The risk of acute and early HIV (AEH) infection among MSM with different behaviour trajectories: an open cohort study in Tianjin, China, 2011-2019.
Xiaomeng Wang, Tiantian Zhang, Qinxue Chang, Chun Wang, Keyun Wang, Zeyang Yu, Honglu Zhang, Huijie Huang, Desheng Song, Elissa Peixoto, Jie Yang, Changping Li, Zhuang Cui, Yuanyuan Liu, Jun Ma
Author Information
Xiaomeng Wang: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Tiantian Zhang: Medical Service Division, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Qinxue Chang: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Chun Wang: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Keyun Wang: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Zeyang Yu: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Honglu Zhang: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Huijie Huang: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Desheng Song: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Elissa Peixoto: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Jie Yang: "Shenlan" Public Health Counseling Service Center, Tianjin, China.
Changping Li: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Zhuang Cui: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China. ZhuangCui417@126.com. ORCID
Yuanyuan Liu: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Jun Ma: Department of Epidemiology and Biostatistics, Tianjin Medical University, 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
BACKGROUND: Acute and early HIV (AEH) infection is characterized by a high viral load and infectivity. Approximately 50% of cases of HIV-1 transmission occur during AEH. Understanding sexual behaviour trajectories would be useful for predicting changes in the risk of HIV acquisition. However, few studies have investigated sexual behaviour trajectories and their association with AEH acquisition. This study identified behaviour trajectories among men who have sex with men (MSM), determined the risk of AEH infection, and compared risk factors between different behaviour trajectories. METHODS: The study was based on an ongoing prospective open cohort of voluntary HIV counselling and testing (VHCT) among MSM in Tianjin, China. From 2011 to 2019, 1974 MSM were recruited. Group-based trajectory modelling (GBTM) was used to identify behaviour trajectories by constructing a sexual risk behaviour score. Logistic regression and generalized estimating equation (GEE) were used to compare the risk of AEH infection and risk factors for different behaviour trajectories. All data analyses were performed using SAS 9.4. RESULTS: The incidence of AEH infection was 1.76/100 person-years, with 64 AEH infections documented in 3633 person-years of follow-up. Three sexual behaviour trajectories were identified: CL (consistently low risk, 35.46%), CH (consistently high risk, 42.71%) and HTL (high to low risk, 21.83%). MSM in the HTL and CH groups had higher AEH infection rates than MSM in the CL group (6.73%, 3.08% and 1.28%, respectively), with ORs of 5.54 (2.60, 11.82) and 2.44 (1.14, 5.25), respectively. MSM aged 30-50 years old and MSM who underwent HIV testing in the last year were more likely to be in the CH group and HTL group. In addition, the HTL group was characterized by a lower likelihood of local registration and a higher likelihood of working as a MSW. CONCLUSION: MSM in the CH group and the HTL group had a higher risk of AEH infection. In the future, VHCT should be performed more often among younger MSM, and HIV counselling should be given the same priority as HIV testing. In addition, VHCT combined with PrEP may have a better preventive impact on MSM with a high risk of AEH infection.
