Liu Yuanyuan, Liu Xuan, Wei Siyue, Cheng Zhaoyu, Xian Yidan, Zhao Yicheng, Ma Jun, Chen Jiageng, Chen Zhongdan, Yang Jie, Liu Fengli, Yu Maohe, Cui Zhuang, Li Changping
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Nankai Hospital, Tianjin, China.
J Virus Erad. 2024 Jun 18;10(2):100382. doi: 10.1016/j.jve.2024.100382. eCollection 2024 Jun.
Men who have sex with men (MSM) are at a high risk of HIV infection and should be offered effective preventive measures, such as pre-exposure prophylaxis (PrEP). However, PrEP uptake among eligible MSM was not as high as desired. Diverse research findings on how risky sexual behaviors affect PrEP uptake highlight the necessity for a comprehensive investigation. Understanding the interconnectedness of different sexual behaviors is crucial for evaluating their impact on PrEP uptake among eligible MSM. Using a proportional sampling method, we recruited 5877 MSM aged 16 years and above in mainland China according to PrEP eligibility criteria. Through latent class analysis (LCA), three distinct sexual behavior patterns were identified among eligible MSM. Demographic variances and PrEP uptake among the three distinct sexual behavior patterns were examined using chi-squared tests and multinomial logistic regression. LCA revealed three patterns: low-risk (4,815 MSM), medium-risk (516 MSM), and high-risk (546 MSM). MSM aged 25 years or older with a monthly income of ≥¥8,000 were more likely to be in the medium-risk group. Those from areas with high HIV prevalence and engaging as "top" in anal sex were more likely to be in the medium- and high-risk groups. The medium- and high-risk groups had a higher willingness, uptake, and adherence rates for PrEP than the low-risk group. LCA is effective in identifying diverse sexual behavior patterns among MSM, aiding targeted interventions to enhance PrEP uptake. Addressing demographic variations and tailoring interventions for specific risk groups are crucial for promoting PrEP dissemination and reducing HIV infection risk in eligible MSM.
男男性行为者（MSM）感染艾滋病毒的风险很高，应提供有效的预防措施，如暴露前预防（PrEP）。然而，符合条件的男男性行为者对PrEP的接受程度并不如预期的高。关于危险的性行为如何影响PrEP接受程度的各种研究结果凸显了进行全面调查的必要性。了解不同性行为之间的相互联系对于评估它们对符合条件的男男性行为者PrEP接受程度的影响至关重要。我们采用比例抽样方法，根据PrEP资格标准在中国大陆招募了5877名16岁及以上的男男性行为者。通过潜在类别分析（LCA），在符合条件的男男性行为者中识别出三种不同的性行为模式。使用卡方检验和多项逻辑回归研究了这三种不同性行为模式之间的人口统计学差异和PrEP接受程度。LCA揭示了三种模式：低风险（4815名男男性行为者）、中等风险（516名男男性行为者）和高风险（546名男男性行为者）。年龄在25岁及以上、月收入≥8000元的男男性行为者更有可能属于中等风险组。来自艾滋病毒高流行地区且在肛交中扮演“主动方”的人更有可能属于中等风险和高风险组。中等风险和高风险组对PrEP的意愿、接受程度和依从率高于低风险组。LCA在识别男男性行为者中的不同性行为模式方面是有效的，有助于进行有针对性的干预以提高PrEP的接受程度。解决人口统计学差异并针对特定风险群体量身定制干预措施对于促进PrEP传播和降低符合条件的男男性行为者感染艾滋病毒的风险至关重要。
