男男性行为青年学生感染HIV风险防控行为及影响因素分析

张晓燕; 刘媛媛; 董静然; 蔺展; 张峻峰; 杨杰; 于茂河; 李长平; 崔壮

doi:10.16835/j.cnki.1000-9817.2025268

男男性行为青年学生感染HIV风险防控行为及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2025268

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，天津 300070
3.
天津市疾病预防控制中心性病艾滋病预防控制所，天津 300070

基金项目:

国家自然科学基金面上项目 72374153

详细信息

作者简介:
张晓燕(2000-)，女，内蒙古巴彦淖尔人，在读硕士，主要研究方向为流行病与卫生统计学

通讯作者:
李长平，E-mail: ChangpingLi417@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R167 R512.91
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-20
- 修回日期: 2025-07-26
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-25

Analysis of risk prevention behaviors and influencing factors of HIV infection among young students with MSM

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

摘要

摘要: 目的探讨男男性行为(MSM)青年学生感染人类免疫缺陷病毒(HIV)风险防控行为的潜在类别模式及其对HIV感染和晚发现的影响，为优化干预策略提供依据。方法 2017年9月至2024年12月，通过线上、线下相结合方式招募天津市1 637名MSM青年学生，运用潜在类别分析对11项HIV风险防控行为进行分类。通过多因素Logistic回归分析人口学特征和干预服务情况与潜在类别的关联，同时比较不同行为模式在HIV感染及晚发现上的差异。结果 MSM学生的HIV风险防控行为可分为安全套依赖组(38.42%)、低预防组(27.73%)和综合预防组(33.85%)。接受安全套宣传/检测服务的学生更可能属于综合预防组(OR=5.58)，而接受同伴教育的学生属于综合预防组的可能性更低(OR=0.43)(P值均 < 0.01)。学生MSM人群中，HIV感染率为4.83%，晚发现感染者占2.26%；综合预防组HIV感染率(1.45%)和晚发现病例比例(0.82%)均低于低预防组(7.89%，3.83%)(χ²值分别为16.20，7.31，P值均 < 0.01)。结论 MSM青年学生的HIV风险防控行为存在较大的异质性，综合预防策略可有效降低HIV感染及晚发现风险；但需优化同伴教育内容，加强PrEP/PEP等多元化预防措施的可及性，以提升HIV防控效果。
- 同性恋，男性 /
- 人免疫缺陷病毒蛋白质类 /
- 行为 /
- 回归分析 /
- 学生
Abstract: Objective To explore the potential category patterns of risk prevention and control behaviors of HIV infection among young students who have sex with men (MSM) and their impact on HIV infection and late detection, aiming to optimize intervention strategies. Methods From September 2017 to December 2024, a total of 1 637 MSM young students in Tianjin were recruited through both online and offline channels. Latent class analysis was applied to classify 11 HIV risk prevention and control behaviors. Multivariate Logistic regression analyzed associations between demographic characteristics/intervention services factors and latent classes. Differences in HIV infection and late detection across behavior patterns were compared. Results HIV risk prevention and control behaviors among MSM students were classified into three latent classes: condom-dependent group (38.42%), low prevention group (27.73%), and comprehensive prevention group (33.85%). Students who received condom promotion/testing services were more likely to belong to the comprehensive prevention group (OR=5.58), while those who received peer education were less likely to the comprehensive prevention group (OR=0.43) (both P < 0.01). Among the MSM student population, the HIV infection rate was 4.83%, with 2.26% of cases detected late. The HIV infection rate (1.45%) and late detection proportion (0.82%) in the comprehensive prevention group were lower than those in the low prevention group (7.89% and 3.83%, respectively) (χ²=16.20, 7.31, both P < 0.01). Conclusions HIV risk prevention and control behaviors among MSM young students exhibit significant heterogeneity. Comprehensive prevention strategies can effectively reduce HIV infection and late detection risks. It is necessary to optimize peer education content and improve the accessibility of diversified prevention measures such as PrEP/PEP to enhance HIV prevention and control.
- Homosexuality, male /
- Human immunodeficiency virus proteins /
- Behavior /
- Regression analysis /
- Students
注释:

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图 1 MSM青年学生HIV风险防控行为潜在类别条件概率分布

Figure 1. Conditional probability distributions for latent classes of HIV risk prevention and control behaviors among MSM young students

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表 1 MSM青年学生HIV风险防控行为潜在类别分析拟合指标(n=1 637)

Table 1. Model fit indices for latent class analysis of HIV risk prevention and control behaviors among MSM young students(n=1 637)

类别	AIC值	BIC值	CAIC值	aBIC值	Entropy值	P_LMR值	P_BLRT值	类别概率
1	4 268.08	4 327.49	4 338.49	4 292.54	—	—	—	—
2	2 111.28	2 235.49	2 258.49	2 162.42	0.88	< 0.01	< 0.01	0.64/0.36
3	1 678.34	1 867.36	1 902.36	1 756.17	0.91	< 0.01	< 0.01	0.28/0.38/0.34
4	1 460.40	1 714.23	1 761.23	1 564.92	0.89	0.01	< 0.01	0.22/0.14/0.37/0.27
5	1 290.68	1 609.32	1 668.32	1 421.88	0.89	< 0.09	< 0.01	0.19/0.36/0.27/0.07/0.11

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表 2 MSM青年学生HIV风险防控行为潜在类别的单因素分析

Table 2. Univariate analysis of latent classes of HIV risk prevention and control behaviors among MSM young students

组别	人数	民族		婚姻状况		受教育水平				居住状态
组别	人数	汉族	少数民族	单身	非单身	高中及以下	大专或本科	硕士及以上		≥6个月	< 6个月
安全套依赖组	629	604(96.03)	25(3.97)	623(99.05)	6(0.95)	23(3.66)	499(79.33)	107(17.01)		595(94.59)	34(5.41)
低预防组	454	438(96.48)	16(3.52)	453(99.78)	1(0.22)	21(4.63)	360(79.30)	73(16.08)		430(94.71)	24(5.29)
综合预防组	554	533(96.21)	21(3.79)	548(98.92)	6(1.08)	11(1.99)	422(76.17)	121(21.84)		539(97.29)	15(2.71)
合计	1 637	1 575(96.21)	62(3.79)	1 624(99.21)	13(0.79)	55(3.36)	1 281(78.25)	301(18.39)		1 564(95.54)	73(4.46)
χ²值		0.15		2.69		11.46				6.04
P值		0.91		0.26		0.03				0.05

组别	人数	性取向		HIV/AIDS知识水平		接受安全套宣传和发放/艾滋病咨询与检测			接受同伴教育		近1年是否感染梅毒
组别	人数	同性恋	双性恋	良好	一般	是	否		是	否	是	否
安全套依赖组	629	601(95.55)	28(4.45)	42(6.68)	587(93.32)	384(61.05)	245(38.95)		261(41.49)	368(58.51)	7(1.11)	622(98.89)
低预防组	454	434(95.59)	20(4.41)	37(8.15)	417(91.85)	233(51.32)	221(48.68)		161(35.46)	293(64.54)	9(1.98)	445(98.02)
综合预防组	554	538(97.11)	16(2.89)	18(3.25)	536(96.75)	462(83.39)	92(16.61)		217(39.17)	337(60.83)	12(2.17)	542(97.83)
合计	1 637	1 573(96.09)	64(3.91)	97(5.93)	1 540(94.07)	1 079(65.91)	558(34.09)		639(39.03)	998(60.97)	28(1.71)	1 609(98.29)
χ²值		2.33		11.79		124.99			4.04		2.22
P值		0.30		< 0.01		< 0.01			0.13		0.32
注：()内数字为构成比/%。

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参考文献(25)

[1]	UNAIDS. UNAIDS global AIDS update 2021: confronting inequalities: lessons for pandemic responses from 40 years of AIDS (UNAIDS/JC3020)[R]. Geneva: UNAIDS, 2021.
[2]	刘小峰. 大学生4年间艾滋病感染12 397例, 60%存在这一行为[EB/OL]. (2024-12-03)[2025-03-20]. https://news.ifeng.com/c/8f0gFxalbYU.
[3]	尹承东, 周晓燕. 高校大学生男男性行为人群中HIV传播相关因素分析[J]. 中国校医, 2020, 34(1): 69-71. YIN C D, ZHOU X Y. Analysis of relevant factors of HIV transmission in men who have sex with men (MSM) population of college students[J]. Chin J School Doctor, 2020, 34(1): 69-71. (in Chinese)
[4]	WONG C S, WEI L, KIM Y S. HIV late presenters in Asia: management and public health challenges[J]. AIDS Res Treat, 2023, 2023(1): 9488051.
[5]	The Lancet HIV. Time to tackle late diagnosis[J]. Lancet HIV, 2022, 9(3): e139. doi: 10.1016/S2352-3018(22)00040-6
[6]	POPPING S, VERSTEEGH L, NICHOLS B E, et al. Characteristics and short- and long-term direct medical costs among adults with timely and delayed presentation for HIV care in the Netherlands[J]. PLoS One, 2023, 18(2): e0280877. doi: 10.1371/journal.pone.0280877
[7]	SINHA P, CALFEE C S, DELUCCHI K L. Practitioner's guide to latent class analysis: methodological considerations and common pitfalls[J]. Crit Care Med, 2021, 49(1): e63-e79. doi: 10.1097/CCM.0000000000004710
[8]	时同鑫, 魏薇. 天津市2 104名高校学生男男性行为者的HIV感染情况及影响因素分析[J]. 口岸卫生控制, 2024, 29(3): 14-19. SHI T X, WEI W. HIV infection and influencing factors among 2 104 students who have sex with men in Tianjin[J]. Port Health Control, 2024, 29(3): 14-19. (in Chinese)
[9]	刘优招, 揭宇, 徐慧芳, 等. 中国青年学生男男同性性行为人群HIV感染状况及影响因素[J]. 中国预防医学杂志, 2025, 26(4): 500-504. LIU Y Z, JIE Y, XU H F, et al. HIV infection status and influencing factors among young male students engaging in same-sex behavior in China[J]. Chin J Prev Med, 2025, 26(4): 500-504. (in Chinese)
[10]	LIU Z, CHEN Y, YAO T, et al. Factors related to HIV testing frequency in MSM based on the 2011-2018 survey in Tianjin, China: a hint for risk reduction strategy[J]. BMC Public Health, 2021, 21(1): 1900. doi: 10.1186/s12889-021-11948-6
[11]	MALHOTRA R K. Errors in the use of multivariable Logistic regression analysis: an empirical analysis[J]. Indian J Commun Med, 2020, 45(4): 560-562. doi: 10.4103/ijcm.IJCM_16_20
[12]	VERMUNT J K. Latent class modeling with covariates: two improved three-step approaches[J]. Polit Anal, 2010, 18(4): 450-469. doi: 10.1093/pan/mpq025
[13]	WELLER B E, BOWEN N K, FAUBERT S J. Latent class analysis: a guide to best practice[J]. J Black Psychol, 2020, 46(4): 287-311. doi: 10.1177/0095798420930932
[14]	曾宪华, 肖琳, 张岩波. 潜在类别分析原理及实例分析[J]. 中国卫生统计, 2013, 30(6): 815-817. ZENG X H, XIAO L, ZHANG Y B. Principle of latent class analysis and case analysis[J]. Chin J Health Stat, 2013, 30(6): 815-817. (in Chinese)
[15]	LIU Y, XIAN Y, LIU X, et al. Significant insights from a national survey in China: PrEP awareness, willingness, uptake, and adherence among YMSM students[J]. BMC Public Health, 2024, 24(1): 1009. doi: 10.1186/s12889-024-18512-y
[16]	ETOWA J, THARAO W, MBUAGBAW L, et al. Community perspectives on addressing and responding to HIV-testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among African, Caribbean and Black (ACB) people in Ontario, Canada[J]. BMC Public Health, 2022, 22(1): 913. doi: 10.1186/s12889-022-13093-0
[17]	CHANDRA C, WEISS K M, KELLEY C F, et al. Gaps in sexually transmitted infection screening among men who have sex with men in pre-exposure prophylaxis (PrEP) care in the United States[J]. Clin Infect Dis, 2021, 73(7): e2261-e2269. doi: 10.1093/cid/ciaa1033
[18]	WATSON C W M, PASIPANODYA E, SAVIN M J, et al. Barriers and facilitators to PrEP initiation and adherence among transgender and gender non-binary individuals in Southern California[J]. AIDS Educ Prev, 2020, 32(6): 472-485. doi: 10.1521/aeap.2020.32.6.472
[19]	LUO S. Barriers to expanding HIV testing among male students who have sex with men in Chengdu, China[M]. Los Angeles: University of California, 2019.
[20]	HE J, WANG Y, DU Z, et al. Peer education for HIV prevention among high-risk groups: a systematic review and Meta-analysis[J]. BMC Infect Dis, 2020, 20(1): 338. doi: 10.1186/s12879-020-05003-9
[21]	SUN Y, LU H, YE J, et al. Awareness and use of HIV pre-exposure prophylaxis and factors associated with awareness among MSM in Beijing, China[J]. Sci Rep, 2023, 13(1): 554. doi: 10.1038/s41598-023-27485-8
[22]	BROOKMEYER R, BOREN D, BARAL S D, et al. Combination HIV prevention among MSM in South Africa: results from agent-based modeling[J]. PLoS One, 2014, 9(11): e112668. doi: 10.1371/journal.pone.0112668
[23]	JABR A M, DI STEFANO M D, GRECO P, et al. Errors in condom use in the setting of HIV transmission: a systematic review[J]. Open AIDS J, 2020, 14(1): 16-26. doi: 10.2174/1874613602014010016
[24]	BLAIR C S, JAVANBAKHT M, COMULADA W S, et al. Lubricants and rectal douching: associations with rectal gonorrhea, chlamydia, and/or syphilis infection among men who have sex with men[J]. Int J STD AIDS, 2020, 31(11): 1040-1046. doi: 10.1177/0956462420938485
[25]	BOERING P, SEELEY J, BUULE J, et al. A comparison of self-reported condomless sex and yc-DNA biomarker data from young women engaged in high risk sexual activity in Kampala, Uganda[J]. AIDS Behav, 2024, 28(1): 320-331. doi: 10.1007/s10461-023-04177-y