HIV Incidence and Associated Risk Factors Among Young Men Who Have Sex With Men in Tianjin, China: Retrospective Cohort Study
Bibliographic record
Abstract
Background: Young men who have sex with men (YMSM) have a higher risk of HIV infection. However, evidence of HIV incidence from large cohort studies is limited in this key population, particularly among Chinese YMSM. Objective: This study aimed to investigate the HIV incidence and associated risk factors among YMSM aged 16-24 years in Tianjin, China. Methods: We conducted a retrospective cohort study among men who have sex with men aged 16-24 years from October 2017 to December 2022 through the largest local nongovernmental organization serving men who have sex with men in Tianjin. Participants who responded to the investigations at least twice during the study period were included. They completed questionnaires on demographic information, sexual behaviors, psychoactive substance use, and sexually transmitted infection status. Simultaneously, their blood samples were collected for HIV testing. HIV incidence was calculated by dividing the sum of observed HIV seroconversions by the observed person-years (PYs). A Cox proportional hazards regression model was used to identify risk factors associated with HIV incidence. Results: A total of 1367 HIV-negative YMSM were included in the cohort, among whom 62 seroconversions occurred, contributing 2384.2 observed PYs; the total incidence was 2.6 (95% CI 2.0-3.2) per 100 PYs. The segmented HIV incidence rates were 3 (95% CI 1.5-4.5), 2.4 (95% CI 1.5-3.3), and 2.7 (95% CI 1.5-3.9) per 100 PYs for 2017-2018, 2019-2020, and 2021-2022, respectively. Compared to YMSM who had been followed up fewer than three times, those followed up three or more times had a relatively lower risk of HIV infection (Adjusted hazard ratio [AHR] 0.553, 95% CI 0.325-0.941). YMSM who preferred finding sexual partners offline had a higher risk of HIV infection compared to those who preferred finding sexual partners online (AHR 2.207, 95% CI 1.198-4.066). Compared to YMSM without syphilis, those infected with syphilis had an increased risk of HIV infection (AHR 2.234, 95% CI 1.137-4.391). Additionally, YMSM who used psychoactive substances had a higher risk of HIV infection compared to those who did not use such substances (AHR 2.467, 95% CI 1.408-4.321). Conclusions: Our study complements data on HIV incidence among YMSM in large cities across China. Syphilis infection and the use of psychoactive substances were risk factors associated with HIV occurrence, demonstrating an urgent need for tailored prevention and control interventions for this key population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".