prior to conducting the interviews, all interviewers underwent extensive training in interview techniques, building rapport, and ensuring confidentiality. the assessment of public hiv stigma involved seven items.
the evaluation of public homosexual stigma encompassed 10 items. self-homosexual stigma was gauged using eight items.
higher scores on these measurement scales indicated a greater perceived level of hiv and homosexual stigma. the cronbach coefficient alpha stood at 0.
all measures are available upon request from the authors. the measurement of individualism and collectivism utilized a scale adapted from those developed by triandis and chirkov et al.
horizontal individualism was assessed through eight items. an example item is, "i do not care about what others think." vertical individualism was evaluated using seven items.
an example item is, "i do not like to fall behind others." vertical collectivism was measured with six items. horizontal collectivism was assessed through five items.
respondents were asked to indicate their level of agreement with these items using a 5-point likert-type scale, ranging from 1 (strongly disagree) to 5 (strongly agree).
the total score for each dimension was calculated by summing the scores for all relevant items. social support perceived by homosexual men from sexual partners and non-sexual-partner peers (such as family members, teachers, classmates, colleagues, and villagers) was measured using six items.
respondents rated the likelihood of receiving social support on a scale from 0 (not possible at all) to 4 (quite sure).
the total score for each source of perceived social support was determined by summing the scores for all individual items. participants were questioned about their frequency of condom use during the preceding six months.
the frequency of condom use was categorized into two groups: consistent condom use (using condoms for every sexual act) and inconsistent condom use (not using condoms for every sexual act).
pearson correlation coefficients were calculated to describe the strength of associations among the variables of interest. path analytic modeling was employed to examine the hypothesized interrelationships as depicted in fig.
standardized coefficients β were estimated for all paths.
a total of homosexual men were recruited and interviewed for the study. sixteen participants were excluded from the analysis due to missing data on condom use, resulting in a final sample of homosexual men. sixty-five percent of the homosexual men had attained a high school education or higher.
sixty-one percent reported consistently using condoms for every sexual encounter in the past six months.
table 1 presents the means, standard deviations, and correlations for the variables incorporated into the path analytic model. some correlations exhibited statistical significance. although these correlations were statistically significant, the correlation coefficients ranged from small to moderate in magnitude, suggesting that the original hypothesized path model might not be an ideal fit for the data.
the hypothesized model depicted in fig.
was based on the relationship paths presented. the values for rmsea, tli, and cfi were 0. additionally, we attempted to incorporate two paths from perceived social support (either from sexual partners or non-sexual-partner peers) to condom use.
the revised model, referred to as the final model, is illustrated in fig.
this study lends support to the notion that collectivism and individualism can influence public and self-homosexual stigma, which, in turn, can affect homosexual men's decisions regarding hiv prevention practices and their pursuit of social support.
while the interrelationships among cultural factors, stigma, social support, and protected sex are intricate, understanding these dynamics may facilitate the development of more effective hiv prevention interventions for homosexual men.
to the best of our understanding, this study is the first quantitative investigation to examine these interrelationships among homosexual men.
this research confirms earlier findings regarding the coexistence of both individualistic and collectivist orientations within chinese culture.
the results indicated that chinese homosexual men with higher levels of vertical collectivism tend to experience greater levels of both public and self-homosexual stigma.
individuals who are oriented towards vertical collectivism typically defer to the authority of the in-group and willingly make sacrifices for their peers within the network.
consequently, they may perceive a higher degree of stigma. furthermore, heavily influenced by confucianism, taoism, and buddhism, chinese culture emphasizes not only egalitarianism but also shared responsibility and sacrifice. the societal rejection of homosexuality may lead homosexual men to feel that they are losing face or damaging group values.
an unexpected finding was the lack of association between horizontal collectivism and homosexuality-related stigma.
individuals oriented towards horizontal collectivism tend to integrate themselves with their in-groups. they may not perceive a high degree of stigma if their in-group peers are also homosexual men.
however, further research, particularly using a qualitative approach, is needed to elucidate why this association is absent.
the study revealed a positive association between vertical individualism and self-homosexual stigma, while horizontal individualism was positively associated with public homosexual stigma.
one might assume that homosexual men with high levels of individualism would be unconcerned with stigma associated with their homosexuality.
a possible explanation for these findings is that individualism-oriented homosexual men may feel that their desire for uniqueness or their pursuit of self-accomplishment is challenged by the larger collectivist community, where homosexual behavior is not accepted and homosexuality-related stigma is prevalent.
they may experience marginalization because both individualism and homosexuality are not aligned with their social or cultural environment, where collectivism is dominant.
this marginalization may provoke stigma among homosexual men, as their uniqueness and status are neither valued nor accepted by their community, and consequently, by themselves.
while hiv-related stigma did not correlate with consistent condom use, public homosexual stigma was inversely related to condom use.
even when hiv-related stigma was removed from the model, public homosexual stigma remained inversely associated with consistent condom use. hiv-related stigma may not be a primary concern for homosexual men because they are aware that the majority of their peers are not infected with hiv.
the primary reason individuals stigmatize and discriminate against people living with hiv is their disapproval of the behaviors or practices through which individuals become infected.
in a society that ostracizes homosexuals, these men may opt for practices that reduce the likelihood of revealing their sexual identity.
fear of disclosing their homosexuality and facing subsequent discrimination may prevent homosexual men from participating in hiv intervention programs, thereby limiting their exposure to prevention messages.
liu and choi reported that some homosexual men may avoid safer sex practices or decline health outreach services (even when offered free of charge) to conceal their sexual identity.
the study's findings suggest that hiv intervention programs targeting homosexual men should incorporate strategies for preventing or reducing homosexuality-related stigma.
for example, educational programs aimed at community members, promoting understanding and tolerance towards homosexuality (similar to those used in hiv-related stigma programs), could be particularly beneficial.
reducing public homosexual stigma may also lead to a decrease in self-homosexual stigma by diminishing discriminatory attitudes within the community.
homosexual men with high levels of self-homosexual stigma reported receiving more social support from their sexual partners, but not from non-sexual-partner peers.
it is possible that homosexual men are hesitant to seek social support from non-sexual-partner peers due to concerns about rejection, particularly in a collectivist society where homosexuality is disapproved of and stigmatized.
however, they may seek support from their sexual partners, who likely share similar sexual issues and concerns, can be trusted, and offer support without stigmatizing them.
this finding aligns with a study indicating that individuals who face social stigma tend to seek support from others who share similar circumstances.
these peer support groups can also serve as platforms for disseminating messages about the importance of condom use during all sexual encounters, utilizing the popular opinion leader strategy, which involves identifying, training, and enlisting key opinion leaders within specific populations to educate others in their group.
several limitations should be acknowledged in this study.
first, the study participants were recruited from shenzhen city, which may not be representative of all cities in china. therefore, generalizing these findings to other populations of homosexual men should be done with caution.
since this study employed a cross-sectional design, the findings should be interpreted as associations rather than causal relationships.
reverse relationships can occur in cross-sectional studies; however, this may not be a significant issue in this study given the nature of the variables being analyzed.
nevertheless, future studies are needed to improve the reliability of the sub-scales. these findings enhance our understanding of how individualism and collectivism influence stigma, how stigma affects decisions related to hiv protective behaviors, and how stigma alters perceived social support among homosexual men.
given the potential impact of individualistic and collectivist cultures on stigma and safer sex practices, the development of hiv interventions for homosexual men should consider the specific characteristics of chinese culture, and preventing homosexuality-related stigma should be a crucial component of these programs.
this research was funded by a research grant (rgat) from the foundation for aids research (amfar).
we extend our gratitude to all participants for generously contributing their time and data to the study. search pmc full-text archive, search in pmc journal list, user guide. new: try this search in pmc beta search.
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published in final edited form as: stigma res action.
doi: chinese culture, homosexuality stigma, social support and condom use: a path analytic model hongjie liu, phd. virginia commonwealth university school of medicine, richmond, va, usa.
find articles by hongjie liu. tiejian feng, md. shenzhen center for chronic disease control and prevention, shenzhen, china.
find articles by tiejian feng. toan ha, phd. virginia commonwealth university school of medicine, richmond, va, usa. the difficulty in framing this type of violence and in claiming the needs of lala women poses an existential challenge to many grassroots lala groups, which consist only of volunteers and have no source of income.
this analytical perspective highlights the ways in which the contemporary transnational lgbt movement and politics remain dominated by white gay male leaders due to colonial and patriarchal legacies.
while it is crucial to outline the historical and strategic differences between gay and lala activism, the political-economic analysis of what shapes the forms and politics of lgbt activism must be considered.
the divergence in strategies, and even hostility between these groups, can also be explained by a conflict of interests as they compete for funding and resources within the ngo industry.
national and local politics, as well as funding sources, are key factors that influence the processes of ngo-isation.
donors, whether they are state actors or foundations, define and shape ngo agendas by framing program calls in ways that establish specific norms while marginalizing others.
the ngo-isation of lgbt activism in china is clearly linked to transnational lgbt networks, funding resources, and evaluation metrics.
new forms of colonialism and neoliberal thinking persist in philanthropic giving by favoring and funding projects that are politically oriented (such as legal advocacy) rather than community-oriented programs that are more challenging to evaluate.
on the other hand, chinese lgbt activists are addressing the unequal giving relationships in their own ways.
organizations like parents and friends of lesbians and gays (pflag) adopt a pragmatic approach that aligns with core national and family values by emphasizing narratives of family inclusion and social tolerance, and they solicit funding from the parents of gay men and lalas.
a select few queer organizations focus on arts and culture.
as ngos with educational and language privileges seek funding from transnational human rights networks, numerous rights-based lgbt ngos have been established by activists motivated by the rhetoric of human rights and the legal inclusion of lgbt people in china over the past decade.
participants in human rights projects are expected to have advanced english writing and speaking abilities, as well as a firm grasp of the administrative and strategic aspects of human rights knowledge, including the framework and methodology for documenting human rights violations, composing shadow reports, and advocating in international forums such as the united nations, while also coordinating domestic advocacy efforts.
in reality, only a handful of ngos possess the necessary capabilities to receive such funding.
disparities in education levels and proficiency in the english language contribute to the uneven distribution of human rights funding, favoring large and elite groups in cosmopolitan cities like beijing and guangzhou.
the regional lala organization where i worked in guangzhou from organized a series of human rights training sessions intended to equip grassroots activists with the knowledge needed to utilize the international mechanisms of the convention on the elimination of all forms of discrimination against women.
law professors and experienced feminist activists were invited to train the queer activists.
because the majority of grassroots activists were not professionalized and were struggling to balance full-time jobs with unpaid activism, many expressed limited interest in international advocacy.
at best, they contributed data on human rights violations to a large and elite group that could then access these international venues.
this dynamic reinforces regional inequality, as professionalized ngos gain greater recognition in the international sphere and attract more funding as a result of their advocacy efforts.
chinese feminists and lgbt activists have been particularly attentive to the role of international advocacy in pressuring the chinese government to implement its gender equality policies and acknowledge lgbt issues domestically.
even if the promises made by the party-state are not always fulfilled, activists still consider these commitments a success for future advocacy.
his comments were a response to a report by victor madrigal-borloz, the independent expert on sexual orientation and gender identity, which documented two successful antidiscrimination lawsuits in china.
these cases highlighted the existence of effective legislative measures to protect the human rights of lgbt individuals in china.
the first case involved a favorable verdict against a company in guizhou province that had discriminated against an employee based on their sexual orientation.
the second case involved a court ruling against forced conversion therapy in henan province. in both instances, local lgbt ngos coordinated to provide legal aid to the individuals in filing lawsuits against unfair discrimination and violence.
over the past decade, lgbt human rights advocacy has achieved some success internationally, increasing the global visibility of chinese lgbt communities.
the foreign ngo management law is a clear attempt by the chinese party-state to curb the influence and impact of foreign ngos and foundations, as well as to restrain domestic organizations with close transnational ties.
this clearly indicates that chinese authorities view these domestic and international organizations primarily as a public security concern.
the lack of official recognition and status for lgbt ngos stems largely from strict registration requirements and their inability to find a supervisory unit to represent them. this forces many organizations to register as commercial enterprises without tax benefits, making them vulnerable to political crackdowns.
under the new law, lgbt ngos lose their only available funding source: support from transnational partners.
for the first time, two organizations working on lgbt issues were listed, signaling that illegalization is both a material and symbolic act. by declaring ngos that do not adhere to official mandates illegal, the party-state sends a clear message to the broader civil society about the limits of acceptable behavior under its rule.
this divide-and-conquer strategy effectively disaggregates and demoralizes the ngo community.
ngos become reluctant to express dissenting opinions or organize collectively when other organizations face danger or harassment. in recent years, several lgbt groups have successfully transitioned into social work organizations focused on adolescent and community issues.
these mainstream topics allow them to apply for government funding and programs.
while adapting their missions has been arduous, their ultimate goal is to subtly incorporate concepts of gender diversity into their work. local governments often undervalue ngo work, expecting organizations to maximize their efforts with minimal financial compensation.
ngos strategically comply with these unfavorable conditions, viewing it as a necessary step toward accessing government resources and gaining approval in the future.
however, as political spaces continue to shrink, fellow lgbt activists are reassessing these tactics.
it is still too early to determine whether these strategies will enable lgbt ngos to survive and continue their original missions. chinese lgbt ngos have come a long way, facing challenges due to unequal transnational collaborations, hostile state interventions, and internal conflicts.
influenced by euro-american identity politics, mainstream lgbt activism in china actively negotiates with chinese national constructs and ideals of family and normativity, adopting pragmatist politics of social tolerance and acceptance, as well as a reformist approach similar to their western counterparts, including campaigns for marriage equality and other human rights advocacy efforts.
a critical analysis of the ngo-isation process, human rights projects, and gendered issues within the sector requires an expansive vision of social movements that prioritize community care.
beyond focusing on economic and political notions of precarity, examining the affective dimensions of social movements highlights the personal and felt experiences of activism.
stephanie yingyi wang is an assistant professor of gender and sexuality studies at st. lawrence university.
she graduated from the university of washington, where she earned her phd in feminist studies. read more. made in china publications are open access and always available for free download.
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journal, books, syllabi, podcast, events, about us, contact, submissions, calls for papers, guidelines. made in china journal article unfinished revolution: an overview of three decades of lgbt activism in china.
unfinished revolution: an overview of three decades of lgbt activism in china written on july 15. author: stephanie yingyi wang made in china: then and now january-april towards a politics of care chinese lgbt ngos have come a long way, their journey fraught with tensions due to unequal transnational collaborations, hostile state interventions, and internal splits.
pc: cc liang hh, flickr.
in this essay, lgbt is used when referring to lgbt activism because it is deeply influenced by euro-american identity politics. additionally, queerness aims to deconstruct the stableness of the identity categories of lgbt. references: engebretsen, elisabeth l.
queer women in urban china: an ethnography.
new york, ny: routledge. guangzhou civil affairs bureau. hildebrandt, timothy.