Joseph T F Lau

The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Publications (252)732.05 Total impact

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    ABSTRACT: Mental health problems are prevalent among drug users. Methadone maintenance treatment (MMT) is an evidence-based effective treatment for drug addiction; however, there are few studies investigating depression, suicidal ideation, and their related factors among MMT users. In this cross-sectional study, 648 MMT users were recruited from six MMT clinics in Guangzhou, China. Data were collected through face-to-face interviews by trained interviewers. Of all participants, 270 (42.7%) exhibited probable depression (Depression Subscale of the Chinese short version of Depression, Anxiety, and Stress Scale (DASS-D), score ≥ 10) and 99 (15.3%) reported having suicidal ideation in the last six months. After adjusting for significant socio-demographic characteristics, all studied variables, including drug use history, social support, family support for MMT use, and satisfaction toward MMT services were significantly associated with both probable depression and suicidal ideation in the last six months. Furthermore, depression fully mediated the associations between drug use history, satisfaction toward MMT services, and suicidal ideation. In the final multivariate models, probable depression was associated with social support (OR = 0.88, 95% CI = 0.83-0.93) and satisfaction toward MMT services provided by doctors (OR = 0.59, 95% CI = 0.40-0.86), while for suicidal ideation, social support (OR = 0.85, 95% CI = 0.78-0.92) and probable depression (OR = 5.94, 95% CI = 3.39-10.42) were significant. The findings suggest that there are unmet mental health needs among MMT users. For countries with limited resources of psychological services, mental health care toward MMT users should be implanted into current health care settings and incorporate components such as social support, family's understanding of MMT, and service satisfaction.
    No preview · Article · Feb 2016 · AIDS Care
  • Joseph T. F. Lau · Phoenix K. H. Mo · Jing Gu · Chun Hao · CoCo H. Y. Lai
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    ABSTRACT: This study investigates event-specific factors that differentiate the last episodes of unprotected anal intercourse (UAI) from protected anal intercourse (PAI) with regular partner (RP) among 213 men who have sex with men (MSM) who did not use condoms consistently using case-crossover analysis. Factors positively associated with the last episode of UAI with RP included: two situational factors (i.e., participant's suggestion to have UAI, alcohol use) and three environmental/setting factors (i.e., sex took place overseas, during a weekday and not at home). Negative associations with an episode of UAI with RP included: five situational factors (i.e., discussion about condom use prior to sex, RP's suggestion to have PAI, participant's suggestion to have PAI, perception that RP would like to use a condom, participant's planning to use a condom) and two environmental/setting factors (i.e., condoms placed at the venue where sex took place, partner possessed a condom). Thus, these significant event-specific factors explained under which circumstances some MSM would use and would not use condoms during anal sex with RP.
    No preview · Article · Feb 2016 · AIDS Education and Prevention
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    ABSTRACT: Background: The HIV-epidemic among MSM in China has worsened. In this key population, prevalence of HSV-2 and syphilis infection and co-infection with HIV is high. Methods: A longitudinal study was conducted (n = 962) in Beijing, China, with three overlapping cohorts (n = 857, 757 and 760) consisting of MSM that were free from pairs of infections of concern (i.e. HIV-HSV-2, HIV-syphilis, HSV-2-syphilis) at baseline to estimate incidence of HIV, HSV-2, syphilis, and those of co-infection. Results: The incidence of HIV, HSV-2 and syphilis in the overall cohort was 3.90 (95% CI = 2.37, 5.43), 7.87 (95% CI = 5.74, 10.00) and 6.06 (95% CI = 4.18, 7.94) cases per 100 person-years (PYs), respectively. The incidence of HIV-HSV-2, HIV-Syphilis and HSV-2-Syphilis co-infections was 0.30 (95% CI = 0.29, 0.88), 1.02 (95% CI = 0.13, 2.17) and 1.41 (95% CI: 0.04, 2.78) cases per 100 PYs, respectively, in the three sub-cohorts constructed for this study. Conclusions: The incidence of HIV, HSV-2 and syphilis was very high and those of their co-infections were relatively high. Such co-infections have negative impacts on the HIV/STI epidemics. Prevention practices need to take such co-infections into account.
    Preview · Article · Jan 2016 · PLoS ONE
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    ABSTRACT: Fear appeal approach has been used in health promotion, but its effectiveness has been mixed. It has not been well applied to HIV prevention among men who have sex with men (MSM). The present study developed and evaluated the relative efficacy of three online interventions (SC: STD-related cognitive approach, SCFI: STD-related cognitive plus fear appeal imagery approach, Control: HIV-related information based approach) in reducing prevalence of unprotected anal intercourse (UAI) among 396 MSM using a randomized controlled trial design. Participants’ levels of fear-related emotions immediately after watching the assigned intervention materials were also assessed. Participants were evaluated at baseline and 3 months after the intervention. Results showed that participants in the SCFI scored significantly higher in the instrument assessing fear after the watching the intervention materials. However, no statistically significant differences were found across the three groups in terms of UAI at Month 3. Some significant within-group reductions in some measures of UAI were found in three groups. Further studies are warranted to test the role of fear appeal in HIV prevention.
    No preview · Article · Jan 2016 · AIDS and Behavior

  • No preview · Article · Jan 2016 · Emerging infectious diseases
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    ABSTRACT: HIV-positive men who have sex with men (HIVMSM) face severe stigma and high levels of stressors, and have high prevalence of mental health problems (e.g., depression and anxiety). Very few studies explored the role of positive psychological factors on mental health problems among HIVMSM. The present study investigated the prevalence of two mental health problems (anxiety and depression), and their associated protective (gratitude) and risk (enacted HIV-related stigma, and perceived stress) factors among HIVMSM in China. A cross-sectional survey was conducted among 321 HIVMSM in Chengdu, China, by using a structured questionnaire. Over half (55.8%) of the participants showed probable mild to severe depression (as assessed by the Center of Epidemiologic Studies Depression scale); 53.3% showed probable anxiety (as assessed by the General Anxiety Disorder scale). Adjusted logistic regression models revealed that gratitude (adjusted odds ratio (ORa = 0.90, 95% confidence intervals (95% CI) = 0.86-0.94) was found to be protective, whilst perceived stress (ORa = 1.17, 95% CI = 1.12-1.22) and enacted stigma (ORa = 7.72, 95% CI = 2.27-26.25) were risk factors of depression. Gratitude (ORa = 0.95, 95% CI = 0.91-0.99) was also found to be protective whilst perceived stress (ORa = 1.19, 95% CI = 1.14-1.24) was a risk factor of anxiety. Gratitude did not moderate the associations found between related factors and poor mental health. It is warranted to promote mental health among HIVMSM, as depression/anxiety was highly prevalent. Such interventions should consider enhancement of gratitude, reduction of stress, and removal of enacted stigma as potential strategies, as such factors were significantly associated with depression/anxiety among HIVMSM.
    No preview · Article · Dec 2015 · AIDS Care
  • P K H Mo · J T F Lau
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    ABSTRACT: The impact of influenza on elderly can be severe and fatal. Influenza vaccination (IV) has been shown to be effective in reducing influenza-related complications, but the IV uptake among elderly in Hong Kong remains low. This study investigated the prevalence and factors associated with IV among Chinese elderly in Hong Kong using the Health Belief Model (HBM). A total of 1101 Chinese elderly aged over 65 was randomly selected and completed a phone interview. Background information, experience of and intention to receive IV and IV-related knowledge and perceptions based on the HBM were measured. Results showed that 48.5 and 49.5% of the participants have ever been vaccinated and intended to receive IV, respectively. Female gender, having chronic disease, and participating in community activities were significantly associated with previous IV. Knowledge of the fact that IV is required every year, lower perceived side effect, IV price lower than HK$150, and recommendations from health care providers was associated with both previous IV and intention to be vaccinated in the next year. Interventions promoting IV among elderly should disseminate knowledge regarding the necessity of IV and correct misconceptions about the side effects of IV. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
    No preview · Article · Sep 2015 · Health Education Research
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    ABSTRACT: Physical inactivity is a strong risk factor of non-communicable diseases (NCD). In China, there are 250 million migrant factory workers, who are susceptible to physical inactivity and hence NCD because of work nature and setting. With random stratified sampling, 807 such workers of the light industry were recruited in Shenzhen, China and completed a self-administered questionnaire with informed consent. The prevalence of inadequate physical activity (defined according to the World Health Organization's recommendation on level of moderate/vigorous physical activity) was 95.4%. Of all participants, 69.1% showed "a very low level of physical activity" (VLLPA), defined as ≤30 minutes of weekly moderate/vigorous physical activity, which was significantly associated with female sex (Odds ratio [OR]=1.65), lower education level (OR=0.10 to 0.33, primary education as the reference group) and married status (OR=0.63, single status as the reference group). Adjusted for these factors, perceived social support (Adjusted OR=0.87) was negatively associated with VLLPA, while job stress due to workload, which was significant in the univariate analysis (OR=0.98), became non-significant (p=0.184). Significant interaction between perceived social support and perceived job stress onto VLLPA was found (p=0.044), implying that the negative association between job stress and VLLPA, which might reflect a potential response to cope with stress by performing exercises, was stronger among those with weaker social support. The extremely low level of physical activity rings an alarm, as it implies high risk of NCD, and as there are no existing programs promoting physical activity in this group. Interventions need to take into account social support, potential coping to job stress, and structural factors of the factory setting, while involving factories' management.
    Preview · Article · Aug 2015 · PLoS ONE
  • Anise M.S. Wu · Joseph T.F. Lau · Yee Ling · Mason M.C. Lau
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    ABSTRACT: Influenza results in severe complications among 24- to 59-month-old children, who are recommended by the WHO to take up influenza vaccination (IV) annually. Health promotion is warranted. Yet, there is a dearth of studies on IV prevalence and associated factors in this age group. A random population-based telephone survey interviewed 540 parents of Chinese children aged 24-59 months in Hong Kong in June, 2011. Constructs of the Health Belief Model (HBM) and subjective norm formed basis for assessing parental perceptions on influenza and IV. For data analysis, adjusted, and stepwise multiple logistic regression models were fit. The prevalence of having taken up at least one dose and two doses of IV among children aged 24-59 months was 58.9 and 42.4%, respectively. Significant associated factors included family members' IV experience (ORu=5.37, 95% CI: 3.48, 8.29), variables related to the HBM constructs (except perceived severity) [perceived susceptibility of seasonal influenza (ORu=2.03, 95% CI: 1.39, 2.95), perceived benefits of IV (ORu=3.11, 95% CI: 2.05, 4.71), perceived barriers (ORu=0.49, 95% CI: 0.25, 0.96) of IV, and cue to action (ORu=4.79, 95% CI: 2.87, 7.99)], supportive subjective norm (ORu=4.26, 95% CI: 2.91, 6.25), and level of fear felt during the H1N1 pandemic (ORu=1.97, 95% CI: 1.01, 3.87). Adjusted for the child's age, the same significant factors were found. Exposure to related media messages was statistically non-significant. The reported IV prevalence was higher than that of 24-59-month-old children reported in other studies. There is room for improvement through health promotion, which should modify parental cognitions related to HBM (except perceived severity and self-efficacy) and involve family members to create subjective norm. Media campaigns may be inadequate for promotion of IV; use of the setting approach may be considered. Copyright © 2015. Published by Elsevier Ltd.
    No preview · Article · Jun 2015 · Vaccine
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    ABSTRACT: This study investigated the associations between the variables of the theory of planned behavior (TPB), influence of significant others, and smoking intentions and behaviors among adolescents living in rural southern China. A cross-sectional study was conducted among 2609 students in two junior high schools in rural Shantou, Guangdong province, using a self-administered questionnaire. Logistic regression models were fitted to estimate univariate and adjusted odds ratios and corresponding 95% confidence intervals. Multivariate analyses showed that having favorable attitudes towards smoking on psychological and social aspects, perceived behavioral control, and having most friends who were current smokers were significantly associated with smoking intentions in the next six months and in the next five years. Having most family members who were current smokers was also significantly related to smoking intention in the next five years. Having favorable attitudes towards smoking on psychological aspect and negative attitudes on physical aspect, perceived support from friends on smoking, and having most friends and senior relatives being current smokers were significantly associated with increased likelihood of ever smoking. Perceived behavioral control and having most friends being current smokers were also significantly associated with regular smoking and smoking in the past 30days. Our results suggest that the key constructs of the TPB model and friends' smoking behaviors play important roles in accounting for smoking intentions and behaviors among a sample of rural Chinese adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Apr 2015 · Addictive behaviors
  • Joseph T F Lau · Dongliang Li · Zixin Wang · Coco H Y Lai
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    ABSTRACT: High risk MSM are recommended to take up HIV voluntary counseling and testing (VCT) once every 6 months. 809 HIV-negative MSM in Beijing, China entered the 18-month prospective cohort study; 228 joined an extended study at month 21. The majority (92.5 %) of the participants had taken up four rounds of VCT over the study period. HIV prevalence at months 0, 6, 12, 18 and 21 ranged from 2.5 to 6.3 %; HIV incidences for the four intervals between the five visits ranged from 5.00 to 14.28 per 100-person year. Despite experiencing repeated VCT, high levels of risk behaviors were reported at month 21. 18 % of the participants interviewed at month 21 self-reported increased in UAI and other risk behaviors, comparing recent and pre-baseline experiences. HIV transmission and risk behaviors had not been reduced by multiple rounds of VCT. Reasons behind apparent ineffectiveness and tailored repeated testing strategies need to be investigated.
    No preview · Article · Apr 2015 · AIDS and Behavior
  • Jinghua Li · Jing Gu · Joseph T.F. Lau · Hongyao Chen · Phoenix K.H. Mo · Mei Tang
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    ABSTRACT: People who inject drugs (PWID) have a high prevalence of mental health problems (e.g., depression) which compromise the effects of HIV prevention. We investigated the prevalence of depression and associated factors among PWID in Dazhou, China. Anonymous face-to-face interviews were administered to eligible participants by well-trained doctors. The Center of Epidemiological Studies Depression Scale (CES-D) was used to measure depression, using hierarchical linear regression models. Among the 257 participants, 7.0%, 11.3%, and 75.1% were probable cases of mild (16≤CES-D<21), moderate (21≤CES-D<25), and severe (CES-D≥25) depression, respectively. Hopefulness (standardized β=-0.34, p<0.001) and emotional family support (β=-0.21, p<0.001) were negatively associated, whereas severity of drug dependence (β=0.12, p=0.034) and unmet service needs (β=0.20, p<0.001) were positively associated, respectively, with CES-D scores. The adjusted analysis showed that resilience was negatively associated with CES-D, but it was not selected by the stepwise model containing hopefulness and emotional family support. Protective factors (i.e., hopefulness and emotional family support) and risk factors (i.e., severity of drug dependence and unmet service needs) remained significant in the same regression model. Protective and risk factors were independently associated with depressive symptoms. Integrated interventions covering basic and psychosocial needs for PWID are warranted. Such interventions should strengthen emotional family support and cultivate positive factors such as hopefulness. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Apr 2015 · Drug and alcohol dependence
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    Dongliang Li · Chunrong Li · Zixin Wang · Joseph T F Lau
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    ABSTRACT: The HIV prevalence and incidence among men who have sex with men (MSM) in China are high. Unprotected anal intercourse (UAI) with a regular male sex partner (RP), a significant predictor of HIV sero-conversion, was high yet under-emphasized among MSM having RP (MSMRP). The present cross-sectional survey interviewed 307 HIV negative MSMRP recruited through convenient sampling from multiple sources, including venue-based outreaching, online recruitment, and referrals made by peers, in Beijing and Chengdu, China. Among MSMRP, the prevalence of UAI with RP in the last three months was 52.4%. The results of the multivariate analysis showed that trust and intimacy within the relationship with RP and presence of clinical depression symptoms were positively associated with UAI with RP in the last three months. Other associated scalar factors derived from the Theory of Planned Behavior were related to perceptions on condom use, including positive attitudes toward condom use (a negative association), subjective norm of the perception that MSM do not usually use condoms during anal intercourse with RP (a positive association), perceived behavioral control over condom use with RP (a negative association), and behavioral intention to use condoms with RP in the coming three months (a negative association). It is seen that MSMRP were at high risk of HIV/STD transmission. The associated factors hence involved those related to perceptions about condom use, mental health, and interpersonal relationship. Future interventions should take these multi-dimensional factors into account. In particular, future research to test the efficacy of couple-based interventions that include mental health elements needs to be conducted, as trust and intimacy within the relationship were associated with UAI among MSMRP, and mental health problems may exist for both the MSMRP and their RP.
    Preview · Article · Mar 2015 · PLoS ONE
  • Zixin Wang · Tiejian Feng · Joseph T F Lau
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    ABSTRACT: Voluntary medical male circumcision (VMMC) is an evidence-based biomedical HIV prevention method. It is under-utilized in countries outside Africa, including China. The present single-arm, non-blinded test-of-concept trial was designed to promote VMMC among 179 male sexually transmitted diseases patients (MSTDP) in Shenzhen, China. It was based on behavioral health theories and results of a formative survey. At month 4, 45.5 % of the MSTDP responded positively to the intervention (19.9 % had taken up VMMC and 25.6 % intended to do so in the next 6 months). Adjusted analysis showed that cognitive variables measured at baseline (perceived self-efficacy, subjective norm and behavioral intention) significantly predicted adoption of VMMC during the 4-month follow-up period. Process evaluation involving clinicians of the STD clinics was positive. At month 6, 36.0 % of the circumcised participants used condom less frequently with their regular sex partner. We recommend scaling up the intervention, taking prevention of risk compensation into account.
    No preview · Article · Mar 2015 · AIDS and Behavior
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    Jing Gu · Joseph T F Lau · Zixin Wang · Anise M S Wu · Xuhui Tan
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    ABSTRACT: HIV antibody testing is a key measure of HIV prevention for men who have sex with men (MSM). The World Health Organization recommends sexually active and at-risk MSM to take up HIV antibody testing regularly. This study aimed to investigate the prevalence of behavioral intention to take up HIV antibody testing in the next six months among Hong Kong MSM who were ever-testers. An anonymous cross-sectional survey recruited 326 MSM who had taken up HIV antibody testing from gay-friendly venues and internet in Hong Kong. Of the participants, 40.8% had had unprotected anal intercourse with regular or non-regular male sex partners in the last six months; they were at risk of HIV transmission despite experience in HIV antibody testing. Only 37.2% showed a strong intention to take up HIV antibody testing again in the next six months. Adjusted analysis showed that both perceived discrimination toward Hong Kong MSM (AOR = .60, 95% CI: .36-.98) and the CARE Measure assessing perceived empathy of service providers (AOR = 1.05, 95% CI: 1.02-1.08) were significantly associated with intention for retesting. Perceived discrimination, however, became statistically non-significant (AOR = .68, 95% CI: .41-1.14), when both CARE Measure and perceived discrimination entered into the adjusted model. It is warranted to increase HIV retesting rate by removing perceived discrimination and reducing the negative effect of perceived discrimination through enhancement of empathy of service providers.
    Preview · Article · Feb 2015 · PLoS ONE
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    ABSTRACT: Background: Inhaled nitrites are commonly used by men who have sex with men (MSM) in western countries. As such compounds are not illicit, they are widely available in China. Recent studies have documented a high prevalence of inhaled nitrites use in this population. Methods: Snowball sampling was used to recruit 576 MSM in Beijing, China, who completed an anonymous face-to-face interview. Results: Of the participants, 49.8% had heard of "Rush" or "inhaled nitrites". The prevalence of use in the last three months was 28.3% among all participants and 56.8% among those with awareness about the compounds. A stepwise model found that age group (26-35 years old, ORm= 3.91; ≤ 25 years old, ORm = 3.05; reference group: >35 years old, P < 0.01) and multiple male sex partnerships (ORm = 2.29, P < 0.01) were associated with inhaled nitrites use. Adjusted for these two variables, constructs based on the Health Belief Model (HBM) were significantly associated with inhaled nitrites use in the last three months: Perceived Severity Scale [Adjusted Odds Ratios (AOR) = 0.72, P < 0.001], the Perceived Benefit Scale (AOR = 1.20, P < 0.001), the Perceived Barrier Scale (AOR = 0.81, P < 0.01), the Cue to Action Scale (AOR = 1.45, P < 0.001), and the Perceived Self-efficacy Scale (AOR = 0.71, P < 0.001). Conclusions: The prevalence of inhaled nitrites use was high. It may further increase sharply among MSM in China when awareness becomes more common. Cognitive variables derived from the HBM provided a useful framework for designing interventions at structural, inter-personal and individual levels. Policy changes should also be considered.
    No preview · Article · Jan 2015 · Drug and Alcohol Dependence
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    ABSTRACT: The Illness Perception Questionnaire-Revised (IPQ-R) has commonly been used to measure illness representations of various diseases. The present study examined whether the original factor structure of the IPQ-R could be confirmed or a new structure could be established on substance dependence among injecting drug users (IDU) in China. A total of 257 IDU completed the 38-item IPQ-R on substance dependence. Results of confirmatory factor analysis (CFA) showed that the 7-factor structure as proposed by the original IPQ-R reported poor goodness-of-fit statistics. Although removal of 12 items improved the model fit, the goodness-of-fit statistics were still below acceptable standards. Furthermore, factors obtained from the exploratory factor analysis (EFA) of the IPQ-R were not interpretable. The CFA found that the original IPQ-R factor structure fit the data poorly. Factors derived from EFA were also not interpretable. Use of the IPQ-R for assessment of illness representations of substance dependence among IDU in China is cautioned until further validation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Jan 2015 · Drug and Alcohol Dependence
  • Phoenix K H Mo · Jing Gu · Joseph T F Lau · Hua You
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    ABSTRACT: Sexually transmitted disease (STD) increases risk of HIV infection and has profound psychological consequences. The present study examined the mental health problems (poor emotional well-being, insomnia, probable depression) and their associated factors among monogamous Chinese female STD patients. A total of 537 Chinese female STD patients who self-reported having had only one male sex partner in the last 12 months were recruited from a STD clinic in Hong Kong. They completed a survey including measures of mental health, STD-related history, perceptions, feelings related to STD infection, and perceptions toward condom use. Results showed that 22% had poor emotional well-being, 25.7% had insomnia, and 43% were probable cases of depression. Unemployment, worsened relationship with partners after STD diagnosis, STD history in last three months, finding STD examinations embarrassing, and feelings of helplessness were significant risk factors for poor emotional well-being and insomnia. Also, unemployment, worsened relationships with partners after STD diagnosis, and perceived high chance of STD in the coming six months were significant risk factors for probable depression. Perceived efficacy of condom use for STD prevention was a significant protective factor against poor emotional well-being and probable depression. Findings suggest that interventions are warranted to improve the mental health among this population.
    No preview · Article · Nov 2014 · AIDS Care
  • Anise M S Wu · Joseph T F Lau
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    ABSTRACT: AimsThis paper provides an overview of gambling issues in China, including historical development, governmental responses and social consequences.Methods Based on materials written in Chinese or English available at academic databases and other online resources, historical, cultural and policy analyses were conducted. The focus is on mainland China, but reference is made to Hong Kong and Macao to illustrate differences.ResultsThroughout Chinese history, gambling was strictly prohibited by law. In contrast, small-stakes betting for entertainment instead of monetary gain, defined as ‘gaming’ in this paper, has been culturally acceptable and tolerated by governments. After banning gambling for three decades, the Chinese government attempts to meet public demand for ‘gaming’ and to confine gambling to ‘gaming’ by issuing national lotteries. In response to increased economic wealth, gambling opportunities were allowed to develop, but were restricted to Macao. Social problems such as illegal and youth gambling are, however, emerging. The ‘gaming’ perception may predispose Chinese individuals to wagering activities and increase the risk of gambling disorder, which has been widely seen as misconduct rather than a mental disorder. Currently, the country has a dearth of gambling research and limited prevention and rehabilitation services, almost none at national level.ConclusionsA distinction between small-stakes ‘gaming’ and large-stakes ‘gambling’, which has cultural roots, plays an important role in relevant governmental policies and social responses in mainland China. Gambling disorder prevention and treatment is not yet on the national agenda. The country's knowledge and services gaps on gambling problems need to be filled out.
    No preview · Article · Sep 2014 · Addiction
  • Jing Gu · Joseph T.F. Lau · Mingqiang Li · Haochu Li · Qi Gao · Xianxiang Feng · Yu Bai · Chun Hao · Yuantao Hao
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    ABSTRACT: Objective Female injection drug users who are also sex workers (FSW-IDUs) occupy a pivotal population in HIV transmission, whereas their mental health problems are largely overlooked. We aimed to investigate prevalence and associated socio-ecological factors of depression, suicidal ideation and suicidal attempts among FSW-IDUs in China. Methods Using snowball sampling methods, 200 FSW-IDUs were recruited from communities in Liuzhou, China. Anonymous face-to-face interviews were administered by trained doctors. Results Thirty-nine percent of participants had severe or extremely severe depression, 44.7% had suicidal ideation in the last six months and 26.8% had suicidal attempts in the last six months. After adjusting for background variables, self-stigma was significantly associated with severe or extremely severe depression (OR = 1.18, 95% CI: 1.07-1.31). Self-stigma (OR = 1.08, 95% CI: 1.01-1.15), depression (OR = 1.11, 95% CI: 1.05-1.18), having completely broken up with family (OR = 2.60, 95% CI: 1.35-5.02) and having been abused by clients or gatekeepers (OR = 2.15, 95% CI: 1.32-3.50) were associated with suicidal ideation in the last six months, while self-stigma (OR = 1.03, 95% CI: 1.10-1.16), depression (OR = 1.12, 95% CI: 1.04-1.20) and being abused by clients or gatekeepers (OR = 2.15, 95% CI: 1.09-4.24) were associated with suicidal attempt in the last six months. In mediation analyses, the associations between self-stigma and the two suicidal outcomes were fully mediated by depression. Conclusions There are unmet mental health needs of FSW-IDUs. Screening of mental health problems should be integrated into current HIV-related services. Psychological intervention efforts should include components such as self-stigma, family support and abuse.
    No preview · Article · Sep 2014 · Drug and Alcohol Dependence

Publication Stats

6k Citations
732.05 Total Impact Points

Institutions

  • 1992-2016
    • The Chinese University of Hong Kong
      • • The Jockey Club School of Public Health and Primary Care
      • • Department of Public Health
      • • Faculty of Medicine
      • • Center for Clinical Trials and Epidemiological Research
      Hong Kong, Hong Kong
  • 2010-2015
    • Sun Yat-Sen University
      • • School of Public Health
      • • Department of Anthropology
      Shengcheng, Guangdong, China
  • 2007
    • The University of Hong Kong
      Hong Kong, Hong Kong
  • 1992-2007
    • Prince of Wales Hospital, Hong Kong
      Chiu-lung, Kowloon City, Hong Kong
  • 2002
    • University of Wolverhampton
      • School of Sport, Performing Arts and Leisure
      Wolverhampton, England, United Kingdom
  • 1997
    • Princess Margaret Hospital, Hong Kong
      Hong Kong, Hong Kong
  • 1995
    • Oxford University Hospitals NHS Trust
      Oxford, England, United Kingdom