Skip to main content
SpringerLink
Log in

Non-disclosure of Sexual Orientation to Parents Associated with Sexual Risk Behaviors Among Gay and Bisexual MSM in China

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The objective of this study was to explore the relationship between non-disclosure of sexual orientation to parents and sexual risk behaviors among gay and bisexual men who have sex with men (MSM) in China. A total of 295 eligible participants (gay n = 179, bisexual n = 116) were recruited from MSM venues and MSM organizations in Anhui Province, China. Overall, 16.6 % of participants chose to disclose their sexual orientation to parents. Fewer bisexual participants chose to disclose their sexual orientation than gay participants (9.5 vs. 21.2 %, p < 0.01). A multivariate logistic regression analysis indicated that non-disclosers were more likely than disclosers to report having one or more female sex partners among gay and bisexual MSM (AOR = 2.91), non-disclosure of sexual orientation to parents was positively associated with the number of female sex partners (AOR = 3.40) and with engagement in unprotected anal intercourse with men (AOR = 2.49) among gay MSM, in the past 6 months. Our findings indicated that HIV/AIDS intervention programs should promote the disclosure of sexual orientation and should design interventions specific to gay and bisexual MSM separately.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chen GC, Li Y, Zhang BC, et al. Psychological characteristics in high-risk MSM in China. BMC Public Health. 2012;12:58. doi:10.1186/1471-2458-12-58.

    Article  PubMed  PubMed Central  Google Scholar 

  2. UNAIDS (2013) HIV in China: facts and figures. http://www.unaids.org.cn/en/index/page.asp?id=197&class=2&classname=China+Epidemic+%26+Response. Accessed 22 April 2013.

  3. Lau JTF, Lin C, Hao C, Wu X, Gu J. Public health challenges of the emerging HIV epidemic among men who have sex with men in China. Public Health. 2011;125(5):260–5.

    Article  PubMed  CAS  Google Scholar 

  4. Guo Y, Li X, Stanton B. HIV-related behavioral studies of men who have sex with men in China: a systematic review and recommendations for future research. AIDS Behav. 2011;15(3):521–34.

    Article  PubMed  Google Scholar 

  5. Wong FY, Huang ZJ, Wang W, et al. STIs and HIV among men having sex with men in China: a ticking time bomb? AIDS Educ Prev. 2009;21(5):430–46.

    Article  PubMed  Google Scholar 

  6. Zhang BC, Chu QS. MSM and HIV/AIDS in China. Cell Res. 2005;15(11–12):858–64.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Everett BG. Sexual orientation disparities in sexually transmitted infections: examing the intersection between sexual identity and sexual behavior. Arch Sex Behav. 2013;42(2):225–36.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wang Y. The research of the main affecting factors of the high risk behaviors of men who have sex with men (MSM) in Taiyuan. Shanxi Medical University, 2007.

  9. Jessor R. Risk behaviors in adolesence: a psychological framework for understanding and action. J Adolesc Health. 1991;12(8):597–605.

    Article  PubMed  CAS  Google Scholar 

  10. Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998;101(5):895–902.

    Article  PubMed  CAS  Google Scholar 

  11. Liu YY. Association between mental disorders and high risk sexual behaviors among men who have sex with men in urban area of Liaoning province. Dalian Medical University, 2009.

  12. Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995;36(1):38–56.

    Article  PubMed  CAS  Google Scholar 

  13. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Greene K, Derlega VJ, Mathews A. Self-disclosure in personal relationships. In: Vangelisti AL, Perlman D, editors. The Cambridge handbook of personal relationships. Cambridge: Cambridge University Press; 2006. p. 409–28.

    Chapter  Google Scholar 

  15. Cole SW, Kemeny ME, Taylor SE, Visscher BR. Elevated physical health risk among gay men who conceal their homosexual identity. Health Psychol. 1996;15(4):243–51.

    Article  PubMed  CAS  Google Scholar 

  16. Taylor B. Coming out as a life transition: homosexual identity formation and its implications for health care practice. J Adv Nurs. 1999;30(2):520–5.

    Article  PubMed  CAS  Google Scholar 

  17. Rosario M, Hunter J, Maguen S, Gwadz M, Smith R. The coming-out process and its adaptational and health-related associations among gay, lesbian, and bisexual youths: stipulation and exploration of a model. Am J Community Psychol. 2001;29(1):133–60.

    Article  PubMed  CAS  Google Scholar 

  18. Kuyper L, Fokkema T. Minority stress and mental health among Dutch LGBs: examination of differences between sex and sexual orientation. J Couns Psychol. 2011;58(2):222–33.

    Article  PubMed  Google Scholar 

  19. Lewis RJ, Derlega VJ, Griffin JL, Krowinski AC. Stressors for gay men and lesbians: life stress, gay-related stress, stigma consciousness, and depressive symptoms. J Soc Clin Psychol. 2003;22(6):716–29.

    Article  Google Scholar 

  20. Frable DES, Wortman C, Joseph J. Predicting self-esteem, well-being, and distress in a cohort of gay men: the importance of cultural stigma, personal visibility, community networks, and positive identity. J Pers. 1997;65(3):599–624.

    Article  PubMed  CAS  Google Scholar 

  21. Hershberger SL, Pilkington NW, D’Augelli AR. Predictors of suicide attempts among gay, lesbian, and bisexual youth. J Adolesc Res. 1997;12(4):477–97.

    Article  Google Scholar 

  22. D’Augelli AR, Hershberger SL, Pilkington NW. Lesbian, gay, and bisexual youth and their families: disclosure of sexual orientation and its consequences. Am J Orthopsychiatry. 1998;68(3):361–71.

    Article  PubMed  Google Scholar 

  23. Xue LJ, Wang WM, Xu Y, et al. An online-survey of HIV related knowledge and high risk behaviors, social pressure and their influencing factors among MSM. Chin J AIDS STD. 2011;3:324–7.

    Google Scholar 

  24. LaSala MC. Gay male couples: the importance of coming out and being out to parents. J Homosex. 2000;39(2):47–71.

    Article  PubMed  CAS  Google Scholar 

  25. Mallon GP. Knowledge for practice with gay and lesbian persons. In: Mallon G, editor. Foundations of social work practice with lesbian and gay persons. New York: Harrington Park Press; 1998. p. 1–18.

    Google Scholar 

  26. LaSala MC. Lesbians, gay men, and their parents: family therapy for the coming-out crisis. Fam Process. 2000;39(1):67–81.

    Article  PubMed  CAS  Google Scholar 

  27. Willoughby B, Doty ND, Malik NM. Parental reactions to their child’s sexual orientation disclosure: a family stress perspective. Parent Sci Pract. 2008;8(1):70–91.

    Article  Google Scholar 

  28. Green RJ. Lesbians, gay men, and their parents: a critique of LaSala and the prevailing clinical “wisdom”. Fam Process. 2000;39(2):257–66.

    Article  PubMed  CAS  Google Scholar 

  29. Wong CY, Tang CS. Coming out experiences and psychological distress of chinese homosexual men in Hong Kong. Arch Sex Behav. 2004;33(2):149–57.

    Article  PubMed  Google Scholar 

  30. Liu H, Li J, Lu Z, Liu W, Zhang Z. Does Chinese culture influence psychosocial factors for heroin use among young adolescents in China? A cross-sectional study. BMC Public Health. 2010;10:563. doi:10.1186/1471-2458-10-563.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Park IH, Cho LJ. Confucianism and the Korean family. J Comp Fam Stud. 1995;26:117–34.

    Google Scholar 

  32. Park M, Chesla C. Revisiting Confucianism as a conceptual framework for Asian family study. J Fam Nurs. 2007;13(3):293–311.

    Article  PubMed  Google Scholar 

  33. Liu H, Feng T, Ha T, et al. Chinese culture, homosexuality stigma, social support and condom use: a path analytic model. Stigma Res Action. 2011;1(1):27–35.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  34. Berger RM. Men together: understanding the gay couple. J Homosex. 1990;3:31–49.

    Article  Google Scholar 

  35. Bryant AS, Demian. Relationship characteristics of American gays and lesbians couples: findings from a national survey. J Gay Lesbian Soc Serv. 1994;1(2):101–17.

    Article  Google Scholar 

  36. Zang C, Guida J, Sun Y, Liu H. Collectivism culture, HIV stigma and social network support in Anhui, China: a path analytic model. AIDS Patient Care STDS. 2014;28(8):452–8.

    Article  PubMed  Google Scholar 

  37. Neillands TB, Steward WT, Choi KH. Assessment of stigma towards homosexuality in China: a study of men who have sex with men. Arch Sex Behav. 2008;37(5):838–44.

    Article  Google Scholar 

  38. Wang QF. Well-identified but not coming out: contemporary gay minority investigation. Chin Agric Univ J Soc Sci Ed. 2011;28(4):142–53.

    CAS  Google Scholar 

  39. Peng TX. The reason and effect of chinese homesexual choosing marriage of convenience. Chin J Hum Sex. 2014;23(8):97–9.

    Google Scholar 

  40. Bostwick WB, Boyd CJ, Hughes TL, McCabe SE. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health. 2010;100(3):468–75.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health. 2010;100(10):1953–60.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Warner J, McKeown E, Griffin M, et al. Rates and predictors of mental illness in gay men, lesbians, and bisexual men and women: results from a survey based in England and Wales. Br J Psychiatry. 2004;185:479–85.

    Article  PubMed  Google Scholar 

  43. Henry E, Awondo P, Fugon L, Yomb Y, Spire B. Coming out of the Nkuta: disclosure of sexual orientation associated with reduced risk behavior among MSM in Cameroon. Arch Sex Behav. 2012;41(3):525–7.

    Article  PubMed  Google Scholar 

  44. From the Centers for Disease Control and Prevention. HIV/STD risks in young men who have sex with men who do not disclose their sexual orientation—six U.S. cities, 1994-2000. JAMA. 2003;289(8):975–7.

    Article  Google Scholar 

  45. Kelly JA, St Lawrence JS, Brasfield TL, et al. Psychological factors that predict AIDS high-risk versus AIDS precautionary behavior. J Consult Clin Psychol. 1990;58(1):117–20.

    Article  PubMed  CAS  Google Scholar 

  46. Henry E, Marcellin F, Yomb Y, et al. Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon. Sex Transm Infect. 2010;86(2):136–40.

    Article  PubMed  CAS  Google Scholar 

  47. Liu JX, Choi K. Experiences of social discrimination among homosexual men in Shanghai, China. AIDS Behav. 2006;10(4 Suppl):S25–33.

    Article  PubMed  Google Scholar 

  48. Zhang L, Zhang D, Yu B, et al. Prevalence of HIV infection and associated risk factors among men who have sex with men (MSM) in Harbin, P. R. China. PLoS One. 2013;8(3):e58440. doi:10.1371/journal.pone.0058440.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  49. Strathdee SA, Hogg RS, Martindale SL, et al. Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;19(1):61–6.

    Article  PubMed  CAS  Google Scholar 

  50. Liu MH. High risk behaviors related HIV/AIDS and demographic variables of men whohave sex with men (MSM) in Jiangsu province. Qindao University, 2005.

  51. Yu F, Nehl EJ, Zheng T, et al. Syndemic including cigarette smoking and sexual risk behaviors among a sample of MSM in Shanghai, China. Drug Alcohol Depend. 2013;132(1–2):265–70.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  52. Prestage G, Van De Ven P, Grulich A, Kippax S, McInnes D, Hendry O. Gay men’s casual sex encounters: discussing HIV and using condoms. AIDS Care. 2001;13(3):277–84.

    Article  PubMed  CAS  Google Scholar 

  53. Wang D. A depth interview research, of bisexual identity. Nanjing Normal University, 2013.

  54. Dai ZZ, Zhong XN, Peng B, et al. Comparative analysis on characteristics of gay-identified and bisexual-identified men in western China. J Third Mil Med Univ. 2014;36(19):2025–9.

    Google Scholar 

  55. Agronick G, O’Donnell L, Stueve A, Doval AS, Duran R, Vargo S. Sexual behaviors and risks among bisexually- and gay-identified young Latino men. AIDS Behav. 2004;8(2):185–97.

    Article  PubMed  Google Scholar 

  56. Newman PA, Chakrapani V, Cook C, Shunmugam M, Kakinami L. Determinants of sexual risk behavior among men who have sex with men accessing public sex environments in Chennai, India. J LGBT Health Res. 2008;4(2–3):81–7.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by the national nature science foundation of China under Grant No. 71173002 and No. 71303007. The authors thank the participations and all who were involved in the surveys. Specially thanks to Wuhu, Hefei and Maanshan CDC and local grassroots organizations for assisting the field work.

Author information

Author notes

    Authors and Affiliations

    1. School of Health Service management, Anhui Medical University, Hefei, China

      Ye Zhao, Ying Ma, Ren Chen, Xia Qin & Zhi Hu

    2. Department of Literature Review and Analysis, Library of Anhui Medical University, Hefei, China

      Ye Zhao

    3. Medicare Office, Anhui Provincial Children’s Hospital, Hefei, China

      Feng Li

    Authors
    1. Ye Zhao
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Ying Ma
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Ren Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Feng Li
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Xia Qin
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Zhi Hu
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Zhi Hu.

    Additional information

    Ye Zhao and Ying Ma contributed equally to this paper.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Zhao, Y., Ma, Y., Chen, R. et al. Non-disclosure of Sexual Orientation to Parents Associated with Sexual Risk Behaviors Among Gay and Bisexual MSM in China. AIDS Behav 20, 193–203 (2016). https://doi.org/10.1007/s10461-015-1135-6

    Download citation

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10461-015-1135-6

    Keywords

    Search

    Navigation