Identifying High-Risk Populations for Sexually Transmitted Infections in Chinese Men Who Have Sex With Men: A Cluster Analysis.

BACKGROUND

This study aimed to identify subpopulations of Chinese men who have sex with men (MSM) with distinct sexual behavioral patterns and explore their correlations with sexually transmitted infections (STIs).

METHODS

We recruited 892 eligible MSM in Xi'an, China, collecting sociodemographic, sexual behavior, and STI data. Cluster analysis identified distinct sexual behavioral patterns, allowing us to examine STI differences across clusters.

RESULTS

Among the 892 MSM analyzed, 3 clusters were identified. Cluster 1 (n = 157) exhibited high-risk sexual behavioral patterns, including the highest median number of sexual partners (5 vs 1 in cluster 2 vs 3 in cluster 3, P < .001), lowest consistent condom use for insertive anal sex (0% vs 64.12% vs 99.76%, P = .004) and receptive anal sex (9.22% vs 67.71% vs 98.91%, P = .006), highest uncertainty of partners' STIs (77.07% vs 57.89% vs 64.5%, P < .001), all recent partners being casual, longest length of sequential sexual acts (6 vs 5 vs 5, P = .045), and highest rates of gonorrhea (20.38% vs 10.09% vs 14.99%, P = .019) and chlamydia (16.56% vs 8.33% vs 13.21%, P = .045). Cluster 2 (n = 228) showed the lowest engagement in high-risk behaviors and STIs, characterized by the fewest sexual partners, highest certainty of partner's STIs, and all recent partners being regular. Cluster 3 (n = 507) showed moderate levels of high-risk behaviors and STIs, with the highest consistent condom use during anal sex.

CONCLUSIONS

This study identified 3 subpopulations of Chinese MSM with distinct sexual behavioral patterns. Targeted public health interventions to the most at-risk subpopulations of MSM are essential for STI prevention.