基于轨迹模型的青少年男男性行为者HIV感染风险及影响因素

Risk and influencing factors of HIV infection among adolescent men who have sex with men based on trajectory model on trajectory model

目的 探究青少年男男性行为者(young men who have sex with men, YMSM)HIV感染风险发展轨迹,并分析HIV感染风险的影响因素。方法 基于在湖北省、湖南省、江西省3地开展的动态随访队列,运用基于群组轨迹模型(group-based trajectory model, GBTM)分析YMSM人群HIV感染风险的发展轨迹,使用广义估计方程(generalized estimation equation, GEE)分析与HIV感染风险相关的因素。结果 2017年9月20日―2018年1月21日共460名HIV阴性YMSM被纳入随访,GBTM识别出3组HIV感染风险发展轨迹,分别为低风险组、中风险组、高风险组,风险越高组的YMSM首次同性性行为年龄越低、农村户口比例更高,差异均有统计学意义(均有P<0.05)。GEE结果显示首次性行为年龄、抑郁量表得分、同性恋歧视、心理韧性均与HIV感染风险存在关联(均有P<0.05)。结论 YMSM人群普遍存在HIV感染风险且感知歧视水平高者HIV感染风险高,应关注YMSM人群的心理健康。

Objective To explore the trajectory of HIV infection risk among young men who have sex with men(YMSM), and to analyze associated factors of HIV infection risk. Methods A dynamic cohort among YMSM was conducted in Hubei, Hunan and Jiangxi Provinces. The group-based trajectory model(GBTM) was used to explore the trajectory of HIV infection risk of YMSM, and the generalized estimation equation(GEE) was performed to analyze the risk factors related to HIV infection. Results A total of 460 HIV-negative YMSM were included in the cohort from September 20, 2017 to January 21, 2018. Three groups were identified by GBTM, including low-risk group, medium-risk group and high-risk group. The YMSM were in the group with higher risk, the lower the age at which they first had sex debut, and the higher proportion of rural residents(all P<0.05).The results of GEE showed that the age of sexual debut, depression, sexual minority stigma and resilience were associated with HIV infection risk(all P<0.05). Conclusions YMSM were generally at the risk of HIV infection, and those who with high level of stigma were at a higher risk of HIV infection. Importance should be attached to the mental health of YMSM.