AIDS and Behavior

, Volume 16, Issue 3, pp 499–507 | Cite as

HIV/AIDS-Related Stigmatizing and Discriminatory Attitudes and Recent HIV Testing Among Men Who Have Sex With Men in Beijing

  • Xuefeng Li
  • Hongyan Lu
  • Xiaoyan Ma
  • Yanming Sun
  • Xiong He
  • Chunmei Li
  • H. F. Raymond
  • Willi McFarland
  • Stephen W. Pan
  • Yiming Shao
  • Sten H. Vermund
  • Yan Xiao
  • Yuhua Ruan
  • Yujiang Jia
Original Paper


This study assessed the correlates of recent HIV testing and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Beijing, China. A cross-sectional study probed demographics, sexual and drug use behaviors, HIV testing, and prevention services. Of 500 participants, 39.3% recently received a test for HIV. Recent testing was independently associated with expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes, more male sex partners, no female sexual partners and knowing HIV status of their last male partner. Expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with recent testing, younger age, and knowing HIV status of their last male partner. This study revealed that HIV/AIDS-related stigmatizing and discriminatory attitudes were common and inversely associated with recent HIV testing. Low levels of testing highlighted the urgent needs to reduce HIV/AIDS-related stigma and discrimination and expand HIV testing among MSM in Beijing.


HIV/AIDS Stigma Discrimination Testing Men who have sex with men 


El estudio fue evaluar la correlación de los últimos la prueba del VIH y el VIH/SIDA relacionados con las actitudes estigmatizantes y discriminatorias entre hombres que tienen sexo con hombres (HSH) en Beijing, China. Un estudio transversal investigado los datos demográficos, las conductas sexuales y de uso de drogas, pruebas de VIH y servicios de prevención. De 500 participantes, el 39,3% ha recibido recientemente una prueba de VIH. Pruebas recientes se asoció independientemente con la expresión de los niveles más bajos de VIH/SIDA relacionados con las actitudes estigmatizantes y discriminatorias, más parejas sexuales masculinas, no las parejas sexuales femeninas y conocer el estado de VIH de su pareja masculina pasado. Expresar niveles más bajos de VIH/SIDA actitudes estigmatizantes y discriminatorias se asoció independientemente con las pruebas recientes, una edad más joven, y conocer el estado de VIH de su pareja masculina pasado. Este estudio reveló que el VIH/SIDA relacionados con las actitudes estigmatizantes y discriminatorias eran comunes e inversamente asociada con las recientes pruebas de VIH. Los bajos niveles de las pruebas destacó la necesidad urgente de reducir el VIH/SIDA, el estigma y la discriminación y ampliar las pruebas del VIH entre los HSH Beijing.

Palabras clave

VIH/SIDA el estigma la discriminación las pruebas los hombres que tienen sexo con hombres 



This study was supported by grants from the National Natural Science Foundation of China (81161120428), the National Institutes of Health (#R01 AI078933 and # 5D43TW001035-13), the Ministry of Science and Technology of China (2012ZX10001-002) and Chinese State Key Laboratory for Infectious Disease Develop Grant (2011SKLID102).

Conflict of interest



  1. 1.
    UNAIDS. Fact sheet on stigma and discrimination. Available at: Accessed 29 Nov 2010.
  2. 2.
    Wu Z, Sun X, Sullivan GS, Detels R. Public health: HIV testing in China. Science. 2006;312(5779):1475–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Mahajan AP, Sayles JN, Patel VA, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79.PubMedCrossRefGoogle Scholar
  4. 4.
    Chesney MA, Smith AW. Critical delays in HIV testing and care. Am Behav Sci. 1999;42(7):1162–74.CrossRefGoogle Scholar
  5. 5.
    Kalichman SC, Simbayi LC. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sex Transm Infect. 2003;79(6):442–7.PubMedCrossRefGoogle Scholar
  6. 6.
    van Griensven F, de Lind van Wijngaarden JW, Baral S, Grulich A. The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS. 2009;4(4):300–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Abadia-Barrero CE, Castro A. Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil. Soc Sci Med. 2006;62(5):1219–28.PubMedCrossRefGoogle Scholar
  8. 8.
    Thi MD, Brickley DB, Vinh DT, et al. A qualitative study of stigma and discrimination against people living with HIV in Ho Chi Minh City, Vietnam. AIDS Behav. 2008;12(4 Suppl):S63–70.PubMedCrossRefGoogle Scholar
  9. 9.
    Rahmati-Najarkolaei F, Niknami S, Aminshokravi F, et al. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran. J Int AIDS Soc. 2010;13:27.PubMedCrossRefGoogle Scholar
  10. 10.
    Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999. Am J Public Health. 2002;92(3):371–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Letamo G. Prevalence of, and factors associated with, HIV/AIDS-related stigma and discriminatory attitudes in Botswana. J Health Popul Nutr. 2003;21(4):347–57.PubMedGoogle Scholar
  12. 12.
    Unnikrishnan B, Mithra PP, Rekha T, Reshmi B. Awareness and attitude of the general public toward HIV/AIDS in coastal Karnataka. Indian J Community Med. 2010;35(1):142–146.PubMedCrossRefGoogle Scholar
  13. 13.
    Flowers P, Duncan B, Frankis J. Community, responsibility and culpability: HIV risk-management amongst Scottish gay men. J Community Appl Soc Psychol. 2000;10(4):285–300.CrossRefGoogle Scholar
  14. 14.
    Courtenay-Quirk C, Wolitski RJ, Parsons JT, Gomez CA. Is HIV/AIDS stigma dividing the gay community? Perceptions of HIV-positive men who have sex with men. AIDS Educ Prev. 2006;18(1):56–67.PubMedCrossRefGoogle Scholar
  15. 15.
    De Boer IM, Op de Coul E, Koedijk F, van Veen MG, van Sighem AI, van de Laar MJW. HIV and sexually transmitted infections in the Netherlands in 2005. RIVM report 441100024/2006; p. 1–163.Google Scholar
  16. 16.
    Hall HI, Song R, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Ma X, Zhang Q, He X, et al. Trends in prevalence of HIV, syphilis, hepatitis C, hepatitis B, and sexual risk behavior among men who have sex with men. Results of 3 consecutive respondent-driven sampling surveys in Beijing, 2004 through 2006. J Acquir Immune Defic Syndr. 2007;45(5):581–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. Am J Public Health. 1999;89(9):1397–405.PubMedCrossRefGoogle Scholar
  19. 19.
    Leaity S, Sherr L, Wells H, et al. Repeat HIV testing: high-risk behaviour or risk reduction strategy? AIDS. 2000;14(5):547–52.PubMedCrossRefGoogle Scholar
  20. 20.
    Valdiserri RO, Holtgrave DR, West GR. Promoting early HIV diagnosis and entry into care. AIDS. 1999;13(17):2317–30.PubMedCrossRefGoogle Scholar
  21. 21.
    Janssen RS, Holtgrave DR, Valdiserri RO, Shepherd M, Gayle HD, De Cock KM. The serostatus approach to fighting the HIV epidemic: prevention strategies for infected individuals. Am J Public Health. 2001;91(7):1019–24.PubMedCrossRefGoogle Scholar
  22. 22.
    Magnani R, Sabin K, Saidel T, Heckathorn D. Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS. 2005;19(Suppl 2):S67–72.PubMedCrossRefGoogle Scholar
  23. 23.
    Malekinejad M, Johnston LG, Kendall C, Kerr LR, Rifkin MR, Rutherford GW. Using respondent-driven sampling methodology for HIV biological and behavioral surveillance in international settings: a systematic review. AIDS Behav. 2008;12(4 Suppl):S105–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Genberg BL, Kawichai S, Chingono A, et al. Assessing HIV/AIDS stigma and discrimination in developing countries. AIDS Behav. 2008;12(5):772–80.PubMedCrossRefGoogle Scholar
  25. 25.
    Volz E, Wejnert C, Degani I, Heckathorn DD. Respondent-Driven Sampling Analysis Tool (RDSAT) Version 5.6. Ithaca, NY: Cornell University. Available at: Accessed 28 Aug 2011.
  26. 26.
    Ma W, Detels R, Feng Y, et al. Acceptance of and barriers to voluntary HIV counselling and testing among adults in Guizhou province, China. AIDS. 2007;21(Suppl 8):S129–35.PubMedCrossRefGoogle Scholar
  27. 27.
    Fortenberry JD, McFarlane M, Bleakley A, et al. Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health. 2002;92(3):378–81.PubMedCrossRefGoogle Scholar
  28. 28.
    Genberg BL, Hlavka Z, Konda KA, et al. A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS. Soc Sci Med. 2009;68(12):2279–87.PubMedCrossRefGoogle Scholar
  29. 29.
    Jin FY, Prestage G, Law MG, et al. Predictors of recent HIV testing in homosexual men in Australia. HIV Med. 2002;3(4):271–6.PubMedCrossRefGoogle Scholar
  30. 30.
    McGarrigle CA, Mercer CH, Fenton KA, et al. Investigating the relationship between HIV testing and risk behaviour in Britain: national survey of sexual attitudes and lifestyles 2000. AIDS. 2005;19(1):77–84.PubMedCrossRefGoogle Scholar
  31. 31.
    Do TD, Chen S, McFarland W, et al. HIV testing patterns and unrecognized HIV infection among young Asian and Pacific Islander men who have sex with men in San Francisco. AIDS Educ Prev. 2005;17(6):540–54.PubMedCrossRefGoogle Scholar
  32. 32.
    Sifakis F, Hylton JB, Flynn C, et al. Prevalence of HIV infection and prior HIV testing among young men who have sex with men. The Baltimore young men’s survey. AIDS Behav. 2010;14(4):904–12.PubMedCrossRefGoogle Scholar
  33. 33.
    MacKellar DA, Valleroy LA, Anderson JE, et al. Recent HIV testing among young men who have sex with men: correlates, contexts, and HIV seroconversion. Sex Transm Dis. 2006;33(3):183–92.PubMedCrossRefGoogle Scholar
  34. 34.
    Dias SF, Matos MG, Goncalves AC. AIDS-related stigma and attitudes towards AIDS-infected people among adolescents. AIDS Care. 2006;18(3):208–14.PubMedCrossRefGoogle Scholar
  35. 35.
    Maman S, Mbwambo JK, Hogan NM, Weiss E, Kilonzo GP, Sweat MD. High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. AIDS Behav. 2003;7(4):373–82.PubMedCrossRefGoogle Scholar
  36. 36.
    Centers for Disease Control and Prevention. HIV testing among men who have sex with men—21 cities, United States, 2008. MMWR. 2011;60(21):694–9.Google Scholar
  37. 37.
    Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(RR-14):1–17. quiz CE1-4.PubMedGoogle Scholar
  38. 38.
    Abdool Karim Q, Abdool Karim SS, Frohlich JA, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–74.PubMedCrossRefGoogle Scholar
  39. 39.
    NIAID/NIH. Treating HIV-infected people with antiretrovirals protects partners from infection: findings result from NIH-funded international study. Available at: Accessed 25 May 2011.
  40. 40.
    Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2011;363(27):2587–99.CrossRefGoogle Scholar
  41. 41.
    Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.PubMedCrossRefGoogle Scholar
  42. 42.
    Kalichman SC, Simbayi LC, Jooste S, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9(2):135–43.PubMedCrossRefGoogle Scholar
  43. 43.
    Liao M, Kang D, Jia Y. Bisexual behavior and infection with HIV and syphilis among men who have sex with men along the east coast of China. AIDS Patient Care STDS. 2011;25(11):683–91.PubMedCrossRefGoogle Scholar
  44. 44.
    Choi KH, Gibson DR, Han L, Guo Y. High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China. AIDS Educ Prev. 2004;16(1):19–30.PubMedCrossRefGoogle Scholar
  45. 45.
    Gu Y, Qu P, Lu S, Luo M, Wang X, Gu J. Survey of knowledge, attitude behavior and practice related to STI/HIV among male homosexuals in Shenyang. Chin J Public Health. 2004;20(5):573–4.Google Scholar
  46. 46.
    Ruan S, Yang H, Zhu Y, et al. HIV prevalence and correlates of unprotected anal intercourse among men who have sex with men, Jinan, China. AIDS Behav. 2008;12(3):469–75.PubMedCrossRefGoogle Scholar
  47. 47.
    Jiang J, Cao N, Zhang J, et al. High prevalence of sexually transmitted diseases among men who have sex with men in Jiangsu Province, China. Sex Transm Dis. 2006;33(2):118–23.PubMedCrossRefGoogle Scholar
  48. 48.
    Hightow LB, Leone PA, Macdonald PD, McCoy SI, Sampson LA, Kaplan AH. Men who have sex with men and women: a unique risk group for HIV transmission on North Carolina College campuses. Sex Transm Dis. 2006;33(10):585–93.PubMedCrossRefGoogle Scholar
  49. 49.
    Liu JX, Choi K. Experiences of social discrimination among men who have sex with men in Shanghai, China. AIDS Behav. 2006;10(4 Suppl):S25–33.PubMedCrossRefGoogle Scholar
  50. 50.
    Choi KH, Hudes ES, Steward WT. Social discrimination, concurrent sexual partnerships, and HIV risk among men who have sex with men in Shanghai, China. AIDS Behav. 2008;12(4 Suppl):S71–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Johnston LG, Malekinejad M, Kendall C, Iuppa IM, Rutherford GW. Implementation challenges to using respondent-driven sampling methodology for HIV biological and behavioral surveillance: field experiences in international settings. AIDS Behav. 2008;12(4 Suppl):S131–41.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Xuefeng Li
    • 1
  • Hongyan Lu
    • 2
  • Xiaoyan Ma
    • 2
  • Yanming Sun
    • 2
  • Xiong He
    • 2
  • Chunmei Li
    • 1
  • H. F. Raymond
    • 3
  • Willi McFarland
    • 3
    • 4
  • Stephen W. Pan
    • 5
  • Yiming Shao
    • 1
  • Sten H. Vermund
    • 6
    • 7
  • Yan Xiao
    • 1
  • Yuhua Ruan
    • 1
  • Yujiang Jia
    • 7
  1. 1.Epidemiology and Biostatistics Branch of Division of Virology and Immunology, State Key Laboratory for Infectious Disease Control and Prevention, and National Center for AIDS/STD Control and PreventionChinese Center for Disease Control and PreventionBeijingPeople’s Republic of China
  2. 2.Beijing Center for Disease Control and PreventionBeijingPeople’s Republic of China
  3. 3.San Francisco Department of Public HealthSan FranciscoUSA
  4. 4.Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoUSA
  5. 5.The School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  6. 6.Department of Pediatrics, Institute for Global HealthVanderbilt University School of MedicineNashvilleUSA
  7. 7.Department of Preventive Medicine, Institute for Global HealthVanderbilt University School of MedicineNashvilleUSA

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