JMIR Publications

ABSTRACT

Background:

Young men who have sex with men (YMSM) have a higher risk of HIV infection. However, the evidence of HIV incidence from large cohort was limited in this key population, especially in Chinese YMSM

Objective:

This study aimed to investigate the HIV incidence and its associated risk factors among YMSM aged 16-24years in Tianjin, China.

Methods:

We conducted the investigations in the largest local non-governmental organization (NGO) serving MSM in Tianjin from October 2017 to December 2022. YMSM completed a face-to-face questionnaire face-to-face, which contained their demography information, sexual behaviors, psychoactive substances use, and sexually transmitted infections status.At the same time, their blood samples were collected for HIV testing. All YMSM who received at least two investigations during the study period were included in this open retrospective cohort. HIV incidence was calculated by dividing the sum of observed HIV seroconversions by the observed personyears (PYs). A Cox proportional hazards regression model was used to identify risk factors of HIV incidence.

Results:

A total of 1367 HIV-negative YMSM were included in the cohort. The overall incidence was 2.6 (95% CI: 2.0–3.2) per 100 PYs The segmented HIV incidence was 3.0 (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 in 2017-2018, 2019-2020 and 2021-2022, respectively. Compared to YMSM who had been followed less than three times, those who had been followed three times and above had relatively lower risk of HIV infection [Adjusted hazard ratio (AHR)=0.553, 95% CI: 0.325-0.941]. YMSM who would linke to find sexual partners through offline places had a higher risk of HIV infection compared to those who find sexual partners online (AHR=2.207, 95% CI:1.198-4.064). Compared to YMSM without syphilis those infected with syphilis had increased risk of HIV incidence (AHR=2.249, 95% CI: 1.143-4.425). YMSM who used psychoactive substances had a higher risk of HIV infection compared to those did not use (AHR=2.459, 95% CI: 1.403-4.309).

Conclusions:

Given the severity of the HIV epidemic among YMSM in recent years, we conducted this study, which complements data on HIV incidence among YMSM in large cities in China. Our study find that the incidence of HIV among YMSM in Tianjin is high, and there has been no decline in recent years, meanwhile dangerous behaviors such as use of psychoactive substances are widely present, demonstrating a urgent need for tailored prevention and control interventions for this key population.