: Female fine arts students hold more tolerant attitudes toward sex than other female students. They were more inclined to risky sexual behaviours, and thus more vulnerable to unwanted pregnancy and STIs.

Associations of gestational and the first year of life exposure to ambient air pollution with childhood eczema in Hubei, China.

Whether exposure to air pollution is associated with the increased incidence of childhood eczema is controversial. Only a few previous researches about the relationship between gestational and early-life exposures to ambient air pollutants and childhood eczema were conducted in China, and there is a lack of studies in Hubei province. This study aimed to explore the associations between air pollution exposure in gestation and the first year of life and childhood eczema. From November to December 2017, a total of 3383 children aged 3-6 years were recruited from 12 kindergartens in Hubei, China; 3167 were included in the final analysis. Parent-reported data involved with childhood eczema was inquired by questionnaire, and the concentrations of NO2, PM2.5, and PM10 were acquired from air quality monitoring stations which were the nearest to the twelve kindergartens. A binary logistic regression model was used to evaluate the associations of period-mean concentrations of individual pollutant exposure with childhood eczema. Of the 3167 children, 848 (26.8%) had a history of doctor-diagnosed eczema. After adjusting for the covariates, high levels of NO2, PM2.5, and PM10 exposures were significantly associated with a positive increase in risk of childhood eczema during the gestational period and the first year of life. In the gestational period, the estimate OR in the 3rd and 4th quartiles of NO2 was 1.256 and 1.496, respectively. During the first year of life, the estimate OR in the 3rd and 4th quartiles of NO2 was 1.371 and 1.335, respectively. Our study indicated that the gestational period and the first year of life exposures to high levels of ambient NO2, PM2.5, and PM10 were significantly associated with increased eczema among preschool children. Some effective measures of prevention and intervention could be developed for preschool children.

Epidemiology, Seasonality and Treatment of Hospitalized Adults and Adolescents with Influenza in Jingzhou, China, 2010-2012.

BACKGROUND: After the 2009 influenza A (H1N1) pandemic, we conducted hospital-based severe acute respiratory infection (SARI) surveillance in one central Chinese city to assess disease burden attributable to influenza among adults and adolescents. METHODS: We defined an adult SARI case as a hospitalized patient aged ≥ 15 years with temperature ≥38.0°C and at least one of the following: cough, sore throat, tachypnea, difficulty breathing, abnormal breath sounds on auscultation, sputum production, hemoptysis, chest pain, or chest radiograph consistent with pneumonia. For each enrolled SARI case-patient, we completed a standardized case report form, and collected a nasopharyngeal swab within 24 hours of admission. Specimens were tested for influenza viruses by real-time reverse transcription polymerase chain reaction (rRT-PCR). We analyzed data from adult SARI cases in four hospitals in Jingzhou, China from April 2010 to April 2012. RESULTS: Of 1,790 adult SARI patients enrolled, 40% were aged ≥ 65 years old. The median duration of hospitalization was 9 days. Nearly all were prescribed antibiotics during their hospitalization, less than 1% were prescribed oseltamivir, and 28% were prescribed corticosteroids. Only 0.1% reported receiving influenza vaccination in the past year. Of 1,704 samples tested, 16% were positive for influenza. Influenza activity in all age groups showed winter-spring and summer peaks. Influenza-positive patients had a longer duration from illness onset to hospitalization and a shorter duration from hospital admission to discharge or death compared to influenza negative SARI patients. CONCLUSIONS: There is substantial burden of influenza-associated SARI hospitalizations in Jingzhou, China, especially among older adults. More effective promotion of annual seasonal influenza vaccination and timely oseltamivir treatment among high risk groups may improve influenza prevention and control in China.

[Study on the unintended pregnancy among married women of child-bearing age living in Qingshan district, Wuhan].

OBJECTIVE: To investigate the prevalence of unintended pregnancy (UP) and exploring the risk factors of UP for married women of child-bearing age from Qingshan district, Wuhan. METHODS: A cross-sectional study was adopted in this study. Cluster sampling method was used with 3256 women recruited, in 2010. Information on history and risks related to social-demographic factors of UP were collected, using a self-administered questionnaire. RESULTS: Of the 3256 participants, over half of them (53.8%) reorted ever having had the history of UP and 9.1% reported UP in the past year. Rate of UP in the past year for different age cohorts (18-30, 31-40, 41-49 years) were 31.8%, 10.5% and 1.8% respectively. The most frequently reported reason for UP across all the age cohorts was "Did not use any contraceptive methods", with proportions on the reason that reported by women at 18-30, 31-40 and 41-49 year-olds, were 69.7%, 51.1% and 42.4% respectively. The second frequently reported reasons for UP were "Failure of traditional contraception" for younger cohort (18-30 years: 13.0%) and "IUD dropped or pregnancy with IUD" for older-age cohorts (23.4% at 31-40 year-olds and 37.0% at the 41-49 year-olds). The most frequently cited reason for "Did not use any contraceptive methods" was "Believe we were lucky so far, not to get pregnant" (59.6%). The risk factors of UP were being at older age, experiencing sex debut at younger age and got married at younger age. CONCLUSION: The prevalence of lifetime UP history was high among women at child-bearing age from Qingshan district, Wuhan. Reproductive health services and interventions should be taken according to the needs from different age cohorts of women. Younger cohort of women should receive more attention.