Yang Zijie, Wei Lan, Xu Zhongliang, Li Simei, Xing Yiwen, Zhang Yan, Yuan Yuan, Liu Shaochu, Xie Wei, Tan Wei, Ye Wei, Tan Jingguang, Shi Xiangdong, Yan Xiangyu, Feng Tiejian, Jia Zhongwei, Zhao Jin
School of Public Health, Peking University, Beijing, China.
Shenzhen Center for Disease Control and Prevention, Shenzhen, China.
Front Public Health. 2024 Dec 16;12:1476642. doi: 10.3389/fpubh.2024.1476642. eCollection 2024.
Seeking sexual partners in men who have sex with men (MSM) venues has been regarded as a high-risk behavior for HIV among MSM. Nevertheless, with the implementation of venue-based interventions and the change in the way MSM seek sexual partners, the continued status of MSM venues as the HIV risk factor remains inconclusive. This study endeavors to delve into this ambiguity by examining the MSM sexual contact network (SCN) as a foundation.
A series of cross-sectional surveys were conducted in Shenzhen in the period 2010-2022. MSM sexual contact network and venue network were acquired, and network metrics were employed to identify core MSM and core venues. We compared the risk of HIV and risk behaviors between MSM who sought sexual partners in core venues and those who did not, with subgroup analyses based on different time periods.
The overall HIV prevalence among the 4,408 MSM surveyed in this study was 14.6%. Notably, 17 core venues were identified out of the 68 reported MSM venues, with 1,486 MSM who had sought sexual partners in core venues. These MSM had significantly higher risk of HIV and were more likely to take HIV testing and receive intervention services. Subgroup analyses showed that the heightened HIV risk associated with seeking partners in core venues was specific to the period 2010-2014, while HIV testing and service access remained consistently higher across all-period subgroups. Multiple sexual partners, seeking partners in core venues, receptive or both sexual roles, drug abuse, absence of HIV test, unprotected anal intercourse (UAI), and lower education levels were associated with elevated HIV risk among MSM.
Following the implementation of differentiated venue-based interventions, the risk of HIV among MSM who had sought sexual partners in core venues decreased to a level comparable to that of MSM who had not. The accessibility of HIV testing and intervention services remains uneven between MSM who had sought sexual partners in core venues and those who had not. As the Internet sex-seeking behavior gains prevalence among MSM, strategic adjustments of public health resource allocation may be necessary to address this imbalance.
在男男性行为者(MSM)场所寻找性伴侣被视为MSM中感染艾滋病毒的高危行为。然而,随着基于场所的干预措施的实施以及MSM寻找性伴侣方式的改变,MSM场所作为艾滋病毒危险因素的持续状况仍无定论。本研究试图通过以MSM性接触网络(SCN)为基础进行调查,深入探究这一模糊问题。
2010 - 2022年期间在深圳进行了一系列横断面调查。获取了MSM性接触网络和场所网络,并使用网络指标来识别核心MSM和核心场所。我们比较了在核心场所寻找性伴侣的MSM与未在核心场所寻找性伴侣的MSM之间的艾滋病毒感染风险和风险行为,并基于不同时间段进行了亚组分析。
本研究调查的4408名MSM中,艾滋病毒总体感染率为14.6%。值得注意的是,在报告的68个MSM场所中识别出17个核心场所,有1486名MSM在核心场所寻找性伴侣。这些MSM感染艾滋病毒的风险显著更高,并且更有可能进行艾滋病毒检测并接受干预服务。亚组分析表明,在核心场所寻找性伴侣与更高的艾滋病毒感染风险相关这一情况在2010 - 2014年期间较为突出,而在所有时间段亚组中,艾滋病毒检测和服务获取情况一直较高。多个性伴侣、在核心场所寻找性伴侣、接受性行为或同时扮演两种性角色、药物滥用、未进行艾滋病毒检测、无保护肛交(UAI)以及较低的教育水平与MSM中较高的艾滋病毒感染风险相关。
在实施差异化的基于场所的干预措施后,在核心场所寻找性伴侣的MSM中的艾滋病毒感染风险降至与未在核心场所寻找性伴侣的MSM相当的水平。在核心场所寻找性伴侣的MSM与未在核心场所寻找性伴侣的MSM之间,艾滋病毒检测和干预服务的可及性仍然不均衡。随着互联网寻性行为在MSM中日益普遍,可能需要对公共卫生资源分配进行战略调整以解决这种不平衡。