Migration and illicit drug use among two types of male migrants in Shanghai, China.
Large-scale internal migrations within China have led to
speculation of increased drug use, but with little empirical evidence.
This cross-sectional study examines the association between migration
characteristics and illicit drug use in 100 general male migrants and
239 "money boys" (i.e., male migrants engaging in same-sex
transactional sex) in Shanghai, China. Only three general male migrants
reported any drug use. Among money boys, lifetime illicit drug use was
12%; Ecstasy and methamphetamine appeared to be the most popular drugs.
In addition, depression prevalence was very high among both types of
male migrants. Depression was associated with lifetime soft- and
hard-drug use, while earning a higher income was associated with
lifetime soft-drug use. These findings provide the first set of
quantitative evidence of illicit drug use among Chinese male migrants.
Although illicit drug use among male migrants is low compared to Western
countries, its resurgence after 30 years of drug control gives cause for
Keywords--Chinese, drug use, male migrants, money boys, Shanghai
Drug abuse (Demographic aspects)
Drug abuse (Research)
Drug abuse (Prevention)
Social networks (Analysis)
Wong, Frank Y.
|Publication:||Name: Journal of Psychoactive Drugs Publisher: Haight-Ashbury Publications Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 Haight-Ashbury Publications ISSN: 0279-1072|
|Issue:||Date: March, 2010 Source Volume: 42 Source Issue: 1|
|Topic:||Event Code: 310 Science & research|
|Product:||Product Code: E198450 Immigrants|
|Geographic:||Geographic Scope: China Geographic Code: 9CHIN China|
Historically, drug use (excluding alcohol and tobacco use) was
practiced among various segments of the Chinese privileged class and was
generally tolerated by society. However, since the British moved to
forcibly impose the opium trade on China in the late 1800s a more rigid
attitude deploring "moral vice" or "Western
decadence" has prevailed (Booth 1998). Soon after the founding of
the People's Republic of China in 1949, the government instituted a
nationwide antidrug campaign, which, in conjunction with a "closed
door" policy throughout the 1960s and 1970s, led to the
proclamation of a "country free from drugs" for over 30 years.
During this period, opium, heroin, and other illegal drugs were
inaccessible to the vast majority of the population. Legal deterrence
became the main weapon for fighting drug use, as drug trafficking was
punishable by death (Bakken 1993). As a result, little attention was
given to the prevention and treatment of drug addiction. By the end of
the 1970s, however, these dramatic enforcement programs became
increasingly difficult to maintain as China opened its doors to the West
and foreign investment brought rapid economic development (Chen &
Huang 2007; Gifford 2007). The rate of illicit drug use continued to
rise throughout the 1980s and grew rapidly in the 1990s. In 2000, the
lifetime prevalence of illicit drug use was just 1.52% (Hao et al. 2004)
(which is very low compared to rates in Western countries); heroin,
methamphetamine, and Ecstasy are the current major drugs of choice in
China (Chen & Huang 2007).
As China broadens its engagements with the outside world, the government has made greater efforts to monitor and control drug use. It has established drug control entities in all of China's counties and cities, and the number of registered addicts is rising. According to the Ministry of Health, one million addicts were registered at the end of 2002. Close to 75% of these individuals are aged 25 or younger. A majority of these cases have been among hardcore users (heroin or opium) or addicts such as injection drug users or IDUs (Zhao et al. 2004). Nonetheless, the approach used is legal deterrence (i.e., being caught with subsequent incarceration/"cold turkey" detoxification) instead of primary prevention efforts such as voluntary programs similar to Narcotics Anonymous.
The limited information that does exist suggests that drug (legal and illegal) use/abuse is a growing problem. For example, a recent study, Survey of Drug Use among Middle Schools in Three Districts: 1998-1999, conducted by the Beijing University's Chinese Medicine Research Center (2001) with three sets of middle school youth (n = 2,742; 2,988; 1,038) found that the age of initiation ranged from 11 to 12.9 years old. Drugs used included alcohol, cigarettes, heroin, and painkillers. In a second study (n = 12,000) in 1997, 32.5% of male students and 13% of female students had ever smoked cigarettes (Beijing University Children's Hospital 2001). The average age of smoking initiation was 10.7. Other drugs used include alcohol and marijuana as well as tranquilizers.
To the best of our knowledge, national estimates of drug (legal and illegal) use prevalence are not available to the public. Meanwhile, large-scale internal migrations due to China entering the global economy has led to speculation of increased drug use. However, there is little empirical evidence to support this assertion; indirect evidence suggests that migrants who engage in high-risk sexual behaviors that might place them at risk for HIV infection also tend to use more alcohol (Lin et al. 2005).
A brief review of the historical context will help to provide a framework to better appreciate the emergence of drug use, as well as drug control efforts, in China. In 1958, the government instituted a nationwide household system (known as hukou) that assigned every individual to a particular place of residence and officially classified people as either urban or rural residents. Those wishing to relocate to another part of the country required official approval, allowing the central government to effectively control the social, political, and economic lives of its people (Zhang 2001). During the heyday of the hukou system (between 1953 and the late 1970s), the government was also able to control illicit drug use and trade (Cohen et al. 1996). In the early 1980s, however, the Chinese government undertook a series of structural economic reforms that improved the efficiency of farming and created a labor surplus of nearly 200 million rural laborers. The reforms simultaneously spurred rapid urban economic growth and a soaring demand for cheap urban labor. In response, millions of peasants began migrating illegally to cities throughout China. The city of Shanghai, China's largest center of commerce and finance, became one of the most popular migrant destinations. As of 2000, there were 121 million migrants throughout China, and Shanghai's metropolitan population included some 4.4 million migrants (Chinese National Bureau of Statistics 2002).
A subgroup of migrants, known locally as "money boys," engage in same-sex transactional sex activities primarily for economic survival. To the best of our knowledge, there have been only three English-language empirical HIV-related studies targeting this population (He et al. 2007a, b; Wong et al. 2008). Using a qualitative methodology (focus group), He and colleagues (2007a) found that money boys reported more encounters and experiences with soft drugs such as Ecstasy than did general male migrants. Usually, the soft drugs were introduced by foreign customers and were used to stimulate sex drive. Wong and colleagues (2008) found that non-gay-identified money boys tended to use more drugs than gay-identified money boys.
Anecdotal evidence also suggests that money boys trade sex for money (1) and drugs, and some money boys specifically target Western foreigners. A popular travel website (http://www.utopia-asia.com/chinbeij.htm) provides the following description and warning for tourists planning to visit Beijing:
The purpose of this study was to examine the association between migration characteristics and illicit drug use in two types of male migrants. Given the paucity of research on illicit drug use among migrants in general and money boys in particular in China, we have borrowed a conceptual model related to migration developed by Chng, Wong, Park, Edberg, and Lai (2003) to guide the present study. Acknowledging that Chng's model was developed to focus on the characteristics and experiences of Asian immigrants and refugees as well as Asian immigrant MSM in the U.S., we believe it is reasonable to assume that many characteristics and experiences specific to migration are common among most immigrants, refugees, and non-native or transient populations throughout the world. For example, migrant money boys in Shanghai likely endure cultural isolation and discrimination (for being gay, coming from outside Shanghai, and not speaking the Shanghaiese dialect), just as many Asian immigrants and refugees might encounter cultural, racial, and language barriers in the U.S. In turn, these processes and experiences may place stress on the well-being of the individuals, which might result in negative coping mechanisms or health outcomes.
Study Population and Sampling Methods
This cross-sectional survey study examines migration characteristics and illicit drug use among two types of male migrants--general male migrants and money boys--in Shanghai, China. To be eligible for the study, participants must have been: (1) aged 18 and above; (2) not native to Shanghai, and (3) able to give verbal and written consent (in Mandarin) to participate. Those who were money boys must have: (1) ever had sex with another man, and (2) self-identified as a money boy at the time of participation. A total of 100 general male migrants and 239 money boys were recruited between April 1, 2006 and June 30, 2006.
A venue-based methodology (construction sites) was used to recruit general male migrants. For the money boys, two recruitment methods were used: (1) a variation of snowball sampling methodology modeled after respondent-driven sampling (or RDS) and (2) use of a community leader who worked for a local nongovernmental organization (NGO) serving MSM in Shanghai. Specifically, the research team selected three seeds--two gay-identified migrant money boys and one non-gay-identified money boy. Each seed was asked to recruit up to three peers, and each eligible participant (excluding the three seeds) was asked to identify (1) the nature of his relationship to the seed, and (2) how long he had known the seed. Although the number of seeds and "waves" of recruitment were somewhat limited due to resource constraints, referrals from one of the gay-identified seeds yielded 130 participants (in seven waves); the other gay-identified seed yielded 41 participants (in three waves). Selection of the non-gay-identified seed resulted in 12 participants (in two waves). The selected community leader was a highly visible member of the gay and MSM community in Shanghai, and highly regarded by members of the local money boy community.
Recruited participants were verbally informed of the nature and purpose of the study, survey procedures, sensitive nature of the questions, confidentiality parameters, payment for participation, risks and benefits (including referrals for other services if needed), and the freedom to cease participation at any time without penalty. After respondents verbally indicated an understanding of these issues, they signed a consent form. They were also given a copy of the Research Subject's Bill of Rights. All consent and human subject forms and procedures had been reviewed by the appropriate academic institutional review boards, Georgetown University in the U.S. and Fudan University in China.
All eligible participants agreed to take part in the study without any expressed reservations. In one instance, an individual (money boy) presented a fake referral coupon. He was subsequently disqualified from participating.
As part of a larger study, participants were asked questions regarding (1) demographic information, (2) migration characteristics, and (3) illicit drug use via a self-administered questionnaire. The paper-and-pencil survey took approximately 30 to 75 minutes (and an average of 45 minutes) for participants to complete. A research assistant was onsite to answer any survey-related questions from participants.
Outcome Variables. Major outcomes included types of illicit drug use. Respondents were asked about their lifetime, past 12-month, and past 30-day use of (1) cocaine;
(2) Ecstasy; (3) heroin; (4) methamphetamine; and (5) other illicit drugs. Hard drug use was classified as having ever used cocaine and/or heroin. Soft drug use was classified as having ever used Ecstasy or methamphetamine. (2)
Predictors: Migrant Characteristics. Measures on the migration model are grouped in three domains: (1) status in hometown (occupation at home and reasons for leaving hometown); (2) migration characteristics (cities traveled to before Shanghai; years away from hometown; time spent in Shanghai; and whether they received a job offer in Shanghai before coming); and (3) current situation in Shanghai (living situation; experience with discrimination; amount of stress felt; satisfaction with life; and depression). Discrimination, life stress, and satisfaction in Shanghai were measured using a single item. Depression was measured by the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff 1977). Cronbach's alpha was .83.
Chi-square analyses were used to test for associations between type of migrant, migration characteristics, and illicit drug use. Logistic regression analyses were used to provide crude odds ratios and examine the independent effects of migration characteristics on illicit drug use. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were computed by using the beta coefficients and standard errors obtained from the multivariable logistic analyses. The multivariable logistic regression was limited to the money boy subgroup, as the number of male migrants who used drugs was extremely low (three of 100 subjects).
Table 1 shows the demographic characteristics, socioeconomic status, and migration characteristics of participants in this survey study. Compared to the general male migrants, money boys were significantly younger (25.2 vs. 29.9 years old for general male migrants, p = .0002); were more educated (50.6% vs. 25.0% had some high school experience, p = .0001); were more likely to never have been married (89.5% vs. 52.0%, p = .0001); and earned more income (34.7% vs. 8.0% earned 3000 to 4999 RMB Yuan per month [$1 USD = ~7.64 RMB Yuan3], p = .0001).
Money boys cited "no freedom at home" as a major reason for migrating, whereas the general male migrants cited "nothing to do at home." Compared to the general male migrants, money boys were significantly more likely to report less satisfaction with life in Shanghai (22.6% vs. 10.0%) and a higher rate of depression (60.7% vs. 26.0%). This sense of isolation might also be reflected in the fact that money boys are more likely than the general male migrants to live by themselves (46.4% vs. 12.0%, p = .0001). Although money boys reported a shorter stay in Shanghai than the general male migrants, on average money boys had been away from their hometown longer than the general male migrants.
Illicit Drug Use
Only three of the 100 general male migrants self-reported using illicit drugs. As a result, Table 2 presents the prevalence of illicit drug use specifically among money boys. Lifetime use of any illicit drug was 12.1%. Ecstasy appears to be the most popular illicit drug (9.6% lifetime; 5.4% past 12 months; 3.4% past 30 days), followed by cocaine (6.7% lifetime; 4.2% past 12 months; 3.8% past 30 days) and methamphetamine (2.5% lifetime; 1.3% past 12 months; 1.7% past 30 days).
Table 3 presents the results of a series of bivariate analyses between migrant characteristics and illicit drug use among the two types of male migrants. Money boys had more lifetime illicit drug use than the general male migrants. Income, life satisfaction in Shanghai, and depression were significantly associated with some form of illicit drug use. Interestingly, higher income was associated with lifetime soft-drug use (p = .0000), whereas depression was associated with lifetime drug use.
Table 4 displays a multivariable logistic regression to look at drug use among money boys (since only three general male migrants reported drug use). Results show that depression was significantly associated with lifetime illicit drug use (OR = 3, 95CI = 1.27-6.68) and lifetime hard-drug use (OR = 6, 95CI = 1.71-20.75), whereas earning a higher income was associated with lifetime illicit drug use (OR = 3.6, 95CI = 1.25-10.36) and lifetime soft-drug use (OR = 5.9, 95CI = 1.65-21.23). Thus, it would appear that higher incomes may promote experimentation with illicit soft drug use, while depression may promote hard-drug use. Indeed, feeling less satisfaction with life in Shanghai was significantly associated with all hard-drug use (OR = 3.4, 95%CI = 1.34-8.49).
This is the first quantitative study to systematically examine the influence of numerous factors on illicit drug use among two types of male migrants in a large Chinese city. The "open door" policy that began in 1986 has contributed to the erosion of long-standing taboos associated with the free market, migration, and drug use. The driving force for migration from rural areas to nearby major cities like Shanghai has been primarily economic in nature. With an estimated 121 millions migrants, the Chinese government is rightfully concerned about any potential health crisis or epidemic such as a surge in substance use.
Although the prevalence of illicit drug use among male migrants is very low relative to Western countries, its resurgence after 30 years of strict drug control gives cause for concern. Our overall results are in agreement with recent studies reporting on rising substance use trends, especially among other high-risk groups in China, such as commercial sex workers and male clients (Rogers et al. 2002).
While studies among rural-to-urban migrants are limited, Lin and colleagues (2005) has produced findings that further strengthen the evidence base around Chinese rural-to-urban migrants' substance use and sexual risk behaviors. Data collected from 2,153 participants found that approximately one-third reported having been intoxicated during the previous month. Additionally, these respondents reported higher incidence of depression, less satisfaction with life and work, and finding themselves embedded in a peer group engaging in sexual risk behavior. The study confirmed that respondents reporting substance use, compared to nonusers, were found to be more likely to report purchasing and selling sex, having multiple sex partners and engaging in premarital sex.
The association between higher incomes (and larger amounts of disposable income) and soft drug use found in our study suggests that as people become more affluent, they are more likely to experiment with drug use. Although we were unable to compare illicit drug use between the general male migrants (only three of 100 indicated that they had used drugs) and money boys, our findings suggest that income and illicit drug use among money boys may be related to their profession, which often creates an environment for risky behaviors and provides potential access to soft drugs.
Examining the effects of workplace with income as a predictor of substance use, Chen and colleagues ' (2008) findings resonate with our results. Specifically, analyzing data from 3,752 rural-to-urban migrants, the cross-sectional study found that among male migrants, higher monthly incomes were predictive of increased substance use, particularly for men who worked in nightclubs, construction and small shops. In both that work and our study, workplace-related stress may have contributed to respondents' increased risk for substance use and may be related to feelings of depression as a result.
Illicit drug use aside, depression prevalence was very high among the two types of male migrants in Shanghai. Depression appears to fuel hard drug use, which is consistent with the general literature's observation that these individuals may be using drugs as a form of self-medication (Harris & Edlund 2005; Volkow 2004; Abraham & Fava 1999; Markou, Kosten & Koob 1998). A correlate of depression--life satisfaction in Shanghai--is associated with illicit drug use, as those who feel less satisfied with life in Shanghai use more illicit drugs. It is unclear if depression or life satisfaction in Shanghai is related to an individual's migrant status, which likely relegates him to second-class citizenship in a fast-changing society where he does not directly benefit from the economic boom. In addition to the tendency to live alone, the triple discriminations (e.g., being a rural migrant, gay, and a sex worker) and the lack of family and social support may also contribute to the higher depression rate among money boys.
Differing characteristics among the two types of male migrants clearly demonstrate that migrants in China are not a homogeneous or monolithic group. Future research is needed to examine shared (e.g., high prevalence of depression) and unique (e.g., vocation) characteristics and/or correlates that are associated with drug use and related risk behaviors such as transactional sex.
Limitations of the Study
This study has several limitations. First, because a crosssectional and correlational design was used, causation could not be inferred. Second, the use of a snowball-type sampling or a "truncated" respondent driven sampling (RDS) methodology might restrict generalizability. Third, we were unable to measure pre- and post-migration normative attitudes, beliefs, and behaviors, which prevent validation of Chng and colleagues' model (2003), although the model remains heuristic in understanding illicit drug use. Finally, self-reported measures may underestimate illicit drug use.
Although this study is limited in its generalizability, these limitations do not threaten the validity of the results. With little known about the illicit drug use behaviors of Chinese male rural-to-urban migrants, this study applies a conceptual framework and sampling methodology that highlight the intricately networked characteristic of the sampled population. These findings contribute to the characterization of this special population in China. Informally, the study's success in recruiting 130 participants in seven waves with one seed participant may determine the feasibility of other social network analysis approaches which may help shape future sampling methodologies and prevention interventions focused on this hard-to-reach population. Ideally, future research using a longitudinal design is needed to explore causal relationships involving drug use among rural-to-urban migrants.
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Frank Y. Wong, Ph.D. *; N. He, M.D., Ph.D. **; Z. J. Huang, M.B.B.S., Ph.D., M.P.H. ***; D. Young, B.S. ****; C. O'Conor ***; Y.Y. Ding, M.D. **; C. Fu, M.D. ** & S. Arayasirikul, M.S.P.H., C.H.E.S. *****
([dagger]) This article was supported in part by a National Institute on Drug Abuse grant (R01DA15623-04S1) to the first author while he was affiliated with Georgetown University. The preparation of this article was support in part by the Emory Center for AIDS Research (P30 AI050409), Emory University, the current institutional affiliation of the first author.
* Associate Professor, Department of Behavioral Sciences and Health Education & Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
** Professor and Vice Chair, Department of Epidemiology, Fudan University, Shanghai, China.
** Lecturer, Department of Epidemiology, Fudan University, Shanghai, China.
*** Associate Professor, Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, D.C.
*** Undergraduate Student, School of Foreign Services, Georgetown University, Washington, D.C.
**** Associate Analyst, Abt Associates, Washington, D.C.
***** Health Policy & Health Literacy Fellow, Association for Prevention Teaching and Research, Washington, D.C.
(1.) In 2003, a judge dismissed a case involving a pimp profiting from a male prostitution operation (involving samesex sexual exchanges) since Chinese laws define prostitution as selling female sex to a male client (Wan 2003).
(2.) Although methamphetamine is often classified as a hard drug due to its addictive and destructive nature, it is perceived to be a soft drug by users in China, and consequently was classified as such in this analysis.
(3.) Exchange rate at the time of data collection.
Please address correspondence and reprint requests to Frank Y. Wong, Ph.D., Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road N.E., Room 534, Atlanta, GA 30306; Phone (404) 727-9568; email: fwong3@emory. edu
Many locals caution that bars and saunas here are filled with "money boys" on the prowl, mostly needy men from other provinces. Stories of blackmail, robbery and thugs abound. Cruising areas seem to be more seriously at-your-own-risk than elsewhere in Asia. Saunas are traditional public baths-- small, shabby, and without private spaces. If the men you meet don't have a job and come from elsewhere in the country, you can assume they are looking for financial assistance.
TABLE 1 Demographics and Migration Characteristics of Male Migrants and Money Boys in Shanghai, 2006 All Male Migrants (N = 339) (n = 100) % % Demographics Age (mean+/- SD) 26.5+/-7.9 29.9+/-12.0 Marriage Never Married 78.5 52.0 Married or Divorced 21.5 48.0 Education Cannot Read 0.6 0.0 Elementary 5.3 7.0 Middle School 45.1 66.0 High School 43.1 25.0 College + 5.6 2.0 Monthly income <1000 Yuan 26.6 39.0 1000-2999.99 Y 46.3 53.0 3000-4999.99 Y 27.1 8.0 Status at Hometown Occupation at Home Students 36.3 41.0 Small Business 37.2 31.0 Farmer 13.9 22.0 Looking for Job 12.6 6.0 Reasons for Leaving Hometown (multiple choices) Earn more Income 56.1 50.0 No Freedom at Home 12.4 6.0 Nothing to do at Home 6.8 13.0 Want to see the World 35.4 38.0 Migration Experience Cities went to before Shanghai None 29.0 37.4 1 to 2 43.4 40.4 3 to 5 23.7 19.2 >=6 3.9 3.0 Years away from Home 0 to 1 7.6 15.2 2 to 5 31.7 23.9 6 to 9 42.4 30.4 10+ 18.4 30.4 Time in Shanghai <3 Months 28.6 16.0 3-6 Months 31.6 27.0 7-12 Months 39.8 57.0 Had a Job before coming to Shanghai Yes 34.5 64.0 No 65.5 36.0 Current Situation in Shanghai Live with Alone 36.3 12.0 Co-worker or Friends 46.3 61.0 Partner or Spouse 10.6 16.0 Other 6.8 11.0 Discrimination Yes 52.8 52.0 No/ Don't Know 47.2 48.0 Life in Shanghai is Stressful Yes 36.3 29.0 No/ Don't Know 63.7 71.0 Satisfied with Life in Shanghai? No 18.9 10.0 Yes/Doesn't Matter 81.1 90.0 Depression (CESD score > 16) Yes 50.4 26.0 No 49.6 74.0 Money Boy (n = 239) % p-value Demographics Age (mean+/- SD) 25.2+/-4.7 0.0002 Marriage Never Married 89.5 <0.0001 Married or Divorced 10.5 Education Cannot Read 0.8 <0.0001 Elementary 4.6 Middle School 36.4 High School 50.6 College + 7.1 Monthly income <1000 Yuan 21.3 <0.0001 1000-2999.99 Y 43.5 3000-4999.99 Y 34.7 Status at Hometown Occupation at Home Students 34.3 0.0028 Small Business 39.8 Farmer 10.5 Looking for Job 15.5 Reasons for Leaving Hometown (multiple choices) Earn more Income 58.6 0.1468 No Freedom at Home 15.1 0.0209 Nothing to do at Home 4.2 0.0032 Want to see the World 34.3 0.517 Migration Experience Cities went to before Shanghai None 25.5 0.164 1 to 2 44.7 3 to 5 25.5 >=6 4.3 Years away from Home 0 to 1 4.5 <0.0001 2 to 5 34.8 6 to 9 47.3 10+ 13.4 Time in Shanghai <3 Months 33.9 <0.0001 3-6 Months 33.5 7-12 Months 32.6 Had a Job before coming to Shanghai Yes 22.2 <0.0001 No 77.8 Current Situation in Shanghai Live with Alone 46.4 <0.0001 Co-worker or Friends 40.2 Partner or Spouse 8.4 Other 5.0 Discrimination Yes 53.1 0.8482 No/ Don't Know 46.9 Life in Shanghai is Stressful Yes 39.3 0.0712 No/ Don't Know 61.7 Satisfied with Life in Shanghai? No 22.6 0.0069 Yes/Doesn't Matter 77.4 Depression (CESD score > 16) Yes 60.7 <.0001 No 39.3 TABLE 2 Prevalence of Substance Use among Money Boys (N = 239) in Shanghai, 2006 Ever Use Past 30 Days N % N % Any Drugs or Stimulants 29 12.1 N/A N/A Cocaine 16 6.7 9 3.8 Ecstasy 23 9.6 8 3.4 Heroin (White Powder) 5 2.1 1 0.4 Ice [Toxic]/Methamphetamine 6 2.5 4 1.7 Other Drugs 6 2.5 2 0.8 Past 12 Months N Any Drugs or Stimulants N/A N/A Cocaine 10 4.2 Ecstasy 13 5.4 Heroin (White Powder) 2 0.8 Ice [Toxic]/Methamphetamine 3 1.3 Other Drugs 3 1.3 Note: Among 100 male migrants (non-money boys) in the study, three had ever used drugs. TABLE 3 Association between Migration Variables and Substance Use among Male Migrants and Money Boy in Shanghai, China 2006 Ever Use Drugs (%) (p-value) Demographics Age 18-24 7.6 0.1648 25+ 12.1 Marriage Never Married 9.9 0.6847 Married or Divorced 8.3 Education Cannot Read 50.0 0.1098 Elementary 17.7 Middle School 10.5 High School 8.4 College+ 0.0 Monthly Income <1000 Yuan 5.7 0.0067 1000-2999.99 Yuan 6.5 3000-4.999.99 Yuan 19.1 Occupation at Home Students 5.7 0.1465 Small Business 13.8 Farmer 6.4 Looking for a Job 11.9 Migration Experience Reasons for Leaving Earn more Income Yes 9.6 0.9750 No 9.5 No Freedom at Home Yes 12.5 0.5639 No 9.2 Nothing to do at Home Yes 4.4 0.7108 No 10.0 Want to see the World Yes 13.6 0.0679 No 7.4 Number of Cities went to before Shanghai 0 / None 5.2 0.2099 1 to 5 11.2 >=6 14.3 Years away from Home 0-5 4.9 0.0292 6+ 12.2 Time in Shanghai <3 Months 8.3 0.8777 3-6 Months 10.4 7-12 Months 9.9 Had a Job before coming to Shanghai Yes 7.8 0.4298 No 10.5 Current Situation in Shanghai Live with Alone 9.0 0.9562 Coworker/Friend/Partner/Spouse 10.0 Other 9.1 Do you feel Discriminated against? Yes 11.4 0.2427 No/Don't Know 7.6 Is Life in Shanghai Stressful? Yes 9.9 0.8749 No/Don't Know 9.4 Are you Satisfied with Life in Shanghai? Yes 17.2 0.0215 No 7.8 Is Money Boy or General Male Migrant Money Boy 12.3 0.0091 GMM 3.1 Depression (CESD Score >= 16) Yes 14.3 0.0033 No 4.8 Ever Use Hard Drug (%) (p-value) Demographics Age 18-24 5.2 0.3813 25+ 7.5 Marriage Never Married 5.6 0.4156 Married or Divorced 8.2 Education Cannot Read 50.0 0.2049 Elementary 5.6 Middle School 7.2 High School 5.5 College+ 0.0 Monthly Income <1000 Yuan 4.4 0.1622 1000-2999.99 Yuan 4.5 3000-4.999.99 Yuan 11.1 Occupation at Home Students 4.1 0.2349 Small Business 8.7 Farmer 2.1 Looking for a Job 9.3 Migration Experience Reasons for Leaving Earn more Income Yes 6.3 0.9168 No 6.0 No Freedom at Home Yes 9.5 0.3109 No 5.7 Nothing to do at Home Yes 4.4 1.0000 No 6.3 Want to see the World Yes 10.0 0.0314 No 4.1 Number of Cities went to before Shanghai 0 / None 3.1 0.3116 1 to 5 7.5 >=6 7.1 Years away from Home 0-5 3.2 0.1278 6+ 7.3 Time in Shanghai <3 Months 5.2 0.2566 3-6 Months 9.4 7-12 Months 4.4 Had a Job before coming to Shanghai Yes 6.8 0.7215 No 5.9 Current Situation in Shanghai Live with Alone 3.3 0.1803 Coworker/Friend/Partner/Spouse 8.3 Other 4.4 Do you feel Discriminated against? Yes 7.8 0.1888 No/Don't Know 4.4 Is Life in Shanghai Stressful? Yes 7.3 0.5177 No/Don't Know 5.6 Are you Satisfied with Life in Shanghai? Yes 14.1 0.0078 No 4.4 Is Money Boy or General Male Migrant Money Boy 8.0 0.0463 GMM 2.0 Depression (CESD Score >= 16) Yes 10.5 0.0008 No 1.8 Ever Use Soft Drug (%) (p-value) Demographics Age 18-24 6.3 0.2982 25+ 9.4 Marriage Never Married 8.3 0.4273 Married or Divorced 5.5 Education Cannot Read 50.0 0.1975 Elementary 11.1 Middle School 7.8 High School 7.5 College+ 0.0 Monthly Income <1000 Yuan 3.3 0.0009 1000-2999.99 Yuan 4.5 3000-4.999.99 Yuan 17.8 Occupation at Home Students 5.7 0.6021 Small Business 10.3 Farmer 6.4 Looking for a Job 7.0 Migration Experience Reasons for Leaving Earn more Income Yes 7.9 0.8604 No 7.4 No Freedom at Home Yes 11.9 0.3460 No 7.1 Nothing to do at Home Yes 4.4 1.0000 No 7.9 Want to see the World Yes 10.0 0.2327 No 6.4 Number of Cities went to before Shanghai 0 / None 5.1 0.3800 1 to 5 8.4 >=6 14.3 Years away from Home 0-5 4.0 0.0547 6+ 9.9 Time in Shanghai <3 Months 8.3 0.8687 3-6 Months 6.5 7-12 Months 8.2 Had a Job before coming to Shanghai Yes 6.0 0.3969 No 8.6 Current Situation in Shanghai Live with Alone 7.3 0.9711 Coworker/Friend/Partner/Spouse 7.8 Other 8.7 Do you feel Discriminated against? Yes 9.5 0.1811 No/Don't Know 5.6 Is Life in Shanghai Stressful? Yes 7.3 0.8540 No/Don't Know 7.9 Are you Satisfied with Life in Shanghai? Yes 12.5 0.1189 No 6.6 Is Money Boy or General Male Migrant Money Boy 2.0 0.0121 GMM 10.0 Depression (CESD Score >= 16) Yes 10.5 0.0461 No 4.8 Note. P-values were obtained from Chi-square tests or Fisher's tests as appropriate. TABLE 4 Adjusted Odds Ratios of Migration Factors Associated with Substance Use in Money Boys (N = 239) in Shanghai, China, 2006 Effect Ever Use Drug Depression (CES-D score >=16) Yes 3 (1.27-6.88) No ref Income Low ref Median 1.1 (0.38-3.50) High 3.6 (1.25-10.36) Migration Variables Want to see the world Yes 2 (1.0-4.30) No ref Migration Variables Years away from home 0-5 years ref 6+ years 2.7 (1.05-6.96) Migration Variables Are you satisfied with life in Shanghai Yes ref No 2.3 (1.02-5.13) Effect Ever Use Hard Drug Depression (CES-D score >=16) Yes 6.0 (1.71-20.75) No ref Income Low ref Median 1.0 (0.28-3.55) High 2.3 (0.68-7.80) Migration Variables Want to see the world Yes 2.7 (1.08-6.60) No ref Migration Variables Years away from home 0-5 years ref 6+ years 2.31 (0.74-7.24) Migration Variables Are you satisfied with life in Shanghai Yes ref No 3.4 (1.34-8.49) Effect Ever Use Soft Drug Depression (CES-D score >=16) Yes 2.0 (0.83-4.85) No Ref Income Low Ref Median 1.4 (0.34-5.43) High 5.9 (1.65-21.23) Migration Variables Want to see the world Yes 1.7 (0.74-3.91) No Ref Migration Variables Years away from home 0-5 years Ref 6+ years 2.6 (0.93-7.34) Migration Variables Are you satisfied with life in Shanghai Yes ref No 1.8 (0.73-4.55)
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