"I'll Change His Sexual Orientation, I Don't Think About HIV": A Qualitative Study to Explore Attitudes, Behaviors, and Experiences Among Wives of Men Who Have Sex With Men in Mainland China.
Fang Yan, Cynthia X Shi, Ye Zhang and 3 others
PMID 32205501WHAT IT FOUND
Wives of men who have sex with men in China described trying to change their husbands' orientation through increased sex, viewing condoms only as contraception, and lacking HIV risk perception despite unprotected intercourse.
Most had never been tested for HIV.
Key findings
01Participants frequently believed sexual orientation could be changed by increasing heterosexual sex, using methods like traditional medicine or witchcraft.
02Most women did not use condoms during marital sex, often misunderstanding their purpose as solely for pregnancy prevention rather than disease control.
03Despite having unprotected sex with partners who had male sexual histories, only 14 of 24 participants had ever been tested for HIV, with many stating they had never considered the need.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used purposive and snowball sampling, primarily recruiting women from an online chat group, which introduces selection bias toward those already connected to this community. Only women who were aware of their status as 'tongqi' (wives of men who have sex with men) and willing to discuss it openly were included, excluding those who were unaware or unwilling to disclose. The study did not interview the male partners, so the women's reports of their husbands' behaviors and HIV status were not externally validated. The sample size was small (24 participants), and the findings cannot be generalized to the entire population of women in similar relationships in China. Participants' self-reported HIV status and testing history were not verified by medical records.
Declared interests
The authors report no conflicts of interest. The study was supported by the National Institutes of Health (NIH) and non-U.S. government research support.
The easy way to misread this
Do not interpret the low HIV testing rates or risk perception as evidence that these women are actually at low risk. The study reports themes and self-perceptions, not clinical outcomes or incidence rates. The finding that four women were living with HIV is descriptive, not proof of transmission pathways or prevalence.