{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T04:12:54Z","timestamp":1772079174090,"version":"3.50.1"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"China Family Planning Association"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Gay, bisexual and other men who have sex with men (GBMSM) college students in China have unique sexual health challenges, including a higher risk of HIV infection, stigma and discrimination against LGBTQ (lesbian, gay, bisexual, transgender, and queer) population, and limited access to LGBTQ-affirmative sexual health support. Nonetheless, previous research or policymaking has rarely addressed the students\u2019 needs for sexual health support from their perspectives. This study aims to explore GBMSM college students\u2019 perceptions and attitudes to current sexual health resources, the challenges they encounter, and their expectations to acquiring LGBTQ-affirmative sexual health information and services. The exploration was carried out through field visits and in-depth interviews with 26 GBMSM college students and eight relevant stakeholders in five cities in China. Qualitative thematic analysis was applied to the interview transcripts and fieldwork memos. Four themes emerged around the preference and needs of GBMSM students in dealing with their sexual health challenges: the association between tackling sexual health challenges and entering LGBTQ communities, the roles of emotional attachment in shaping the preference for HIV-related care and support, the desired modes of acquiring sexual health support, and the current unmet service needs. We discovered that the information-and-care-seeking behaviors of GBMSM college students are highly influenced by and connected to their participation in online and in-person LGBTQ communities. Due to the overall stigmatizing sociocultural environment of LGBTQ in China, GBMSM college students tend to rely on LGBTQ communities, seeking trust and a sense of belongingness for tackling their sexual health challenges. Conventional school-based sexual health educational programs, which often apply top-down, stigma-and-fear-based, and non-LGBTQ-inclusive teaching strategies, rarely help GBMSM college students to solve sexual health problems in real life. GBMSM college students are eager to have LGBTQ-affirmative \"health managers\" who can understand their emotional experiences and interpersonal contexts and assist them with sexual health issues. However, such support is generally perceived as limited by the students. Our study highlights these unmet needs of the GBMSM students and emphasizes the importance of developing future LGBTQ-affirmative sexual health programs among Chinese GBMSM college students and young GBMSM in general.<\/jats:p>","DOI":"10.1371\/journal.pone.0291550","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T17:35:57Z","timestamp":1695231357000},"page":"e0291550","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["\u201cThey have their own people\u201d: Emotional connections, community belonging, and Chinese gay, bisexual and other men who have sex with men (GBMSM) college students\u2019 needs for sexual health support"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3120-8181","authenticated-orcid":true,"given":"Minhui","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunyan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiyue","family":"Zou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-186X","authenticated-orcid":true,"given":"Kun","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,9,20]]},"reference":[{"key":"pone.0291550.ref001","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s11904-019-00471-4","article-title":"History of the HIV epidemic in China.","volume":"16","author":"Z Wu","year":"2019","journal-title":"Current HIV\/AIDS Reports"},{"issue":"1","key":"pone.0291550.ref002","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/S1473-3099(17)30711-9","article-title":"Learning about HIV the hard way: HIV among Chinese MSM attending university","volume":"18","author":"H Zou","year":"2018","journal-title":"The Lancet Infectious Diseases"},{"issue":"1","key":"pone.0291550.ref003","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11904-019-00479-w","article-title":"Addressing minority stress and mental health among men who have sex with men (MSM) in China.","volume":"17","author":"S Sun","year":"2020","journal-title":"Current Hiv\/aids Reports"},{"issue":"1","key":"pone.0291550.ref004","first-page":"1","article-title":"The prevalence of HIV among MSM in China: a large-scale systematic analysis.","volume":"19","author":"M-J Dong","year":"2019","journal-title":"Ye Q-nBMC infectious diseases."},{"issue":"1","key":"pone.0291550.ref005","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s10461-015-1135-6","article-title":"Non-disclosure of sexual orientation to parents associated with sexual risk behaviors among gay and bisexual MSM in China.","volume":"20","author":"Y Zhao","year":"2016","journal-title":"AIDS and Behavior"},{"issue":"2","key":"pone.0291550.ref006","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s10461-019-02471-2","article-title":"HIV testing among Chinese men who have sex with men: the roles of HIV knowledge, online social life, and sexual identity concerns","volume":"24","author":"S Sun","year":"2020","journal-title":"AIDS and Behavior"},{"issue":"7","key":"pone.0291550.ref007","doi-asserted-by":"crossref","first-page":"e311","DOI":"10.1016\/S2468-2667(18)30098-7","article-title":"The growing threat of China\u2019s HIV epidemic","volume":"3","author":"S. Zheng","year":"2018","journal-title":"The Lancet Public Health"},{"issue":"5","key":"pone.0291550.ref008","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1080\/09540121.2018.1497768","article-title":"Reducing distress and promoting resilience: a preliminary trial of a CBT skills intervention among recently HIV-diagnosed MSM in China","volume":"30","author":"JP Yang","year":"2018","journal-title":"AIDS care"},{"issue":"9","key":"pone.0291550.ref009","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1080\/09540121.2019.1601677","article-title":"Association between perceived HIV stigma, social support, resilience, self-esteem, and depressive symptoms among HIV-positive men who have sex with men (MSM) in Nanjing, China.","volume":"31","author":"H Yan","year":"2019","journal-title":"Aids Care"},{"issue":"1\u20132","key":"pone.0291550.ref010","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/17441692.2014.881520","article-title":"HIV testing as prevention among MSM in China: the business of scaling-up.","volume":"9","author":"EL Fan","year":"2014","journal-title":"Global public health."},{"key":"pone.0291550.ref011","volume-title":"2014 China AIDS Response Progress Report.","author":"NHC_PRC","year":"2014"},{"issue":"23","key":"pone.0291550.ref012","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1097\/CM9.0000000000001842","article-title":"Prevention and control of HIV\/AIDS in China: lessons from the past three decades","volume":"134","author":"J Xu","year":"2021","journal-title":"Chinese medical journal"},{"key":"pone.0291550.ref013","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/B978-0-08-097086-8.10247-8","article-title":"Sexual minorities in China","volume":"2","author":"D. Wong","year":"2015","journal-title":"International encyclopedia of the social & behavioral sciences."},{"issue":"10","key":"pone.0291550.ref014","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1080\/13691058.2019.1666429","article-title":"Exploring the role of LGBT-affirming churches in health promotion for Black sexual minority men.","volume":"22","author":"JJ White","year":"2020","journal-title":"Culture, health & sexuality."},{"issue":"6","key":"pone.0291550.ref015","doi-asserted-by":"crossref","first-page":"e0178736","DOI":"10.1371\/journal.pone.0178736","article-title":"Culture, social networks and HIV vulnerability among men who have sex with men in Indonesia.","volume":"12","author":"NK Fauk","year":"2017","journal-title":"PloS one"},{"issue":"7","key":"pone.0291550.ref016","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1007\/s10461-021-03567-4","article-title":"Relational Factors and HIV Testing Practices: Qualitative Insights from Urban Refugee Youth in Kampala, Uganda.","volume":"26","author":"CH Logie","year":"2022","journal-title":"AIDS and Behavior"},{"issue":"2","key":"pone.0291550.ref017","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology.","volume":"3","author":"V Braun","year":"2006","journal-title":"Qualitative research in psychology."},{"key":"pone.0291550.ref018","first-page":"2013","article-title":"Access to basic HIV-related services and PrEP acceptability among men who have sex with men worldwide: barriers, facilitators, and implications for combination prevention","author":"G Ayala","year":"2013","journal-title":"Journal of sexually transmitted diseases"},{"issue":"5","key":"pone.0291550.ref019","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1177\/1557988318779737","article-title":"The intention of men who have sex with men to participate in voluntary counseling and HIV testing and access free condoms in Indonesia.","volume":"12","author":"NK Fauk","year":"2018","journal-title":"American Journal of Men\u2019s Health"},{"key":"pone.0291550.ref020","first-page":"0020872820940018","article-title":"The health and well-being of LGBTQ people in mainland China: The role of social work.","author":"Y Li","year":"2020","journal-title":"International Social Work."},{"issue":"11","key":"pone.0291550.ref021","first-page":"448","article-title":"Prejudice, stigma, and social discrimination: perceived barriers in HIV prevention and control among men who have sex with men in China.","volume":"4","author":"W Tang","year":"2014","journal-title":"J Clin Case Rep"},{"issue":"10","key":"pone.0291550.ref022","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1089\/apc.2018.0061","article-title":"Predictors of recent HIV testing among Chinese men who have sex with men: a barrier perspective","volume":"32","author":"W Xu","year":"2018","journal-title":"AIDS patient care and STDs"},{"issue":"1","key":"pone.0291550.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-018-3379-0","article-title":"Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the theoretical domains framework and COM-B model.","volume":"18","author":"C Cassidy","year":"2018","journal-title":"BMC health services research."},{"issue":"1","key":"pone.0291550.ref024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-8195-x","article-title":"Community perspectives on barriers and challenges to HIV pre-exposure prophylaxis access by men who have sex with men and female sex workers access in Nigeria.","volume":"20","author":"G Emmanuel","year":"2020","journal-title":"BMC Public Health"},{"key":"pone.0291550.ref025","first-page":"1","article-title":"HIV and mental health among young people in low-resource contexts in Southeast Asia: A qualitative investigation.","author":"PA Newman","year":"2021","journal-title":"Global Public Health."},{"issue":"2","key":"pone.0291550.ref026","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s10461-021-03412-8","article-title":"The young men and media study: A pilot randomized controlled trial of a community-informed, online HIV prevention intervention for 14\u201317-Year-old sexual minority males","volume":"26","author":"KM Nelson","year":"2022","journal-title":"AIDS and Behavior"},{"issue":"8","key":"pone.0291550.ref027","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.2105\/AJPH.2015.302614","article-title":"Moving beyond biomedicalization in the HIV response: implications for community involvement and community leadership among men who have sex with men and transgender people","volume":"105","author":"P Aggleton","year":"2015","journal-title":"American Journal of Public Health"},{"issue":"2","key":"pone.0291550.ref028","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1080\/14681811.2015.1088434","article-title":"Vernacular knowledge and critical pedagogy: conceptualising sexual health education for young men who have sex with men.","volume":"16","author":"AJ Martos","year":"2016","journal-title":"Sex Education"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T17:36:31Z","timestamp":1695231391000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291550"}},"subtitle":[],"editor":[{"given":"Nelsensius Klau","family":"Fauk","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,9,20]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0291550","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,20]]}}}