Sociocultural Perceptions and Enablers to Seeking Mental Health Support Among Bhutanese Refugees in Western Massachusetts.

This qualitative study aimed to identify cultural influences on seeking mental health support among Bhutanese refugees resettled in Western Massachusetts. Bhutanese refugees aged 18 years or older were recruited for eight focus group discussions, organized by age and gender ( N = 67, 49.3% female, mean age = 38, SD = 15.9). The PEN-3 cultural model was used as the theoretical framework to examine the roles of cultural perceptions that influence mental health-seeking behaviors. Focus group discussions were audio taped to facilitate the thematic-analysis. Younger participants (<35 years) reported experiencing stressors relating to economic hardships and difficulties in developing academic and social skills as they juggle breadwinner and care-giving responsibilities for their families. Older participants reported frustration with the difficulties in learning English and increased dependence on their children. Family members provided the initial frontline support to persons with mental health problems. If family support did not work, they consulted with their relatives and trustworthy community members for further assistance. Psychological factors such as fears of emotions, social norms, beliefs, and self-esteem associated with cultural norms and values influenced seeking mental health support. All participants expressed the need to have a culturally tailored intervention to develop acquired skills to improve their self-esteem and self-efficacy in order to integrate into their new social and cultural environment. Because family members make important decisions about seeking mental health support, involving family members in developing and delivering culturally appropriate skill development interventions could be a potential strategy to reduce their stress and increase resilience in this refugee community.

Associations between psychological characteristics and indicators of metabolic syndrome among Chinese adults.

Current knowledge about the relationship between psychological characteristics and metabolic syndrome (MetS) components is limited in Asian populations. The purpose of this study is to investigate linkages between physiological markers of MetS and life satisfaction, hostility, and depression in Chinese adults. Secondary analyses were conducted using cross-sectional data from parents of randomly selected middle school students participating in a pilot study in Qingdao, China. Among 440 parents who consented to participate (237 women, 203 men), 368 provided valid responses in all three categories of psychological characteristics, and only those subjects were included in these analyses. General linear models and logistic regressions were run separately by gender, controlling for covariates. Among women, life satisfaction was inversely associated with triglyceride levels (p = .04), LDL-C (p < .01), risk of hypertriglyceridemia (OR[.53], p < .01), HDL-C (OR[.78], p = .03), and MetS (OR[.52], p = .03). No associations were found between life satisfaction and any psychological characteristics among men. Among women, hostility was positively associated with triglyceride level (p = .04) and risk of hypertriglyceridemia (OR[2.12], p < .05). Among men, hostility was positively associated with waist circumference (p = .04), waist-hip ratio (p < .05), and fasting plasma insulin (p < .01). Depression was not associated with any physiological measurement in either gender. These findings indicate that relationships exist between certain psychological characteristics and physiological indicators of MetS among Chinese adults, although there may be important differences between genders.

C-reactive protein and depression in persons with Human Immunodeficiency Virus infection: the Positive Living with HIV (POLH) Study.

BACKGROUND: Human Immunodeficiency Virus (HIV) infection has been frequently associated with chronic inflammation as well as depression. C-reactive protein (CRP) is positively associated with depression in people without HIV infection. We tested the hypothesis of an independent relationship between CRP and depression in a cohort of HIV-positive people. METHODS: A cross-sectional survey was conducted among 316 HIV-positive people (181 men and 135 women) aged 18-60years residing in the Kathmandu Valley, Nepal. The latex agglutination turbidimetric method was used to measure serum CRP concentrations and the Beck Depression Inventory (BDI)-I method was used to measure depression, with a cut off of ⩾20 indicating likely depression. The relationship between CRP concentrations and depression symptoms was assessed using both multiple linear regression analysis and multiple logistic regression analysis, with adjustment for potential socio-demographic, cardiovascular, life-style, and HIV-related clinical and treatment confounding factors. RESULTS: Twenty-six percent participants (men: 23%; women: 29%) met criteria for depression. In multiple regression analysis, the authors observed a linear relation between serum CRP concentrations and BDI score (beta for 1 unit change in ln(CRP)=1.13, p=0.001) in HIV-positive participants. In a logistic regression analysis, participants with serum CRP levels>3mg/L had a 2.3-fold higher odds of depression symptoms compared to those with serum CRP level⩽3mg/L (p=0.005). In analyses stratified by sex, associations were stronger in men than in women. For example, CRP>3mg/L was associated with a 3.6-fold higher odds of depression in men (p=0.002), while in women the odds ratio was 1.7 (p=0.33). CONCLUSION: We found a linear relationship between serum CRP concentrations and depression symptoms score in HIV-positive people, and evidence that risk of depression is elevated among HIV-positive men with a high level of inflammation (CRP>3mg/L). Further prospective study to confirm the role of inflammation in depression among HIV-positive people is warranted.

Use of a community-based participatory research approach to assess knowledge, attitudes, and beliefs on biospecimen research among Pacific Islanders.

Objectives. The purpose of this article is to describe a community-based participatory research pilot project conducted to investigate the knowledge, attitudes, and beliefs that Pacific Islanders (PIs) hold toward biospecimen collection, use, and banking, all of which will help drive higher PI participation rates in both medical and behavioral research studies. Method. Academic and community partners worked side by side to develop a conceptual model, study measures, and study protocols. PI community partners screened, recruited, and conducted data collection, which consisted of a paper-and-pencil survey and a 1-hour semistructured interview administered by trained community workers. Results. A total of 60 PI adults representing various PI ethnic groups completed the surveys and interviews. Results showed a general support for biospecimen studies that would benefit the community, and many are willing to provide their biospecimen samples if asked. Conclusion. Due to the established level of trust, community partners were able to successfully recruit and collect data for the study. Many of those interviewed also called for more outreach and education about the importance of biospecimen research in their communities.

Tobacco smoking, quitting, and relapsing among adult males in Mainland China: the China Seven Cities Study.

INTRODUCTION: Despite an estimated 1 million tobacco-related deaths annually in China, public health officials face overwhelming barriers to implementing effective tobacco control policies and programs. Models of effective tobacco control can be adapted for Chinese tobacco use and culture based on reliable and valid data regarding predictors of smoking and abstaining. METHODS: As part of the China Seven Cities Study to assess the role of rapid social, economic, and cultural change on tobacco use and related health practices and outcomes, 4,072 adult male smokers provided data in 3 annual waves. Measures included current smoking, nicotine dependence, readiness for quitting, perceived stress, hostility, depressive symptoms, as well as covariates (e.g., age, marital status, educational attainment, and family income). RESULTS: Odds of being abstinent at Wave 3 were increased by: lower nicotine dependence at Wave 1 and becoming less dependent between Waves 1 and 3; progressing beyond the contemplation stage between Waves 1 and 3; perceiving less stress, whether initially at Wave 1 or over time from Wave 1 to Wave 3; and lower hostility scores at Wave 1 and decreased hostility from Wave 1 to Wave 3. Among those who quit, odds of remaining abstinent rather than relapsing by Wave 3 were higher among those who were less dependent at Wave 1 and who became less dependent from Wave 1 to Wave 3; and those who showed decreases in hostility from Wave 1 to Wave 3. CONCLUSIONS: The public health challenge posed by very high prevalence of male smoking in China can be met by policies and programs that lead to successful long-term cessation. This can only be done successfully by designing interventions based on knowledge of the country's smokers and the current study suggests several elements.

Exposure to violence in relation to depressive symptoms among male and female adolescent students in Cambodia.

PURPOSE: In spite of the apparent increases in family and community violence, research into its effects on adolescent mental health has received limited attention in Cambodia. This study examines the association between exposure to violence and depressive symptoms among adolescents controlling for the effects of several factors in family and school domains. METHODS: We randomly selected 993 male and 950 female students proportionally from 11 junior high schools and high schools in Battembang provincial city. Students were questioned about the violence to which they were subjected and which they witnessed in their family and community. The Asian adolescent depression scale was used to measure depressive symptoms. RESULTS: In this study, 27.9% of male students and 21.5% of female students had been victimized in at least one case of family violence, while 18.0% of male and 5.8% of female students had been victimized in at least one case of community violence. After adjustment, increased levels of depressive symptoms were significantly associated with being the victim of or witnessing family or community violence among both male and female students. However, the positive association between the levels of depressive symptoms and being a witness to community violence was found only in female students. CONCLUSIONS: Efforts to prevent depression in adolescent students should focus on reducing family and community violence; such efforts should also consider gender differences.

Association Between Stress and Social Support Among Young Adult Pacific Islander Smokers.

Recent studies have found high levels of stress among Americans, particularly amongst young adults and ethnic minority groups. The purpose of this secondary data analysis was to explore the association between stress and social support among a sample of 276 young adult smokers of Pacific Islander ancestry, specifically Samoans and Tongans with an average age of 25.3 years. Previous research had documented the protective role of social support on stress, and thus it is hypothesized that young adult Pacific Islander smokers who perceived higher levels of social support will have less perceived stress. Social support was assessed using a 12-item scale which measured participant's perceived social support from family, friends, and significant others. Perceived stress was measured using a 10-item scale with 2 subscales - self efficacy and helplessness. Standardized parameter estimates from structural equation modeling indicated a statistically significant inverse relationship between perceived social support from family and perceived stress related to helplessness. More specifically, young adult Samoans and Tongans who report higher levels of social support from family do not feel as much stress stemming from being helpless. The results highlight the importance of family social support on stress management among this population. Most importantly, these findings add to the limited research around mental health within Pacific Islander (Samoan and Tongan) communities in the US.

Parent-Child Engagement in Decision Making and the Development of Adolescent Affective Decision Capacity and Binge Drinking.

The goal of this study was to investigate how parents' engagement of their child in everyday decision-making influenced their adolescent's development on two neuropsychological functions, namely, affective decision-making and working memory, and its effect on adolescent binge-drinking behavior.We conducted a longitudinal study of 192 Chinese adolescents. In 10(th) grade, the adolescents were tested for their affective decision-making ability using the Iowa Gambling Task (IGT) and working memory capacity using the Self-ordered Pointing Test (SOPT). Questionnaires were used to assess perceived parent-child engagement in decision-making, academic performance and drinking behavior. At one-year follow-up, the same neuropsychological tasks and questionnaires were repeated.Results indicate that working memory and academic performance were uninfluenced by parent-child engagement in decision-making. However, compared to adolescents whose parents made solitary decisions for them, adolescents engaged in everyday decision-making showed significant improvement on affective decision capacity and significantly less binge-drinking one year later.These findings suggest that parental engagement of children in everyday decision-making might foster the development of neurocognitive functioning relative to affective decision-making and reduce adolescent substance use behaviors.

Environmental tobacco use and indicators of metabolic syndrome in Chinese adults.

INTRODUCTION: Exposure to environmental tobacco smoke (ETS) is a widespread source of nicotine exposure, and an estimated 540 million Chinese are exposed to ETS in mainland China. We aimed to investigate associations of ETS exposure and metabolic syndrome (MetS) as well as its individual components independent of active smoking status in Chinese adults. METHODS: A cross-sectional data of 304 randomly selected Chinese households with fourth (elementary school) and seventh (middle school) graders in Qingdao city was used. Assessments of fat mass, metabolic biomarkers, personal history of illness, and health behaviors were conducted. RESULTS: Proportions of current smokers were 3% in women and 60.5% in men, and more men reported exposure to ETS 5-7 days per week than women (60.8% vs. 48.1%). Exposure to ETS was significantly associated with enhanced risks of MetS (odds ratio [OR] = 2.8, p = .01), hypertriglyceridemia (OR = 2.1, p = .02), and central obesity (OR = 2.7, p < .001) and reduced levels of high-density lipoprotein cholesterol (OR = 1.9, p = .02) and elevated mean levels of fasting insulin (p < .01). These observed associations were independent of active smoking status and were successfully replicated in female never-smokers. CONCLUSIONS: Results of our study support the hypothesis that ETS exposure is independently associated with MetS and its individual components. Further large-scale studies with longitudinal design and objective assessment of ETS exposure are needed to elucidate the underlying mechanisms and the causal effects of passive smoking on MetS. Findings of this work emphasize the importance of developing community intervention to reduce smoking, ETS, and promote healthy lifestyle.

Role of risk and protective factors in risky sexual behavior among high school students in Cambodia.

BACKGROUND: In many developing countries, adolescents have become increasingly prone to engage in habitual risky sexual behavior such as early sexual initiation and unprotected sex. The objective of this study was to identify the operation of risk and protective factors in individual, family, peer, school, and community domains in predicting risky sexual behavior among male and female adolescents in Cambodia. METHODS: From October 2007 to January 2008, we collected data from 1,049 students aged 14 to 20 years. Risky sexual behavior was measured using a scale consisting of four items: sexual intercourse during the past three months, number of sex partners during the past three months, age at first experience of sexual intercourse, and use of condom in last sexual intercourse. The risk factors examined included substance use, depression, peer delinquency, family violence, and community violence. Studied protective factors included family support function, frequency of family dinner, and school attachment. RESULTS: Of the 1,049 students surveyed, 12.7% reported sexual intercourse during the past three months. Out of those sexually active students, 34.6% reported having two or more sex partners over the same period, and 52.6% did not use a condom during their last sexual intercourse. After controlling for other covariates, a higher likelihood of risky sexual behavior remained significantly associated among male participants with higher levels of substance use, higher levels of peer delinquency, and higher family income. In contrast, risky sexual behavior did not retain its associations with any of the measured protective factors among male participants. Among female participants, a higher likelihood of risky sexual behavior remained significantly associated with higher levels of substance use, higher levels of community-violence witnessing, and lower levels of family support. CONCLUSIONS: The findings suggest the importance of considering gender-related differences in the effects of risk and protective factors when designing and implementing prevention programs. In interventions for both male and female adolescents, prevention of substance use and risky sexual behavior should be integrated. For boys, efforts should focus on the reduction of peer delinquency, while, for girls, improvement of family support should be emphasized.

Understanding the effect of social capital on the depression of urban Chinese adolescents: an integrative framework.

Using data from an ongoing longitudinal study of 5,164 adolescents and their parents from seven cities in mainland China, this study investigated how social capital embedded in the family and the community, together with family human capital and financial capital, influenced the depressive symptoms of urban Chinese adolescents within an integrative framework. The structural equation modeling results suggested that higher community social capital was associated with lower level of adolescent depressive symptoms and was the strongest predictor among all these contextual factors. Family social capital played a significant role in mediating the effects of all other contextual factors on adolescent depressive symptoms. Unexpectedly, higher family financial capital predicted increased depressive symptoms both directly and indirectly through its negative effect on family social capital. As for gender, female adolescents reported more depressive symptoms as a result of less available family social capital. Implications of these findings for theory, practice, policy, and future research are discussed.

Coping strategies and stress among resettled Bhutanese adults in Massachusetts.

Stress associated with attempts to integrate into a new culture is directly linked to mental health outcomes among refugees. However, there is a paucity of literature on how refugees cope to reduce their stress. This study assessed the association between coping strategies and perceived stress among resettled Bhutanese adults in Western Massachusetts. A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 years residing in Massachusetts. Coping was measured with the 32-item Tobin Coping-Strategies Inventory-Short Form (CSI-SF). The 32-item CSI-SF includes 8 subscales: problem-solving, cognitive-structuring, express-emotions, social-contact, problem-avoidance, wishful thinking, self-criticism, and social-withdrawal, each with 4 items. Four composite constructs were created from subscales, namely, problem-focused engagement (problem solving + cognitive structuring), emotion-focused engagement (express emotions + social contact), problem-focused disengagement (problem avoidance + wishful thinking), and emotion-focused disengagement (self-criticism + social withdrawal). Perceived stress was measured with the 10-item Cohen Perceived Stress Scale. Associations of coping scores with perceived stress score (PSS) were assessed using multiple linear-regression analyses adjusting for sociodemographic, and lifestyle factors. The coping scores of 4 subscales were inversely associated with PSS including problem solving (ß = -0.430, p ≤ .0001), cognitive structuring (ß = -0.416, p = .0002), express emotions (ß = -0.292, p = .004), and social contact (ß = -0.448, p ≤ .0001). Two composite constructs of subscales, namely, problem-focused (ß = -0.236, p ≤ .0001) and emotion-focused (ß = -0.199, p = .0003) engagement coping strategies were inversely associated with PSS. Greater use of problem- or emotion-focused engagement coping strategies was associated with reduced PSS among Bhutanese, suggesting that problem-focused or emotion-focused stress management interventions hold promise for stress reduction among resettled Bhutanese. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Association between psychological factors and adolescent smoking in seven cities in China.

BACKGROUND: Cigarette smoking is a culturally accepted behavior among adult males in China. However, there is limited information on smoking among Chinese adolescents, particularly the information on the relationship between psychological well-being and smoking behavior among this population. PURPOSE: This study explored associations between three psychological factors--anxiety, hostility, and depressive symptoms--and smoking behavior among Chinese adolescents. METHODS: The data presented in this study are a cross-sectional slice from a longitudinal investigation of tobacco use and lifestyle carried out in China. The study population consisted of 4,724 7th and 11th grade students from seven large cities in China. RESULTS: Odds ratios showed that anxiety, hostility, and depressive symptoms were significantly associated with a higher risk of lifetime smoking for both boys and girls. CONCLUSION: Much like their Western counterparts, Chinese adolescents face developmental stress. The resulting distress may increase their risk for substance use and other health-risk behaviors.

Risk factors for adolescent smoking in urban and rural China: findings from the China seven cities study.

Cigarette smoking is rising among urban Chinese adolescents and poses a significant public health concern. The majority of Chinese youth live in rural areas, but most research on the risk factors for smoking has been conducted in urban areas of China. This study examined the associations between parental smoking, peer smoking, and low refusal self-efficacy and smoking among urban and rural Chinese youth. This analysis used a cross-sectional sample of 3412 ninth grade students in urban and rural areas under the administrative jurisdiction of seven large cities in China. Multilevel logistic regression models were used to associate the risk factors with lifetime and current smoking, separately in boys and girls. Adolescent smoking was not strongly associated with parental smoking. However it was strongly associated with peer smoking and low refusal self-efficacy across both the urban and rural samples. Students with lower refusal self-efficacy were approximately 5-17 times more likely to be lifetime or current smokers than those with higher refusal self-efficacy. Smoking prevention interventions in China may need to focus on raising adolescents' refusal self-efficacy.

Why smoking prevention programs sometimes fail. Does effectiveness depend on sociocultural context and individual characteristics?

BACKGROUND: School-based smoking prevention programs sometimes fail in unexpected ways. This study tests the hypotheses that both social/cultural contexts and individual dispositional characteristics may interact with program content to produce effects that are variable in potentially predictable ways. METHODS: Students in 24 culturally heterogeneous or primarily Hispanic/Latino middle schools (N = 3,157 6th graders) received a multicultural collectivist-framed social influences (SI) program, an individualist-framed SI program, or a control condition. Three-way linear and nonlinear interactions, program frame x social context x dispositional phenotype, were tested. RESULTS: Three-way interactions were found for the dispositional phenotypes of depression and hostility with social context and program content/frame. In predominantly Hispanic/Latino schools, larger program effects were observed for high depressed and high hostile youth in both the collectivist and individualist framed programs. In culturally mixed schools, prevention effects were greatest for low depressed and low hostile youth, especially in the individualist framed program. In culturally mixed schools, there may have been a negative treatment effect for both programs among adolescents scoring high on depression and hostility. DISCUSSION: Prevention program effects can vary by combination of program content, social setting, and individual dispositional characteristics. The results suggest that prevention program design and implementation should be sensitive to population characteristics at both the individual and sociocultural levels.

Comorbidity between depression and smoking moderates the effect of a smoking prevention program among boys in China.

Smoking prevention programs based on social influences have reduced smoking prevalence among youth. However, these effects have not been replicated consistently. It is possible that individuals and populations with different dispositional and behavioral characteristics will experience different program effects. This study explored a possible moderation of program effect by comorbidity between depression and smoking (CoM). Data for this analysis were from 2,450 seventh-grade youth (51% boys) who participated in the Wuhan (China) Smoking Prevention Trial (WSPT). WSPT was a randomized, controlled, 14-session, middle-school-based smoking prevention trial. Baseline and 1-year follow-up surveys were administered. The moderation effect between the program and CoM was tested on 1-year change in recent smoking. The CoM indicator was defined dichotomously as monthly cigarette use and high in depression level (among the top 20% in the sample). At baseline, a total of 26 girls and 60 boys were identified to have CoM. Among boys (but not girls), CoM significantly moderated the program effect on recent smoking (p = .01). The program effect among boys with CoM was 4.17 (95% CI 1.47-11.76) times larger than those without CoM. Among boys with CoM, the odds ratio of recent smoking was 0.18 (95% CI 0.06-0.55) for program vs. control condition. Among those without CoM, the program did not reduce the odds of recent smoking significantly (OR = 0.74, 95% CI 0.37-1.48). The study demonstrated that smoking prevention program effects can vary with individual characteristics, in this case comorbidity between depression and smoking. These findings may help explain the inconsistency in program effects across studies and populations. The findings also may contribute to the design of future programs to address the needs of defined populations and individuals with specific characteristics.

Utility of the theory of reasoned action and theory of planned behavior for predicting Chinese adolescent smoking.

One third of smokers worldwide live in China. Identifying predictors of smoking is important for prevention program development. This study explored whether the Theory of Reasoned Action (TRA) and Theory of Planned Behavior (TPB) predict adolescent smoking in China. Data were obtained from 14,434 middle and high school students (48.6% boys, 51.4% girls) in seven geographically varied cities in China. TRA and TPB were tested by multilevel mediation modeling, and compared by multilevel analyses and likelihood ratio tests. Perceived behavioral control was tested as a main effect in TPB and a moderation effect in TRA. The mediation effects of smoking intention were supported in both models (p<0.001). TPB accounted for significantly more variance than TRA (p<0.001). Perceived behavioral control significantly interacted with attitudes and social norms in TRA (p<0.001). Therefore, TRA and TPB are applicable to China to predict adolescent smoking. TPB is superior to TRA for the prediction and TRA can better predict smoking among students with lower than higher perceived behavioral control.

Socio-demographic and economic correlates of overweight status in Chinese adolescents.

OBJECTIVE: To investigate over-weight prevalence and socio-demographic and economic correlates in Chinese adolescents. METHODS: Weight, height, waist circumference, and socio-demo-graphic and economic variables of 6863 middle and high school students were measured. RESULTS: 10% of girls and 17% of boys were overweight. Waist circumference and overweight risk were significantly associated with pubertal status (P<0.05). High levels of parental education and family income were significant risk factors for overweight (P<0.05). DISCUSSION: Our findings underscore the need for development of evidence-based and culturally appropriate public health programs to prevent and treat pediatric obesity in China.

Serum albumin levels and depression in people living with Human Immunodeficiency Virus infection: a cross-sectional study.

BACKGROUND: Lower serum albumin levels and depression are common among HIV-infected persons. High serum albumin levels may provide protection against depression through its defensive role in inflammation and infection. We tested the hypothesis of an independent relationship between serum albumin levels and depressive symptoms in a cohort of HIV-infected persons. METHODS: A cross-sectional survey was conducted among 310 HIV-infected persons (176 men and 134 women) aged 20-60years residing in the Kathmandu Valley, Nepal. The bromocresol green method was used to measure serum albumin levels and the Beck Depression Inventory method was used to measure depressive symptoms, with a cut off score of 20 or higher indicating likely depression. The relationship between serum albumin levels and depressive symptoms was assessed using both multiple linear regression analysis and multiple logistic regression analysis, with adjustment for sociodemographic, cardiovascular, life-style, and HIV-related clinical and treatment confounding factors. RESULTS: Serum albumin levels were inversely associated with depressive symptoms scores (beta for 1 unit change in serum albumin levels: ß=-3.91; p=0.001) for the total participant sample. This inverse association was significant in both men (ß=-3.93; p=0.009) and women (ß=-4.47; p=0.03). A significantly decreased risk of depression was observed among participants with the highest serum albumin levels, with odds ratio and 95% CI for those with >5.0g/dL versus <4.0g/dL of 0.22 (0.06-0.80) (p=0.01). CONCLUSION: Serum albumin levels were inversely associated with depressive symptoms scores in HIV-infected persons.

Coinfection of Sexually Transmitted Infections among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal.

In Asian concentrated HIV epidemics, data on coinfection of sexually transmitted infections (STIs) among HIV-positive individuals are limited. The authors measured the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), and syphilis, and their correlates among 319 HIV-positive individuals in Kathmandu, Nepal. The authors tested blood samples for syphilis and urine samples for CT and NG. Overall, 17 (5.3%) participants had at least 1 STI (CT: 1.3%, NG: 2.8%, and syphilis: 1.2%). Of 226 participants who had sex in past 6 months, 51.3% did not always use condoms. Older (aged 35-60 years) participants were more likely (adjusted odds ratio [AOR] = 3.83; 95% confidence interval [CI] = 1.19-12.33; P = .024) and those who were currently married (AOR = 0.30; 95% CI = 0.09-0.97; P = .046) or on antiretroviral therapy (AOR = 0.21; 95% CI = 0.06-0.71; P = .012) were less likely to have at least 1 STI. Our results suggest the need to strengthen the efforts to screen and treat STIs and to promote safer sexual practices among Nepalese HIV-positive individuals.