Perceived HIV-related stigma, mental health conditions and sexualized drug use among men who have sex with men living with HIV in Chongqing, China: a cross-sectional study
4 affiliations
- 1Department of Infection Control, Sichuan Tianfu New Area People’s Hospital
- 2School of Public Health, Chengdu Medical College
- 3School of Basic Medical Sciences, Southwest Medical University
- 4Department of Operations Management, Chongqing Tongliang District People’s Hospital
Abstract
Background Sexualized drug use (SDU) has become a significant public health concern among men who have sex with men (MSM) worldwide. While much of the existing research has focused on the association of SDU with high-risk sexual behaviors and the risk of human immunodeficiency virus (HIV) infection, relatively little attention has been paid to the broader range of sociodemographic, behavioral, and psychosocial factors that may be associated with SDU. This study aimed to investigate these correlates of SDU among MSM living with HIV. Methods Between June 2022 and June 2023, MSM living with HIV were recruited through two community-based organizations in Chongqing, China. Data were collected via an online questionnaire, which gathered information on demographic characteristics, perceived HIV-related stigma, common mental health conditions (depression and anxiety), SDU, and sexual behaviors. A multivariate Poisson regression model was employed to examine factors associated with SDU. Results Among the 1501 participants, 32.5% reported engaging in SDU during the preceding six months. Multivariate analysis revealed that several factors were associated with an increased likelihood of SDU, including being married, cohabiting, divorced, or widowed (adjusted prevalence ratio [aPR] = 1.49, 95% confidence interval [CI]: 1.24–1.79), being a migrant (aPR = 1.38, 95% CI: 1.19–1.59), initiating anal sex before 18 years of age (aPR = 1.98, 95% CI: 1.64–2.39), consuming alcohol during the preceding six months (aPR = 1.54, 95% CI: 1.30–1.81), and reporting higher levels of personalized stigma (aPR = 1.14, 95% CI: 1.11–1.18). Additionally, mild (aPR = 1.31, 95% CI: 1.10–1.57), moderate (aPR = 1.46, 95% CI: 1.13–1.89), and moderately severe-to-severe depression (aPR = 1.64, 95% CI: 1.10–2.46), as well as moderately severe-to-severe anxiety (aPR = 1.34, 95% CI: 1.01–1.78), were positively associated with SDU. In contrast, preferring a receptive (aPR = 0.65, 95% CI: 0.55–0.78) or versatile (aPR = 0.66, 95% CI: 0.55–0.78) sexual role, as well as reporting higher levels of disclosure concerns (aPR = 0.89, 95% CI: 0.85–0.92), was linked to a lower likelihood of SDU. Conclusions Among MSM living with HIV in Chongqing, SDU was common and was statistically associated with a range of sociodemographic, behavioral, and psychosocial characteristics.These findings suggest that SDU in this population co-occurs with multiple structural and psychosocial vulnerabilities, underscoring the potential value of integrating mental health, stigma, and substance use considerations into HIV-related services for MSM.
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BibTeX
@article{chen2026perceived,
title = {{Perceived HIV-related stigma, mental health conditions and sexualized drug use among men who have sex with men living with HIV in Chongqing, China: a cross-sectional study}},
author = {Huailiang Chen and Yingxin Luo and Panhao Yang and Jin Chen},
journal = {Substance Abuse Treatment, Prevention, and Policy},
year = {2026},
month = jul,
doi = {10.1186/s13011-026-00753-2},
url = {https://doi.org/10.1186/s13011-026-00753-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perceived HIV-related stigma, mental health conditions and sexualized drug use among men who have sex with men living with HIV in Chongqing, China: a cross-sectional study
AU - Huailiang Chen
AU - Yingxin Luo
AU - Panhao Yang
AU - Jin Chen
PY - 2026
DA - 2026/07/01
JO - Substance Abuse Treatment, Prevention, and Policy
DO - 10.1186/s13011-026-00753-2
UR - https://doi.org/10.1186/s13011-026-00753-2
AB - Background Sexualized drug use (SDU) has become a significant public health concern among men who have sex with men (MSM) worldwide. While much of the existing research has focused on the association of SDU with high-risk sexual behaviors and the risk of human immunodeficiency virus (HIV) infection, relatively little attention has been paid to the broader range of sociodemographic, behavioral, and psychosocial factors that may be associated with SDU. This study aimed to investigate these correlates of SDU among MSM living with HIV. Methods Between June 2022 and June 2023, MSM living with HIV were recruited through two community-based organizations in Chongqing, China. Data were collected via an online questionnaire, which gathered information on demographic characteristics, perceived HIV-related stigma, common mental health conditions (depression and anxiety), SDU, and sexual behaviors. A multivariate Poisson regression model was employed to examine factors associated with SDU. Results Among the 1501 participants, 32.5% reported engaging in SDU during the preceding six months. Multivariate analysis revealed that several factors were associated with an increased likelihood of SDU, including being married, cohabiting, divorced, or widowed (adjusted prevalence ratio [aPR] = 1.49, 95% confidence interval [CI]: 1.24–1.79), being a migrant (aPR = 1.38, 95% CI: 1.19–1.59), initiating anal sex before 18 years of age (aPR = 1.98, 95% CI: 1.64–2.39), consuming alcohol during the preceding six months (aPR = 1.54, 95% CI: 1.30–1.81), and reporting higher levels of personalized stigma (aPR = 1.14, 95% CI: 1.11–1.18). Additionally, mild (aPR = 1.31, 95% CI: 1.10–1.57), moderate (aPR = 1.46, 95% CI: 1.13–1.89), and moderately severe-to-severe depression (aPR = 1.64, 95% CI: 1.10–2.46), as well as moderately severe-to-severe anxiety (aPR = 1.34, 95% CI: 1.01–1.78), were positively associated with SDU. In contrast, preferring a receptive (aPR = 0.65, 95% CI: 0.55–0.78) or versatile (aPR = 0.66, 95% CI: 0.55–0.78) sexual role, as well as reporting higher levels of disclosure concerns (aPR = 0.89, 95% CI: 0.85–0.92), was linked to a lower likelihood of SDU. Conclusions Among MSM living with HIV in Chongqing, SDU was common and was statistically associated with a range of sociodemographic, behavioral, and psychosocial characteristics.These findings suggest that SDU in this population co-occurs with multiple structural and psychosocial vulnerabilities, underscoring the potential value of integrating mental health, stigma, and substance use considerations into HIV-related services for MSM.
SN - 1747-597X
ER -