From the Department of Epidemiology, Rollin School of Public Health, Emory University, Atlanta, GA.
Departments of Sociology.
Sex Transm Dis. 2022 Dec 1;49(12):808-814. doi: 10.1097/OLQ.0000000000001708. Epub 2022 Sep 14.
Mean active degree is an important proxy measure of cross-sectional network connectivity commonly used in HIV/sexually transmitted infection epidemiology research. No current studies have compared measurement methods of mean degree using a cross-sectional study design for men who have sex with men (MSM) in the United States. We compared mean degree estimates based on reported ongoing main and casual sexual partnerships (current method) against dates of first and last sex (retrospective method).
We used data from ARTnet, a cross-sectional survey of MSM in the United States (2017-2019). ARTnet collected data on the number and types of sexual partners in the past year, limited to the 5 most recent partners (data truncation). We quantified partnerships for months 0 to 12 before the survey date (retrospective method) and compared that with ongoing partnerships on the day of survey (current method). We used linear regression to understand the impact of truncated partnership data on mean degree estimation.
The retrospective method yielded similar degree estimates to the current for months proximate to the day of survey. The retrospective method mean degree systematically decreased as the month increased from 0 to 12 months before survey date. This was driven by data truncation: among participants with >5 partners in the past year compared with those with ≤5, the average change in main partnership degree between 12 and 0 months before survey date was -0.05 (95% confidence interval, -0.08 to -0.03) after adjusting for race/ethnicity, age, and education. The adjusted average change in casual partnership degree was -0.40 (95% confidence interval, -0.45 to -0.35).
The retrospective method underestimates mean degree for MSM in surveys with truncated partnership data, especially for casual partnerships. The current method is less prone to bias from partner truncation when the target population has high rate of partners per year.
平均活跃程度是 HIV/性传播感染流行病学研究中常用的衡量横截面网络连通性的重要替代指标。目前尚无研究比较过美国男男性行为者（MSM）的横断面研究设计中基于报告的持续主要和偶然性关系（现行方法）与首次和末次性行为日期（回顾性方法）的平均程度估计方法。
我们使用了美国 MSM 的横断面调查 ARTnet 的数据（2017-2019 年）。ARTnet 收集了过去一年中性伴侣的数量和类型的数据，仅限于最近的 5 个性伴侣（数据截断）。我们对调查日期前 12 个月（回顾性方法）的关系进行了量化，并将其与调查日的持续关系进行了比较。我们使用线性回归来了解截断伙伴关系数据对平均程度估计的影响。
回顾性方法在接近调查日的月份中得出的程度估计与现行方法相似。回顾性方法的平均程度随着从调查日期前 12 个月到 0 个月的月份增加而系统地降低。这是由数据截断驱动的：与过去一年中拥有 >5 个性伴侣的参与者相比，那些拥有 ≤5 个性伴侣的参与者，在调查日期前 12 个月到 0 个月期间，主要伙伴关系程度的平均变化为 -0.05（95%置信区间，-0.08 至 -0.03），调整了种族/民族、年龄和教育等因素后。偶然伙伴关系程度的平均变化为 -0.40（95%置信区间，-0.45 至 -0.35）。
在具有截断伙伴关系数据的调查中，回顾性方法低估了 MSM 的平均程度，特别是对偶然伙伴关系而言。当目标人群每年的伴侣数量较高时，现行方法不太容易受到伴侣截断的偏差影响。
