Chinese culture, homosexuality stigma, social support, and condom use: A path analytic model

Hongjie Liu, Tiejian Feng, Toan Ha, Hui Liu, Yumao Cai, Xiaoli Liu, Jian Li


Purpose: The objective of this study was to examine the interrelationships among individualism, collectivism, homosexuality-related stigma, social support, and condom use among Chinese men who have sex with men.

Methods: A cross-sectional study using the respondent-driven sampling approach was conducted among 351 eligible men who have sex with men in Shenzhen, China. Path analytic modeling was used to analyze the interrelationships.

Results: The results of path analytic modeling document the following statistically significant associations: (1) higher levels of vertical collectivism were associated with higher levels of public homosexual stigma [β (standardized coefficient) = 0.12] and self homosexual stigma (β = 0.12); (2) higher levels of vertical individualism were associated with higher levels self homosexual stigma (β = 0.18); (3) higher levels of horizontal individualism were associated with higher levels of public homosexual stigma (β = 0.12); (4) higher levels of self homosexual stigma were associated with higher levels of social support from sexual partners (β = 0.12); and (5) lower levels of public homosexual stigma were associated with consistent condom use (β = -0.19).

Conclusions: The findings enhance our understanding of how individualist and collectivist cultures influence the development of homosexuality-related stigma, which in turn may affect individuals’ decisions to engage in HIV-protective practices and seek social support. Accordingly, the development of HIV interventions for men who have sex with men in China should take the characteristics of Chinese culture into consideration.



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