识别中国男男性行为者中性传播感染的高危人群：一项聚类分析。
Identifying High-Risk Populations for Sexually Transmitted Infections in Chinese Men Who Have Sex With Men: A Cluster Analysis.
作者信息
Lu Fang, She Bingyang, Zhao Rui, Li Gaixia, Hu Yawu, Liu Yi, Zhao Min, Zhang Lei
机构信息
Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
出版信息
Open Forum Infect Dis. 2024 Dec 27;12(1):ofae754. doi: 10.1093/ofid/ofae754. eCollection 2025 Jan.
BACKGROUND
This study aimed to identify subpopulations of Chinese men who have sex with men (MSM) with distinct sexual behavioral patterns and explore their correlations with sexually transmitted infections (STIs).
METHODS
We recruited 892 eligible MSM in Xi'an, China, collecting sociodemographic, sexual behavior, and STI data. Cluster analysis identified distinct sexual behavioral patterns, allowing us to examine STI differences across clusters.
RESULTS
Among the 892 MSM analyzed, 3 clusters were identified. Cluster 1 (n = 157) exhibited high-risk sexual behavioral patterns, including the highest median number of sexual partners (5 vs 1 in cluster 2 vs 3 in cluster 3, < .001), lowest consistent condom use for insertive anal sex (0% vs 64.12% vs 99.76%, = .004) and receptive anal sex (9.22% vs 67.71% vs 98.91%, = .006), highest uncertainty of partners' STIs (77.07% vs 57.89% vs 64.5%, < .001), all recent partners being casual, longest length of sequential sexual acts (6 vs 5 vs 5, = .045), and highest rates of gonorrhea (20.38% vs 10.09% vs 14.99%, = .019) and chlamydia (16.56% vs 8.33% vs 13.21%, = .045). Cluster 2 (n = 228) showed the lowest engagement in high-risk behaviors and STIs, characterized by the fewest sexual partners, highest certainty of partner's STIs, and all recent partners being regular. Cluster 3 (n = 507) showed moderate levels of high-risk behaviors and STIs, with the highest consistent condom use during anal sex.
CONCLUSIONS
This study identified 3 subpopulations of Chinese MSM with distinct sexual behavioral patterns. Targeted public health interventions to the most at-risk subpopulations of MSM are essential for STI prevention.
背景
本研究旨在识别具有不同性行为模式的中国男男性行为者（MSM）亚群，并探讨其与性传播感染（STIs）的相关性。
方法
我们在中国西安招募了892名符合条件的MSM，收集社会人口统计学、性行为和性传播感染数据。聚类分析确定了不同的性行为模式，使我们能够检查各聚类之间的性传播感染差异。
结果
在分析的892名MSM中，识别出3个聚类。聚类1（n = 157）表现出高风险性行为模式，包括性伴侣中位数最高（分别为5个、聚类2中的1个和聚类3中的3个，P <.001），插入式肛交时始终使用避孕套的比例最低（0%、聚类2中的64.12%和聚类3中的99.76%，P =.004）以及接受肛交时的比例（9.22%、聚类2中的67.71%和聚类3中的98.91%，P =.006），性伴侣性传播感染情况的不确定性最高（77.07%、聚类2中的57.89%和聚类3中的64.5%，P <.001），所有近期性伴侣均为临时性伴侣，连续性行为持续时间最长（分别为6次、5次和5次，P =.045），淋病发病率最高（20.38%、聚类2中的10.09%和聚类3中的14.99%，P =.019）和衣原体发病率最高（16.56%、聚类2中的8.33%和聚类3中的13.21%，P =.045）。聚类2（n = 228）表现出参与高风险行为和性传播感染的程度最低，其特征为性伴侣最少，性伴侣性传播感染情况的确定性最高，且所有近期性伴侣均为固定性伴侣。聚类3（n = 507）表现出中等程度的高风险行为和性传播感染，肛交时始终使用避孕套的比例最高。
结论
本研究识别出具有不同性行为模式的3个中国MSM亚群。针对MSM中风险最高的亚群进行有针对性的公共卫生干预对于性传播感染预防至关重要。
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