Relationship Between Adversity Experiences and HIV Status Trajectory of Sexual Partners Among HIV-Negative Young Men Who Have Sex with Men: A Prospective Cohort Study.

Abstract

Background: The sexual partner's HIV status trajectory of young men who have sex with men (YMSM) has a significant impact on HIV prevention. There are some potential associations between adverse experiences and HIV status trajectories of sexual partners among YMSM. This study aimed to examine the trajectory of HIV status in sexual partners and to investigate effects of adversity experiences on the sexual partner's HIV status trajectories.

Method: Study data (N = 411) were derived from a 5-year YMSM cohort conducted in Central China from 2017 to 2021. The adversity experiences, including adverse childhood experiences (ACEs), sexual minority discrimination, everyday discrimination, and internalized discrimination, were measured at baseline. Other psychosocial variables including resilience and social support were measured at baseline. The HIV status of YMSM partners was examined at baseline and each follow-up survey. The group-based trajectory modeling (GBTM) was used to derive trajectories of partners' HIV status, and the multinomial logistic regression was used to examine the association between adversity experiences and the trajectories.

Results: The GBTM categorized the HIV status of YMSM sexual partners into four groups, including Group I (low risk), Group II (risk reduction), Group III (increased risk) and Group IV (high risk). The ACEs among YMSM were associated with a higher risk of their sexual partners being categorized into Group III (OR [95% CI] = 1.353 [1.012, 1.808], p = 0.041) and Group IV (OR [95% CI] = 1.268 [1.023, 1.571], p = 0.030). Among YMSM, older age (OR [95% CI] = 1.245 [1.041, 1.489], p = 0.016) and lower education level (OR [95% CI] = 4.053 [1.710, 9.606], p < 0.001) were associated with a higher risk of their sexual partners being categorized into Group IV. Other adversity experiences and psychosocial variables did not show significant impacts on the trajectories.

Conclusions: ACEs among YMSM exerted a significant impact on the HIV status trajectories of their sexual partners. Our findings underscore that YMSM with a history of ACEs were more likely to have sexual partners in higher-risk HIV status groups, which implies a greater potential for HIV transmission within their sexual networks.