在中国,男男性行为者(MSM)中的无避孕套性行为是年轻人中HIV感染的主要途径。成都是全国年轻人报告艾滋病毒病例的热点地区。地理社交网络(GSN)智能手机应用程序的广泛使用极大地改变了年轻MSM(YMSM)的性行为模式。然而,关于艾滋病毒发病率和使用GSN应用程序的YMSM风险行为的数据仍然不清楚。
本研究旨在分析和了解成都使用GSN应用程序的YMSM中的HIV发病率及其危险因素,中国。
通过成都的GSN同性恋智能手机应用程序,对18-24岁的YMSM进行了一项开放队列研究,中国,从2018年7月到2020年12月。每个参与者都完成了一份基于网络的社会人口统计学特征问卷,性行为,和其他相关状态;预约了基于网络的HIV检测;然后自愿在指定的检测站点进行检测。在研究期间,通过该应用程序进行了至少一项额外的HIV检测,在研究结束时或在HIV血清转换时对参与者进行评估.通过将观察到的HIV血清转化的总和除以观察到的人年,计算并比较了学生和非学生MSM之间的HIV发病率。使用单变量和多变量(Cox比例风险回归)分析来讨论新的HIV感染的危险因素。
在研究队列中,在研究期间,通过该应用程序进行了至少两次HIV检测的625名YMSM中发生了24次血清转化,贡献了505个观察人年。在所有MSM中,每100人年的HIV发病率为4.75(95%CI2.89-6.61),3.60(95%CI1.27-5.93)在学生MSM中,非学生MSM和5.88(95%CI2.97-8.79)。此外,在该地区居住6个月或以下的人群中,每100人年的HIV发病率为11.11(95%CI4.49-17.73),在接受高中或以下教育的人群中为7.14(95%CI1.52-12.77).在过去6个月中,两个或两个以上的性伴侣(调整后的危险比[HR]3.63,95%CI1.08-12.23)是新的HIV感染的危险因素。在过去6个月中,在肛交(调整后的HR0.38,95%CI0.16-0.88)和仅插入性肛交(调整后的HR0.10,95%CI0.01-0.75)中一致使用避孕套是新的HIV感染的保护因素。
积极使用GSN智能手机应用程序的YMSM中,新的HIV感染率很高,尤其是移民非学生MSM。应实施针对GSN智能手机应用程序的有针对性的干预措施,以提供适应需求的预防和服务,以减少艾滋病毒的威胁。
In China, condomless sex among men who have sex with men (MSM) is the primary route of HIV infection in young people. Chengdu is a hotspot for reported HIV cases among young people nationwide. Extensive use of geosocial networking (GSN) smartphone apps has dramatically changed the pattern of sexual behavior among young MSM (YMSM). However, data on HIV incidence and the risk behavior of YMSM using the GSN app are still obscure.
This
study aims to analyze and understand the HIV incidence and its risk factors among YMSM using GSN apps in Chengdu, China.
An open cohort
study was conducted among YMSM aged 18-24 years through a gay GSN smartphone app in Chengdu, China, from July 2018 to December 2020. Every participant completed a web-based questionnaire on sociodemographic characteristics, sexual behaviors, and other related statuses; made a reservation for a web-based HIV testing; and then voluntarily got tested at the designated testing site. At least one additional HIV test was taken via the app during the
study period, and participants were evaluated at the end of the
study or at the time of HIV seroconversion. By dividing the sum of the observed HIV seroconversions by the observed person-years, HIV incidence was calculated and compared between the student and nonstudent MSM. Univariate and multivariate (Cox proportional hazards regression) analyses were used to discuss the risk factors for new HIV infections.
In the study cohort, 24 seroconversions occurred among 625 YMSM who took at least two HIV tests through the app during the
study period, contributing to 505 observed person-years. The HIV incidence rate per 100 person-years was 4.75 (95% CI 2.89-6.61) among all MSM, 3.60 (95% CI 1.27-5.93) among student MSM, and 5.88 (95% CI 2.97-8.79) among nonstudent MSM. In addition, the HIV incidence per 100 person-years was 11.11 (95% CI 4.49-17.73) among those who had resided in the area for 6 months or less and 7.14 (95% CI 1.52-12.77) among those with senior high school or less education. Two or more sexual partners (adjusted hazards ratio [HR] 3.63, 95% CI 1.08-12.23) in the preceding 6 months was a risk factor for new HIV infections. Consistent condom use for anal sex (adjusted HR 0.38, 95% CI 0.16-0.88) and insertive anal sex only (adjusted HR 0.10, 95% CI 0.01-0.75) in the preceding 6 months were protective factors for new HIV infections.
The rate of new HIV infections among YMSM who actively used GSN smartphone apps was high, especially among migrant nonstudent MSM. Targeted interventions on GSN smartphone apps should be implemented to provide demand-adapted prevention and services to reduce the threat of HIV.