Skip to main content

Advertisement

SpringerLink
Log in

Perceptions of HPV, Genital Warts, and Penile/Anal Cancer and High-Risk Sexual Behaviors Among Men Who Have Sex with Men in Hong Kong

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

The prevalence of HIV and HPV is high among men who have sex with men (MSM) in China. It is unclear whether cognitive and affective responses related to HPV and HPV-related diseases are negatively associated with HIV-related risk behaviors among MSM. This cross-sectional study interviewed 449 adult Chinese MSM in Hong Kong. The prevalence of unprotected anal intercourse (UAI) and having had anal sex with more than one man in the last 6 months (multiple male sex partnerships) was 39.0 and 71.3 %, respectively. After adjusting for four significant background variables (education level, cohabitation with a man, exposure to HIV prevention materials, and HIV voluntary counseling and testing), variables negatively associated with UAI and/or multiple male sex partnerships included (1) correct HPV-related knowledge (AOR = 0.48–0.66), (2) perceived susceptibility (AOR = 0.32–0.55) and perceived severity (AOR = 0.12–0.60) related to HPV and HPV-related diseases, and (3) fear towards contracting genital warts and penile/anal cancer (AOR = 0.40–0.55). Perceived high chance of contracting HPV was positively associated with multiple partnerships (AOR = 4.74). It is possible to reduce HIV-related risk behaviors by increasing levels of knowledge, cognitions, and fear related to HPV and related diseases. It is important to integrate prevention of HIV with prevention of sexually transmitted infections. Such interventions are warranted.

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

  • Ajzen, I. (1991). The theory of planned behavior. Organization Behavior and Human Decision Process, 50, 179–211.

    Article  Google Scholar 

  • Akin, A. (2012). The relationships between Internet addiction, subjective vitality, and subjective happiness. Cyberpsychology Behavior and Social Networking, 15, 404–410.

    Article  Google Scholar 

  • Barr, E., & Sings, H. L. (2008). Prophylactic HPV vaccines: New interventions for cancer control. Vaccine, 26, 6244–6257.

    Article  PubMed  Google Scholar 

  • Belcher, L., Sternberg, M. R., Wolitski, R. J., Halkitis, P., & Hoff, C. (2005). Condom use and perceived risk of HIV transmission among sexually active HIV-positive men who have sex with men. AIDS Education and Prevention, 17, 79–89.

    Article  PubMed  Google Scholar 

  • Berg, R. C. (2008). Barebacking among MSM Internet users. AIDS and Behavior, 12, 822–833.

    Article  PubMed  Google Scholar 

  • Centre for Health Protection. (2009). Facesheet: HIV/AIDS situation in Hong Kong 2009. Retrieved from http://www.aidsdatahub.org/en/hong-kong-sar-reference-library/item/11555-factsheet-hiv/aids-situation-in-hong-kong-2009-special-preventive-programme-centre-for-health-protection-department-of-health-hong-kong-2009.

  • Davis, R. A., Flett, G. L., & Besser, A. (2002). Validation of a new scale for measuring problematic internet use: Implications for pre-employment screening. Cyberpsychology & Behavior, 5, 331–345.

    Article  Google Scholar 

  • Dietz, C. A., & Nyberg, C. R. (2011). Genital, oral, and anal human papillomavirus infection in men who have sex with men. Journal of American Osteopathic Association, 111(3 Suppl. 2), S19–S25.

    Google Scholar 

  • Feng, L., Ding, X., Lu, R., Liu, J., Sy, A., Ouyang, L., … Zhao, J. (2009). High HIV prevalence detected in 2006 and 2007 among men who have sex with men in China’s largest municipality: An alarming epidemic in Chongqing, China. Journal of Acquired Immune Deficiency Syndrome, 52, 79–85.

  • Feng, Y., Wu, Z., Detels, R., Qin, G., Liu, L., Wang, X., … Zhang, L. (2010). HIV/STD prevalence among men who have sex with men in Chengdu, China and associated risk factors for HIV infection. Journal of Acquired Immune Deficiency Syndrome, 53(Suppl. 1), S74–S80.

    Google Scholar 

  • Fennema, J. S., van Ameijden, E. J., Coutinho, R. A., & van den Hoek, A. A. (1995). HIV, sexually transmitted diseases and gynaecologic disorders in women: Increased risk for genital herpes and warts among HIV-infected prostitutes in Amsterdam. AIDS, 9, 1071–1078.

    Article  PubMed  Google Scholar 

  • Galvin, S. R., & Cohen, M. S. (2004). The role of sexually transmitted diseases in HIV transmission. Nature Review Microbiology, 2, 33–42.

    Article  Google Scholar 

  • Guo, H., Wei, J. F., Yang, H., Huan, X., Tsui, S. K., & Zhang, C. (2009). Rapidly increasing prevalence of HIV and syphilis and HIV-1 subtype characterization among men who have sex with men in Jiangsu, China. Sexually Transmitted Diseases, 36, 120–125.

    Article  PubMed  Google Scholar 

  • Hershey, J. H., & Velez, L. F. (2009). Public health issues related to HPV vaccination. Jounal of Public Health Management and Practice, 15, 384–392.

    Article  Google Scholar 

  • Hong Kong Special Administrative Region of China. (2008). PRiSM-HIV prevalence and risk behavioural survey of men who have sex with men in Hong Kong 2006. Retrieved from http://www.info.gov.hk/aids/english/surveillance/sur_report/prism2006e.pdf.

  • Hong, F. C., Zhou, H., Cai, Y. M., Pan, P., Feng, T. J., Liu, X. L., et al. (2009). Prevalence of syphilis and HIV infections among men who have sex with men from different settings in Shenzhen, China: Implications for HIV/STD surveillance. Sexually Transmitted Infections, 85, 42–44.

    Article  PubMed  Google Scholar 

  • Huebner, D. M., Neilands, T. B., Rebchook, G. M., & Kegeles, S. M. (2011). Sorting through chickens and eggs: A longitudinal examination of the associations between attitudes, norms, and sexual risk behavior. Health Psychology, 30, 110–118.

    Article  PubMed Central  PubMed  Google Scholar 

  • Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: A decade later. Health Education Quarterly, 11, 1–47.

    Article  PubMed  Google Scholar 

  • Jiang, J., Cao, N., Zhang, J., Xia, Q., Gong, X., Xue, H., … Shao, C. (2006). High prevalence of sexually transmitted diseases among men who have sex with men in Jiangsu Province, China. Sexually Transmitted Diseases, 33, 118–123.

  • Lau, J. T., Cai, W., Tsui, H. Y., Chen, L., Cheng, J., Lin, C., … Hao, C. (2012). Unprotected anal intercourse behavior and intention among male sex workers in Shenzhen serving cross-boundary male clients coming from Hong Kong, China: Prevalence and associated factors. AIDS Care, 24, 59–70.

  • Lau, J. T., Lau, M., Cheung, A., & Tsui, H. Y. (2008). A randomized controlled study to evaluate the efficacy of an Internet-based intervention in reducing HIV risk behaviors among men who have sex with men in Hong Kong. AIDS Care, 20, 820–828.

    Article  PubMed  Google Scholar 

  • Lau, J. T., Siah, P. C., & Tsui, H. Y. (2002). A study of the STD/AIDS related attitudes and behaviors of men who have sex with men in Hong Kong. Archives of Sexual Behavior, 31, 367–373.

    Article  PubMed  Google Scholar 

  • Leventhal, H. (1971). Fear appeals and persuasion: The differentiation of a motivational construct. American Journal of Public Health, 61, 1208–1224.

    Article  PubMed Central  PubMed  Google Scholar 

  • Levina, M., Dantas, G., Fishbein, M., von Haeften, I., & Montano, D. (2001). Factors influencing MSMs’ intentions to always use condoms for vaginal, anal and oral sex with their regular partners. Psychology, Health & Medicine, 6, 191–206.

    Article  Google Scholar 

  • Lin, C., Lau, J. T., Ho, K. M., Lau, M. C., Tsui, H. Y., & Lo, K. K. (2010). Incidence of genital warts among the Hong Kong general adult population. BMC Infectious Diseases, 10, 272.

    Article  PubMed Central  PubMed  Google Scholar 

  • Liu, H., Wang, N., Zhang, Q., Shao, Y., Wu, T., Liu, Y., et al. (2007). Study of HIV and syphilis infection situation and sexual behavioral characteristics among 416 MSM. Chinese Journal of AIDS & HIV, 13, 230–234.

    Google Scholar 

  • Ma, X., Zhang, Q., He, X., Sun, W., Yue, H., Chen, S., … McFarland, W. (2007). 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. Journal of Acquired Immune Deficiency Syndrome, 45, 581–587.

  • MacKellar, D. A., Valleroy, L. A., Secura, G. M., Behel, S., Bingham, T., Celentano, D. D., … Torian, L. V. (2007). Perceptions of lifetime risk and actual risk for acquiring HIV among young men who have sex with men. AIDS and Behavior, 11, 263–270.

  • Mahoney, M. C. (2006). Protecting our patients from HPV and HPV-related diseases: The role of vaccines (pp. 10–17). Suppl: Journal of Family Practice.

    Google Scholar 

  • Manhart, L. E., & Koutsky, L. A. (2002). Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis. Sexually Transmitted Diseases, 29, 725–735.

    Article  PubMed  Google Scholar 

  • Reiter, P. L., Brewer, N. T., McRee, A. L., Gilbert, P., & Smith, J. S. (2010). Acceptability of HPV vaccine among a national sample of gay and bisexual men. Sexually Transmitted Diseases, 37, 197–203.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ruan, Y., Jia, Y., Zhang, X., Liang, H., Li, Q., Yang, Y., … Shao, Y. (2009b). Incidence of HIV-1, syphilis, hepatitis B, and hepatitis C virus infections and predictors associated with retention in a 12-month follow-up study among men who have sex with men in Beijing, China. Journal of Acquired Immune Deficiency Syndrome, 52, 604–610.

  • Ruan, Y., Li, D., Li, X., Qian, H. Z., Shi, W., Zhang, X., … Shao, Y. (2007). Relationship between syphilis and HIV infections among men who have sex with men in Beijing, China. Sexually Transmitted Diseases, 34, 592–597.

  • Ruan, S., Yang, H., Zhu, Y., Wang, M., Ma, Y., Zhao, J., … Raymond, H. F. (2009a). Rising HIV prevalence among married and unmarried among men who have sex with men: Jinan, China. AIDS and Behavior, 13, 671–676.

  • Ruiter, R., Verplanken, B., De Cremer, D., & Kok, G. (2004). Danger and fear control in response to fear appeals: The role of need for cognition. Basic and Applied Social Psychology, 24, 13–24.

    Article  Google Scholar 

  • Schutz, M., Godin, G., Kok, G., Vezina-Im, L. A., Naccache, H., & Otis, J. (2011). Determinants of condom use among HIV-positive men who have sex with men. International Journal of STD and AIDS, 22, 391–397.

    Article  PubMed  Google Scholar 

  • Simatherai, D., Bradshaw, C. S., Fairley, C. K., Bush, M., Heley, S., & Chen, M. Y. (2009). What men who have sex with men think about the human papillomavirus vaccine. Sexually Transmitted Infections, 85, 148–149.

    Article  PubMed  Google Scholar 

  • Smerecnik, C. M., & Ruiter, R. A. (2010). Fear appeals in HIV prevention: The role of anticipated regret. Psychology, Health & Medicine, 15, 550–559.

    Article  Google Scholar 

  • Tsui, H., Lau, J. T., Xiang, W., Gu, J., & Wang, Z. (2012). Should associations between HIV-related risk perceptions and behaviors or intentions be positive or negative? PLoS ONE, 7, e52124.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wang, Z., Lau, J. T., & Gu, J. (2012a). Acceptability of circumcision among clients of female sex workers in Hong Kong. AIDS and Behavior, 16, 1836–1845.

    Article  PubMed  Google Scholar 

  • Wang, Z., Lau, J. T., Hao, C., Yang, H., Huan, X., Yan, H., et al. (2012b). Syphilis-related perceptions not associated with risk behaviors among men who have sex with men having regular male sex partner(s) in Nanjing, China. AIDS Care. doi:10.1080/09540121.2012.748166.

    Google Scholar 

  • Wheldon, C. W., Daley, E. M., Buhi, E. R., Nyitray, A. G., & Giuliano, A. R. (2011). Health beliefs and attitudes associated with HPV vaccine intention among young gay and bisexual men in the southeastern United States. Vaccine, 29, 8060–8065.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2011). Retrieved from http://edition.cnn.com/2011/10/25/health/hpv-vaccine/index.html.

  • Xinhuanet. (2009). HIV incidence among gays increase fast in China. Retrieved from http://news.xinhuanet.com/english/2008-2011/content_10427717.htm.

  • Xu, J. J., Zhang, M., Brown, K., Reilly, K., Wang, H., Hu, Q., … Shang, H. (2010). Syphilis and HIV seroconversion among a 12-month prospective cohort of men who have sex with men in Shenyang, China. Sexually Transmitted Diseases, 37, 432–439.

  • Yang, H., Hao, C., Huan, X., Yan, H., Guan, W., Xu, X., … Lau, J. T. (2010). HIV incidence and associated factors in a cohort of men who have sex with men in Nanjing, China. Sexually Transmitted Diseases, 37, 208–213.

  • Zhang, X., Yu, J., Li, M., Sun, X., Han, Q., Zhou, F., … Gao, L. (2011). Prevalence and related risk behaviors of HIV, syphilis, and anal HPV infection among men who have sex with men from Beijing, China. AIDS and Behavior, 17, 1129–1136.

  • Zhong, F., Lin, P., Xu, H., Wang, Y., Wang, M., He, Q., … Zhao, J. (2011). Possible increase in HIV and syphilis prevalence among men who have sex with men in Guangzhou, China: Results from a respondent-driven sampling survey. AIDS and Behavior, 15, 1058–1066.

Download references

Acknowledgments

This study was funded by Merck Sharp & Dohme (Asia) Ltd. (MSD ref: IISP 37671).

Author information

Authors and Affiliations

  1. Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Joseph T. F. Lau, Zixin Wang, Mason Lau & Coco H. Y. Lai

  2. Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China

    Joseph T. F. Lau

Authors
  1. Joseph T. F. Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zixin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mason Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Coco H. Y. Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph T. F. Lau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lau, J.T.F., Wang, Z., Lau, M. et al. Perceptions of HPV, Genital Warts, and Penile/Anal Cancer and High-Risk Sexual Behaviors Among Men Who Have Sex with Men in Hong Kong. Arch Sex Behav 43, 789–800 (2014). https://doi.org/10.1007/s10508-013-0172-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-013-0172-3

Keywords

Search

Navigation