学生男男性行为者性行为潜在类别分析及其暴露前预防使用的状况

程朝御; 刘萱; 鲜伊丹; 魏思月; 刘媛媛; 刘凤利; 杨杰; 于茂河; 李长平; 崔壮

doi:10.16835/j.cnki.1000-9817.2024215

学生男男性行为者性行为潜在类别分析及其暴露前预防使用的状况

doi: 10.16835/j.cnki.1000-9817.2024215

1.
天津医科大学公共卫生学院流行病与卫生统计学系，天津 300070
2.
天津深蓝公共卫生咨询服务中心
3.
天津市疾病预防控制中心性病艾滋病预防控制所

基金项目:

国家自然科学基金面上项目 72374153

教育部人文社会科学研究规划基金项目 20YJAZH021

天津市卫生健康科技项目 ZC20022

详细信息

作者简介:
程朝御(1999-)，男，天津市人，在读硕士，主要研究方向为流行病与卫生统计学

通讯作者:
崔壮，E-mail：cuizhuang@tmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 C913.5 R512.91 R167
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出版历程
- 收稿日期: 2024-03-29
- 修回日期: 2024-05-03
- 网络出版日期: 2024-07-27
- 刊出日期: 2024-07-25

Analysis of potential categories of sexual behaviors among male students who have sex with men and the status of pre-exposure prophylaxis use

1.
Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin (300070), China

摘要

摘要: 目的使用潜在类别分析学生男男性行为者(MSM)中不同性行为模式人群暴露前预防(PrEP)使用情况，为确定符合MSM的PrEP使用模式提供依据。方法采用按比例抽样的方法对2021年10月20日至12月30日中国大陆31个省级行政区的MSM进行问卷调查，选择其中的1 040名学生纳入研究。对了解性伴HIV感染情况、使用安全套频率、性伴侣数量、进行过多人性行为、提供过商业性行为、使用助性药物以及近一年的性病史共7个性行为特征进行潜类别分析，并对人口学特征进行Logistic回归分析。调查不同性行为风险组的PrEP知晓率、使用意愿率和使用率。结果学生MSM可分为低风险性行为组(82.4%)和高风险性行为组(17.6%)2个潜在类别组。高风险性行为组的PrEP使用率(15.8%)更高，与低风险性行为组(7.2%)比较差异有统计学意义(χ²=13.43，P < 0.05)。居住在东北部、南部和西北部，居住地为试点城市和性角色为“0.5”(可能进行接受性和插入性性行为)的学生更可能属于高风险性行为组(OR值分别为3.13，3.07，3.87，2.22，1.66，P值均 < 0.05)。结论高风险与低风险性行为学生MSM作用PrEP的行为不同，应实施有针对性的干预措施，以促进PrEP在学生MSM中的使用，并降低该人群中感染HIV的风险。
- 同性恋，男性 /
- 暴露前预防 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the use of pre-exposure prophylaxis (PrEP) among male students who had sex with men (MSM) with different sexual behavior patterns using potential categories, so as to provide evidence for determining the use patterns of PrEP consistent with MSM. Methods A questionnaire survey was conducted by proportional sampling method on MSM in 31 provincial administrative regions in mainland China from 20 October to 30 December 2021, a total of 1 040 students were selected for the study. Latent variable analyses were conducted on a total of seven sexual behavioral characteristics, including knowledge of sexual partner HIV infection, frequency of condom use, number of sexual partners, engaging in group sex, provision of commercial sex, use of sex aids, and history of sexually transmitted infections (STIs) in the past year. And demographic characteristics were analyzed by Logistic regression analysis. The rates of PrEP awareness, willingness to use and usage rate in different sexual behavior risk groups were investigated. Results Student MSM could be divided into two potential category groups: a low-risk behavior group (82.4%) and a high-risk behavior group (17.6%). The PrEP usage rate (15.8%) was higher in the high-risk behavior group, and the difference was statistically significant compared to the low-risk behavior group (7.2%) (χ²=13.43, P < 0.05). Student MSM residing in the northeast, south, and northwest of China, in the pilot city, and with a sex role of "0.5" (possible acceptance and insertion of sexual behavior) were more likely to be in the high-risk behavior group (OR=3.13, 3.07, 3.87, 2.22, 1.66, P < 0.05). Conclusion Student MSM in high-risk and low-risk sexual differs in the behavior of PrEP, and targeted interventions should be implemented to promote the use of PrEP and reduce HIV infection in this population.
- Homosexuality, male /
- Pre-exposure prevention /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 学生MSM群体中的2个潜在类别条件概率分布

Figure 1. Conditional probability distribution of 2 latent classes in student MSM population

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表 1 各潜类别模型拟合指标比较

Table 1. Comparison of model fit metrics by latent class

类别数	Log-likelihood	AIC值	BIC值	aBIC值	P_LMRT值	P_BLRT值	Entropy值
1	-3 211.01	6 436.02	6 470.65	6 448.41	—	—	—
2	-3 060.39	6 150.78	6 224.99	6 177.35	< 0.01	< 0.01	0.72
3	-3 042.66	6 131.32	6 245.10	6 172.05	0.08	< 0.01	0.71
4	-3 029.24	6 120.47	6 273.83	6 175.37	0.12	< 0.01	0.74
5	-3 018.40	6 114.80	6 307.73	6 183.86	0.16	—	0.65

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表 2 不同性行为风险组学生MSM的社会人口学特征分布比较

Table 2. Comparison of socio-demographic distribution of MSM among students in different behavioural risk groups

组别	人数	文化程度			月收入			近6个月的肛交中角色
组别	人数	高中或中专	大专或本科	研究生及以上	无固定收入	＜3 000元	≥3 000元	1	0.5	0
低风险组	857	66(7.7)	647(75.5)	144(16.8)	618(72.1)	163(19.0)	76(8.9)	267(31.2)	165(19.3)	425(49.6)
高风险组	183	18(9.8)	136(74.3)	29(15.8)	119(65.0)	37(20.2)	27(14.8)	51(27.9)	52(28.4)	80(43.7)
合计	1 040	84(8.1)	783(75.3)	173(16.6)	737(70.9)	200(19.2)	103(9.9)	318(30.6)	217(20.9)	505(48.6)
χ²值			0.96			6.46			7.67
P值			0.62			0.04			0.02

组别	人数	地理分区							是否为试点城市^a
组别	人数	北部	东北部	东部	南部	西南部	西北部	中部	否	是
低风险组	857	149(17.4)	42(4.9)	273(31.8)	57(6.7)	107(12.5)	40(4.7)	189(22.0)	801(93.5)	56(6.5)
高风险组	183	32(17.5)	18(9.8)	52(28.4)	17(9.3)	14(7.7)	15(8.2)	35(19.1)	160(87.4)	23(12.6)
合计	1 040	181(17.4)	60(5.8)	325(31.3)	74(7.1)	121(11.6)	55(5.3)	224(21.5)	961(92.4)	79(7.6)
χ²值		15.60							7.82
P值		0.02							0.01
注： a试点城市包括沈阳、北京、深圳和重庆；性角色为0.5指可能进行接受性和插入性性行为，0指进行接受性性行为，1指可能进行插入性性行为；()内数字为构成比/%。

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