Zhai Mengxi, Wang Shijie, Li Nuo, Li Jiayu, Zhou Longhui, Wang Qiwen, Xiao Chenchang, Li Yili, Yu Bin, Yan Hong
Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China.
Department of Medicine, City College, Wuhan University of Science and Technology, Wuhan, China.
J Racial Ethn Health Disparities. 2025 Sep 27. doi: 10.1007/s40615-025-02660-x.
The sexual partner's HIV status trajectory of young men who have sex with men (YMSM) has a significant impact on HIV prevention. There are some potential associations between adverse experiences and HIV status trajectories of sexual partners among YMSM. This study aimed to examine the trajectory of HIV status in sexual partners and to investigate effects of adversity experiences on the sexual partner's HIV status trajectories.
Study data (N = 411) were derived from a 5-year YMSM cohort conducted in Central China from 2017 to 2021. The adversity experiences, including adverse childhood experiences (ACEs), sexual minority discrimination, everyday discrimination, and internalized discrimination, were measured at baseline. Other psychosocial variables including resilience and social support were measured at baseline. The HIV status of YMSM partners was examined at baseline and each follow-up survey. The group-based trajectory modeling (GBTM) was used to derive trajectories of partners' HIV status, and the multinomial logistic regression was used to examine the association between adversity experiences and the trajectories.
The GBTM categorized the HIV status of YMSM sexual partners into four groups, including Group I (low risk), Group II (risk reduction), Group III (increased risk) and Group IV (high risk). The ACEs among YMSM were associated with a higher risk of their sexual partners being categorized into Group III (OR [95% CI] = 1.353 [1.012, 1.808], p = 0.041) and Group IV (OR [95% CI] = 1.268 [1.023, 1.571], p = 0.030). Among YMSM, older age (OR [95% CI] = 1.245 [1.041, 1.489], p = 0.016) and lower education level (OR [95% CI] = 4.053 [1.710, 9.606], p < 0.001) were associated with a higher risk of their sexual partners being categorized into Group IV. Other adversity experiences and psychosocial variables did not show significant impacts on the trajectories.
ACEs among YMSM exerted a significant impact on the HIV status trajectories of their sexual partners. Our findings underscore that YMSM with a history of ACEs were more likely to have sexual partners in higher-risk HIV status groups, which implies a greater potential for HIV transmission within their sexual networks.
男男性行为者（YMSM）性伴侣的艾滋病毒感染状况轨迹对艾滋病毒预防有重大影响。YMSM的不良经历与性伴侣的艾滋病毒感染状况轨迹之间存在一些潜在关联。本研究旨在研究性伴侣的艾滋病毒感染状况轨迹，并调查不良经历对性伴侣艾滋病毒感染状况轨迹的影响。
研究数据（N = 411）来自2017年至2021年在中国中部进行的一项为期5年的YMSM队列研究。在基线时测量不良经历，包括童年不良经历（ACEs）、性少数群体歧视、日常歧视和内化歧视。在基线时测量其他心理社会变量，包括心理韧性和社会支持。在基线和每次随访调查中检查YMSM伴侣的艾滋病毒感染状况。使用基于群体的轨迹建模（GBTM）得出伴侣艾滋病毒感染状况的轨迹，并使用多项逻辑回归来检查不良经历与轨迹之间的关联。
GBTM将YMSM性伴侣的艾滋病毒感染状况分为四组，包括第一组（低风险）、第二组（风险降低）、第三组（风险增加）和第四组（高风险）。YMSM中的ACEs与他们的性伴侣被归类为第三组（OR [95% CI] = 1.353 [1.012, 1.808]，p = 0.041）和第四组（OR [95% CI] = 1.268 [1.023, 1.571]，p = 0.030）的较高风险相关。在YMSM中，年龄较大（OR [95% CI] = 1.245 [1.041, 1.489]，p = 0.016）和教育水平较低（OR [95% CI] = 4.053 [1.710, 9.606]，p < 0.001）与他们的性伴侣被归类为第四组的较高风险相关。其他不良经历和心理社会变量对轨迹没有显著影响。
YMSM中的ACEs对其性伴侣的艾滋病毒感染状况轨迹产生了重大影响。我们的研究结果强调，有ACEs病史的YMSM更有可能有处于艾滋病毒高风险感染状况组的性伴侣，这意味着在他们的性网络中艾滋病毒传播的可能性更大。
