This qualitative study purports to explore the prevailing phenomenon of ‘Chem-Fun’, i.e. the combination of drug use and gay sex in the Hong Kong gay community, with the use of in-depth interviews (March 2012 to August 2013 [n=30]), participant observation (February 2012 to July 2013 [18 months]), and textual analysis of two gay websites (March to April 2012 [2 months]). By pinpointing the two loopholes of epidemiological dominance and missing drug in the local drug and local gay literature respectively, this study adopts a cultural approach to fill the gap in which the crucial elements of agency, pleasure, and context are examined. Drawing on the three theoretical strands of postmodern intimacies, geographies of sexuality, and Foucauldian notion of power/resistance, a four-dimensional analytical model has been derived from the data to explore the four major aspects of ‘Chem-Fun’: contexts, spaces, intimacies, and subjectivities. Instead of viewing ‘Chem-Fun’ as a ‘trinity of double’, i.e. double sin (moral/ legal sin), double epidemic (drug addiction and HIV/STDs infection), and double marginalization (from straight/gay world) but rather a ‘way of life’, this study argues that ‘Chem-Fun’ should be understood as a specific form of gay choices, gay project, gay connection, and gay mastery. For contexts, the emergence, prevalence, and transformation of ‘Chem-Fun’ represent a mixture of glocalized and personalized product revolving around the community culture and individual choices, i.e. gay choices. For spaces, the ‘Chem-space’ constitutes a ‘do-it-yourself project’ for the gay men to undermine the dominations of heteronormativity, health imperialism, and homonormativity and hence reclaim their selves and uses of pleasure, i.e. gay project. For intimacies, the intimate ethics of pure eroticism or the ‘RCTF’ culture (respect, collectivity, trust, and flexibility) demonstrates the three principles of emotional democracy (egalitarianism, autonomy, and solidarity) and cultivates an alternative political agenda of gay hedonism, i.e. gay connection. For subjectivities, the refashioning of ‘Chem-Fun’ as an edgework suggests the complicated subjectivities of playmates, i.e. gay mastery. Informed by the cultural approach, these four aspects have painted an alternative picture about ‘Chem-Fun’ in contrast with the epidemiological way of understanding. They are not necessarily a passive, fixed, and pathological retreatist but an arch-inventor, sensation-seeker, and edgeworker to build their own life. Without ignoring the relevant risks, this study gives pleasure an adequate space to understand ‘Chem-Fun’. As a form of queer life, ‘Chem-Fun’ is not just about personal experiences but also collectivities that implies the possible way out of local tongzhi movement from gay pride to gay shame. In this sense, there should be ‘Chem-Fun’ stories but not story. Apart from filling the missing gay and missing drug in local drug and gay study respectively, this research contributes to the sociology of sexuality by connecting the individual intoxicated eroticism to the runaway world of social flows, engaging with the existing concepts to explore the postmodern lives and geographies in the non-Western context, enriching the telling sexual stories tradition, and serving as a methodological remedy for the inadequacy of ethnography or insider perspective in examining drug-related practices in Hong Kong. / published_or_final_version / Sociology / Doctoral / Doctor of Philosophy

In the past decade, the rising incidence of human immunodeficiency virus (HIV) in men who have sex with men (MSM) calls for targeted epidemiological investigations. However, the approach of most current epidemiological studies might be inadequate for characterising transmission risks of MSM, as they focus largely on the practice of risk behaviours in population context and have assumed a homogeneous distribution of such behaviours and their resultant risks in HIV transmission. A study investigating the networking pattern of MSM, in addition to their sexual behaviour, was therefore proposed to re-examine HIV epidemiology in Hong Kong and model HIV transmission dynamics. / Following literature review on network analyses conducted in MSM, it was found that the use of two-mode network data for constructing sexual affiliation network had not been widely applied. Such two-mode network approach could be more feasible in describing sexual structure of MSM, who are connected by their preferred social venues. To adopt this approach, a two-part study, composing a field survey and a modelling study, was performed. A cross-sectional questionnaire survey was conducted between January and April 2013 to obtain data about sex-networking venues and associated behavioural profiles of MSM in Hong Kong. Comparisons of networking patterns, risk behaviour and demographics between MSM in different networks, delineated by two-mode network analysis, were made. Based on the survey data and assumptions derived from other network-based and behavioural studies, HIV transmission dynamics was simulated by building a stochastic agent-based model. / In the field survey, a total of 932 respondents were recruited from physical venues (n=625), including nine bars and six saunas, and the Internet (n=307). The proportion of MSM using condom for every anal sex with casual partners met in physical venues was 66.6% (225/338), while that for partners met in the Internet was 62.6% (139/222). Only 51.5% (204/396) MSM always used condom while having anal sex with regular partners. Community detection by networks of social venues identified nine clusters of MSM from three network bases. The simulation model gave a median number of new HIV infections over a 5-year period at 83 per 1000 MSM. The median numbers of annual infections ranged between 14 and 20. In over 30% of MSM networked through the Internet, having regular sex partners or practising receptive anal sex, more than 50 infections out of 500 iterations could occur in the model simulation, suggesting their higher risk of HIV infection. / In conclusion, the modelling results suggested that HIV transmission in Hong Kong might have occurred largely between regular partners. The potential impact of local sex-networking pattern through social venues with casual partners on HIV transmission is relatively little and indirect. To prevent HIV from spreading into new networks, intervention shall be targeted at MSM having unprotected anal sex with regular partners and seeking casual partners in social venues, especially through the Internet. Network approach in HIV epidemiology, such as collection of network-based data from HIV-infected MSM as part of surveillance, and assessing the network configuration from time to time, shall also be considered. / 過去十年間，透過同性性行為感染愛滋病病毒的個案持續上升，令針對男男性接觸者的流行病學研究顯得重要。現時大部分相關研究都假設所涉行為和相應的傳染風險是平均分佈於研究人群中，採用這研究方法去了解男男性接觸者間的病毒傳播風險明顯有所不足。有鑑於此，本研究透過了解男男性接觸者的社交網絡模式及其風險行為，重新審視本地愛滋病病毒感染的流行病學狀況及設計相關模型，用以了解病毒的傳播及流行規律。 / 探討過往文獻發現，雖然二模網絡能勾劃出男男性接觸者與其結識性伴侶的社交場所間的關係，卻未被廣泛應用於流行病學研究。本研究採納二模網絡的分析方法，並分兩部分進行。實地調查部分於二零一三年一月至四月期間進行，透過問卷收集本港男男性接觸者結交性伴侶的場所及相關性行為等資料，並比較其網絡模式、風險行為及人口特徵。建模研究部分則是利用調查所得之數據及參考其他研究去建立模型，用以模擬愛滋病病毒的傳播規律。 / 問卷調查從九間酒吧、六間桑拿及互聯網中，招募了九百三十二位受訪者參與研究。受訪者中，每次肛交均使用安全套的比率因性伴侶的種類而異，比率介乎百分之五十二至六十七。透過分析三種社交場所的網絡結構，本港男男性接觸者社群共可分為九個群組。由模擬模型得知，五年間新增的愛滋病病毒感染個案為八十三宗（每千人計），而相應的年度感染數字則介乎十四至二十宗。從五百次模擬運算中，發現超過三成透過互聯網結識性伴侶或擁有固定性伴侶的男男性接觸者與及受體肛交者的感染次數多於五十次，顯示其較高的愛滋病病毒感染風險。 / 總括而言，研究發現本港愛滋病病毒的傳播多於固定性伴侶間發生。相反，透過本地社交場所結識非固定性伴侶的網絡模式只間接影響本港愛滋病病毒的散播。為有效預防愛滋病病毒散播，干預措施應針對有與固定伴侶進行不安全性行為及透過互聯網結識性伴侶的男男性接觸者，同時衛生部門亦可考慮將感染愛滋病病毒的男男性接觸者的網絡數據納入恆常監測及不時評估同志社群間的網絡結構。 / Poon, Chin Man. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 112-121). / Abstracts and appendix B also in Chinese. / Title from PDF title page (viewed on 07, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Teng, Yue. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (p. 33-38). / Abstract also in Chinese.

Introduction. The HIV prevalence among men who have sex with men (MSM) in China keeps increasing sharply. A high proportion of the MSM in China have male regular sex partner (RP) and prevalence of unprotected anal intercourse (UAI) involving such RP is higher than when non-RP is involved. Trust, intimacy and cognitive factors are the factors associated with UAI with RP. Several cross-sectional studies have been demonstrated the important factors associated with UAI with RP among MSM in China. However, no study about intervention for MSM-RP is found to be conducted. To reduce UAI with RP, an intervention tailored to RP is urgently developed and identified its efficacy. / Objectives. The study aimed to describe the prevalence of UAI, as well as of which associated factors among MSM-RP in Beijing and Chengdu, China, and to evaluate the efficacy of an enhanced HIV voluntary counseling and testing (VCT) in increasing condom use with RP among MSMRP in China by a randomized controlled trial (RCT). / Subjects and Methods. A cross-sectional survey and a randomized controlled trial have been conducted. For the cross-sectional survey, total 307 HIV negative MSM who have RP have been recruited by three ways. Face to face interview has been conducted to participants. Based on the associated factors found in the cross-sectional survey, interventions including video, education leaflets and enhanced counseling contents have been tailored to RP among MSMRP. For the randomized controlled trial, total 336 MSMRP have been recruited and randomly assigned 169 subjects to the Intervention Group in which participants have been given enhanced VCT plus an audio-visual and four leaflets components and 167 subjects to the Control Group in which participants have been given only standard-of-care VCT at the baseline. Evaluation was conducted at Month 3 and 6. Statistical methods such as descriptive analyses, Chi-square test and logistic regression were used in this study. / Results. The results have been found were the prevalence of UAI with RP among MSMRP was 52.4%, and the Theory of Planned Behavior (TPB) related cognitions, trust, intimacy, depression and anxiety were associated with UAI with RP among MSMRP. In the RCT study, participants in the Intervention Group had less UAI (36.1% vs. 49.1%) than those of the Control Group at Month 3. / Conclusions. This study showed a high prevalence of UAI among MSMRP, whilst trust, intimacy and cognitive factors were associated with UAI with RP. The efficacy of Enhanced VCT tailored to RP has been identified. The acceptability and feasibility of the tailored intervention were demonstrated. In the future HIV prevention programs, the effective intervention should be considered to be incorporated into standard-of-care VCT procedures and be implemented in the specific population. / 介紹：中國男男性接觸者中的愛滋病發病率一直保持著上升的狀態。而在中國男男性接觸者中有很大比例存在著固定性伴侶。男男性接觸者同固定性伴發生無保護肛交行為的比例大於其同非固定性伴。信任，親密以及認知因素已經被證實是影響男男性接觸者同其固定性伴發生無保護肛交行為的因素。但是在中國還沒有發現專門針對有固定性伴的男男性接觸者的干預研究。為了降低男男性接觸者同其固定性伴的無保護肛交的發生率，針對有固定性伴的男男性接觸者的干預方法應該被發展同時證實其有效性。 / 目的：本研究目的在於調查北京及成都男男性接觸者的固定性伴的比例，及其影響因素，包括健康行為理論的影響因素以及人際關係因素。同時，本研究也驗證了以隨機對照實驗來評估針對有固定性伴男男性接觸者的提高型愛滋病自願檢測諮詢對減少其高危性行為的效果。 / 對象與方法：本研究由橫斷面研究以及隨機對照試驗組成。在橫斷面調查中，307名愛滋病陰性的有固定性伴的男男性接觸者被招募。基於在橫斷面調查中發現的對男男性接觸者與固定性伴間發生無保護性行為的影響因素，一項專門針對有固定性伴的男男性接觸者的提高型愛滋病自願檢測諮詢干預方法被發展應用了隨機對照試驗中已驗證其有效性。在隨機對照試驗中，169名和167名研究對象被招募並分別被隨機分配到干預組（接受提高型愛滋病自願檢測諮詢）和對照組（接受標準型愛滋病自願檢測諮詢）中。分別於干預後的3個月和6個月回訪進行干預結果的評估。在本次研究中，運用了卡方检验和logistic回歸等統計學方法。 / 結果：在橫斷面調查中發現，男男性接觸者同固定性伴的無保護肛交發生率為52.4%。影響與固定性伴無保護肛交的因素包括：健康行為理論（TPB）相關的認知，信任，親密以及抑鬱和焦慮。在隨機對照試驗中發現，在3個月隨訪中干預組的男男性接觸者與固定性伴發生無保護肛交的比例較對照組明顯降低（36.1% vs. 49.1%）。 / 結論：本研究結果顯示中國男男性接觸者的固定性伴的比例很高，同時幾乎一半的有固定性伴的的男男性接觸者同時有多個性伴，這就有增加感染愛滋病及其他性病的風險。一項針對有固定性伴的男男性接觸者設計的提高型愛滋病自願檢測諮詢方法在降低其危險性行為上的可接受性和有效性已經被證實。提示在今後的愛滋病干預項目中可以進一步的推廣應用。 / Li, Chunrong. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 149-178). / Abstracts and appendixes also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Li, Chunrong. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.