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Supernatural Explanatory Models of Health and Illness and HIV Antiretroviral Therapy Use Among Young Men Who Have Sex with Men in China

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Abstract

Background

In China, men who have sex with men (MSM) shoulder a disproportionate HIV burden. Early initiation and adherence to HIV antiretroviral therapy (ART) will be critical to reversing the HIV epidemic in China, but ART usage remains suboptimal among MSM diagnosed with HIV. One understudied but potentially important factor underpinning suboptimal ART usage is personal belief in supernatural explanatory models of health and illness (supernatural explanatory models). This study examines associations between beliefs in supernatural explanatory models and ART usage among MSM in China.

Method

In 2017, an online survey was distributed nationwide throughout China by gay community–based organizations. Eligible study participants were self-identified MSM between 16 and 30 years old who had tested positive for HIV and who had seen a doctor in the last 2 years. Beliefs in supernatural explanatory models were measured using a three-item scale developed specifically for the Chinese population (range, 3–15).

Results

Of 73 participants, the majority were currently using ART (83.6%) and 42.5% expressed some endorsement of belief in supernatural explanatory models. However, among 21 participants with the strongest belief in supernatural explanatory models, prevalence of current ART usage was 61.9%. Stronger belief in supernatural explanatory models was significantly associated with lower likelihood of current ART usage (adjusted odds ratio = 0.52; 95% confidence interval = 0.13–0.75).

Conclusion

Belief in supernatural explanatory models may be a powerful predictor of ART usage among MSM living with HIV in China. Further studies are needed to corroborate these findings and elucidate mechanisms of association.

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Funding

This study was funded by the National Institutes of Allergy and Infectious Diseases (grant numbers NIAD1R01AI114310 and NIAID K24AI143471), Fogarty International Center (grant numbers 1D43TW009532 and R25TW009340), and Shenzhen Chronic Disease Hospital. Funders had no role in the study design; collection, analysis, or interpretation of data; writing of the articles; or decision to submit for publication.

Author information

Authors and Affiliations

  1. Department of Health and Environmental Sciences – ES345, Xi’an Jiaotong-Liverpool University, 111 Ren’ai Road, Suzhou Dushu Lake Higher Education Town, Suzhou, 215123, Jiangsu, China

    Stephen W. Pan

  2. UNC-Project China, Guangzhou, China

    Stephen W. Pan, M. Kumi Smith, Jason J. Ong, Wenting Huang, Weiming Tang & Joseph D. Tucker

  3. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    M. Kumi Smith

  4. School of Public Policy, University of California, Riverside, CA, USA

    Richard M. Carpiano

  5. Department of Sociology, University of California, Riverside, CA, USA

    Richard M. Carpiano

  6. Center for Healthy Communities, University of California, Riverside, CA, USA

    Richard M. Carpiano

  7. Eastern Virginia Medical School, Norfolk, VA, USA

    Hongyun Fu

  8. Central Clinical School, Monash University, Clayton, Victoria, Australia

    Jason J. Ong

  9. Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK

    Jason J. Ong & Joseph D. Tucker

  10. School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Weiming Tang & Joseph D. Tucker

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  1. Stephen W. Pan
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  6. Wenting Huang
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  7. Weiming Tang
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Corresponding author

Correspondence to Stephen W. Pan.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Pan, S.W., Smith, M.K., Carpiano, R.M. et al. Supernatural Explanatory Models of Health and Illness and HIV Antiretroviral Therapy Use Among Young Men Who Have Sex with Men in China. Int.J. Behav. Med. 27, 602–608 (2020). https://doi.org/10.1007/s12529-020-09883-8

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  • DOI: https://doi.org/10.1007/s12529-020-09883-8

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