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      Condom use social norms and self-efficacy with different kinds of male partners among Chinese men who have sex with men: results from an online survey

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          Abstract

          Background

          Social norms and self-efficacy play important roles in promoting consistent condom use among men who have sex with men (MSM). Few studies have investigated the association between social norms, self-efficacy and consistent condom use with different kinds of male partners among MSM. We conducted an online survey of MSM to evaluate this in China.

          Methods

          A cross-sectional online survey was conducted in 2015. Participants completed a validated questionnaire covering socio-demographic information, consistent condom use, condom use social norms and self-efficacy. Eligible participants were 16 or older, born biologically as a male, engaged in anal sex with a man at least once during their lifetime, engaged in condomless anal or vaginal sex in the last three months. In this study, we further restricted to people who had sex with male partners in the last three months. Participants were classified into three groups: engaged in sex only with regular partners, engaged in sex only with casual partners and engaged in sex with both regular partners and casual partners.

          Results

          Participants were recruited from 32 provinces in China. Among 1057 participants, 451(42.7%), 217(20.5%), and 389(36.8%) engaged in sex with regular partners only, casual partners only and both types in the last three months, respectively. Men engaged in sex only with regular partners in the last three months had a higher condom use self-efficacy than with other two types of partners ( P < 0.01). Both social norms (regular partners: adjusted OR:1.59, 95% CI: 0.97–2.60; casual partners: adjusted OR: 1.58, 95% CI: 1.19–2.09; both types: adjusted OR: 1.48, 95% CI: 1.13–1.95) and self-efficacy (regular partners: adjusted OR: 2.88, 95% CI: 1.59–5.22; casual partners: adjusted OR: 2.35, 95% CI: 1.69–3.26; both types: adjusted OR: 2.45, 95% CI: 1.81–3.32) were positively associated with consistent condom use. No interaction effect was detected between condom social norms and self-efficacy on consistent condom use among Chinese MSM ( p > 0.05).

          Conclusions

          Both social norms and self-efficacy were positively correlated with consistent condom use with any types of partners among Chinese MSM. Tailored interventions that aimed to improve social norms and self-efficacy has the potential to improve overall condom use among Chinese MSM.

          Trial registration

          ClinicalTrials.gov: NCT02516930. August 6, 2015.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-018-6090-5) contains supplementary material, which is available to authorized users.

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          Most cited references 47

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          Development and validation of a condom self-efficacy scale for college students.

           K Beck,  L Brafford (1991)
          This study proposed to develop and validate a scale for the college population that measures self-efficacy in using condoms. The Condom Use Self-Efficacy Scale (CUSES) was derived from several sources and consisted of 28 items describing an individual's feelings of confidence about being able to purchase condoms, put them on and take them off, and negotiate their use with a new sexual partner. This scale was administered to a sample of 768 college students. It was found to possess adequate reliability (Cronbach's alpha = .91; test-retest correlation = .81) and correlated well with the Attitude Toward the Condom Scale (r = .51) and the Contraceptive Self-Efficacy Scale for women (r = .55). Our scale also correlated with a measure of intention to use condoms (r = .40) but was unrelated to a measure of social desirability. Students who differed on measures of previous condom use as well as on sexual intercourse experience also showed significant differences on this scale in the expected direction, indicating evidence of this scale's discriminant validity. The potential uses of this scale in a college population are discussed, along with the issues underlying condom usage self-efficacy.
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            Norms, social networks, and HIV-related risk behaviors among urban disadvantaged drug users.

            Altering norms may be an important approach to introducing and sustaining health protective behavior change. This study sought to examine the relationship between condom use, condom norms, and social network characteristics among a sample of economically impoverished individuals at risk for acquiring and transmitting HIV. Participants were 1051 individuals from a drug-using community in the USA. Eighty percent were current drug users; 17% were HIV seropositive. Reported condom use was strongly associated with peer norms about condom use (friends talking about condoms, encouraging condom use, and using condoms). Women were less likely than men to report that their friends used condoms. Injection drug use was negatively associated with peer norms about condom use, while church attendance and network characteristics were positively associated with condom-promoting norms. The size of the health advice and the financial support networks was most positively related to condom norms. Network methodology may aid in the identification of specific ties that promote condom use norms in a population. The findings of this study may have implications for norm change interventions among disadvantaged communities at high risk for HIV/AIDS.
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              Crowdsourcing HIV Test Promotion Videos: A Noninferiority Randomized Controlled Trial in China.

              Crowdsourcing, the process of shifting individual tasks to a large group, may enhance human immunodeficiency virus (HIV) testing interventions. We conducted a noninferiority, randomized controlled trial to compare first-time HIV testing rates among men who have sex with men (MSM) and transgender individuals who received a crowdsourced or a health marketing HIV test promotion video.
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                Author and article information

                Contributors
                wangcheng090705@163.com
                jdtucker@med.unc.edu
                chuncheng@seshglobal.org
                zhhpf@hotmail.com
                weimingtangscience@gmail.com
                lingli@mail.sysu.edu.cn
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                16 October 2018
                16 October 2018
                2018
                : 18
                Affiliations
                [1 ]ISNI 0000 0000 8877 7471, GRID grid.284723.8, Dermatology Hospital, , Southern Medical University, ; Guangzhou, China
                [2 ]Guangdong Center for Skin Diseases and STI Control, Guangzhou, China
                [3 ]University of North Carolina at Chapel Hill Project-China, Guangzhou, China
                [4 ]SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
                [5 ]ISNI 0000000122483208, GRID grid.10698.36, School of Medicine of University of North Carolina at Chapel Hill, ; Chapel Hill, USA
                [6 ]ISNI 0000 0001 2360 039X, GRID grid.12981.33, Faculty of Medical Statistics and Epidemiology, School of Public Health, , Sun Yat-sen University, ; Guangzhou, China
                6090
                10.1186/s12889-018-6090-5
                6192108
                30326880
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000060, National Institute of Allergy and Infectious Diseases;
                Award ID: 1R01AI114310
                Funded by: University of North Carolina(UNC)–South China STD Research Training Centre
                Award ID: 1D43TW009532
                Funded by: Center for AIDS Research, University of North Carolina at Chapel Hill (US)
                Award ID: 5P30AI050410
                Funded by: National Center for Advancing Translational Sciences at the National Institutes of Health
                Award ID: UL1TR001111
                Funded by: National Key Research and Development Program of China
                Award ID: 2017YFE0103800
                Funded by: Applied Basic Research Key Project of Yunnan (CN)
                Award ID: QD2017N030,C1034448
                Funded by: UNC CFAR
                Award ID: P30 AI50410
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

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