Clustering analysis of sexual behavioral patterns and risk of sexually transmitted infections in Chinese men who have sex with men

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-04-24 DOI:10.1016/j.jiph.2025.102786

Bingyang She , Yiming Liu , Siqi Lin , Fang Lu , Yi Liu , Jiajun Sun , Gaixia Li , Yawu Hu , Shu Su , Lei Zhang

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Abstract

Introduction

This study identifies clusters in Chinese men who have sex with men (MSM) by sexual behavioral patterns and defines high-risk subgroups for gonorrhea, chlamydia, and syphilis infections.

Methods

We conducted a longitudinal study of Chinese MSM from November 2020 to January 2022, collecting weekly data over 12 consecutive weeks on sequential sexual act patterns and testing for gonorrhea, chlamydia, and syphilis infections. Hierarchical clustering identified sexual behavior patterns, and survival analysis estimated infection incidence within each cluster.

Results

We identified three main clusters (n = 91, 100, 62), one small cluster (n = 8) and 41 unclustered participants. Participants in cluster 1 engaged in both insertive and receptive roles in oral, anal sex and rimming during sexual encounters. Cluster 2 participants predominately performed insertive sexual acts, while cluster 3 performed receptive sexual acts. During follow-up, cluster 1 exhibited a significantly higher incidence of overall gonorrhea infection (581.51/100,000 person-days), pharyngeal (355.45/100,000 person-days), anorectum gonorrhea (487.63/100,000 person-days) and syphilis (17.19 %) while comparing with cluster 2 and 3. Consistently, cluster 1 was significantly more likely to engage in kissing (40.08 %) and insertive rimming (6.77 %) and receptive rimming (7.18 %), in sexual act pairs such as ‘receptive oral sex-insertive oral sex’ (8.71 %), ‘receptive rimming-insertive anal sex’ (4.59 %), ‘kissing-receptive oral sex’ (13.62 %), ‘insertive anal sex-receptive anal sex’ (5.38 %) and ‘insertive rimming-receptive rimming’ (6.83 %).

Conclusion

Sexual role preference is a significant factor in clustering Chinese MSM. Those who assume both insertive and receptive roles demonstrate a substantial higher risk of gonorrhea and syphilis infections.

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中国男男性行为模式与性传播感染风险的聚类分析

本研究通过性行为模式确定了中国男男性行为人群（MSM），并定义了淋病、衣原体和梅毒感染的高危亚群。方法：从2020年11月至2022年1月，我们对中国MSM进行了纵向研究，收集了连续12周的连续性行为模式和淋病、衣原体和梅毒感染检测的每周数据。分层聚类确定性行为模式，生存分析估计每个聚类内的感染发生率。结果我们确定了3个主要集群（n = 91,100,62），一个小集群（n = 8）和41个非聚类参与者。第1组的参与者在口交、肛交和性接触中扮演插入和接受的角色。第二组参与者主要进行插入性行为，而第三组参与者主要进行接受性行为。随访期间，聚类1淋病总感染率（581.51/10万人-日）、咽部淋病感染率（355.45/10万人-日）、肛肠淋病感染率（487.63/10万人-日）、梅毒感染率（17.19 %）显著高于聚类2和聚类3。一致地，集群1更有可能参与接吻（40.08 %）、插入式口交（6.77 %）和接受式口交（7.18 %），在诸如“接受口交-插入口交”（8.71 %）、“接受口交-插入式肛交”（4.59 %）、“亲吻-接受口交”（13.62 %）、“插入式肛交-接受式肛交”（5.38 %）和“插入式肛交-接受式肛交”（6.83 %）等性行为对中。结论性角色偏好是中国男男性行为人群聚集的重要因素。那些同时扮演插入和接受角色的人表现出更高的淋病和梅毒感染风险。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.