Analysis Of Social Networks And Molecular Transmission Networks Of HIV-infected Men Who Have Sex With Men Among Guangzhou

Background: AIDS is the biggest public health challenge in the 21 st century.Since the first case of HIV infection was discovered in 1983,as of2018,there were 37.9 million surviving HIV patients and patients worldwide.It is worth noting that a number of studies have shown that the rate of HIV(human immunodeficiency virus)infection among men who have sex with men(MSM)has increased year by year.MSM populations have multiple sexual partners and unprotected sex.The higher proportion is a high-risk group of people infected with HIV.At present,controlling the epidemic of HIV in MSM population has become the focus and difficulty of sexually transmitted disease prevention and control in Guangzhou.In this study,new HIV-infected persons infected through the men-and-male behavioral pathway were used as a breakthrough point.Social network analysis was used to explore the characteristics of the central social network of the MSM population.Using genetic sequence data to reconstruct the HIV-1 molecular transmission network and rapidly expand the transmission cluster Reveal the HIV-1 transmission characteristics and key management targets in the MSM population to explore precise intervention strategies.Methods: This study was a cross-sectional survey.The institution-based sampling method was used to recruit MSM populations with newly confirmed HIV-1 antibody-positive male-to-male behavioral pathways in Guangzhou from January 1 to August 29,2019.An MSM population with a positive HIV test,a confirmation report number,18 years of age or older,and had had sex with men and men(oral and anal sex)within 1 year,without other mental illnesses,with a clear awareness,and can answer questions normally.Sample size calculation: Due to the hidden nature of the MSM population,the sample size of the MSM sentinel reported in Guangzhou in 2017 and 2018 and seasonal fluctuations are combined,and the sample size is set to 80.On-site recruitment sites include 4 VCTs in Guangzhou.For recruited qualified respondents,use social network analysis methods to analyze the size of the individual centrality relationship network and the individual-centric risk relationship network of individuals in the MSM population,compare the sociodemographic similarities between the respondents and the nominees,and analyze the occurrence of UAI.Influencing factors.The social network questionnaire was designed using the nomination generation method and nomination interpretation method.Based on the sequence of newly confirmed HIV-1 positive infected persons transmitted by the male-male behavioral route in 2015 provided by the Guangzhou Center for Disease Control and Prevention,the alignment was performed with the newly discovered sequences in this study.The threshold value of the genetic distance ≤1.5% can be used to infer whether there is a direct or indirect epidemiological connection between the two sequences.Based on the pairwise sequence data obtained by this threshold,HIV-TRACE was introduced to construct the HIV-1 molecular transmission network.Generate a HIV-1 molecular transmission network diagram,and derive data related to molecular transmission characteristics such as nodes,edges,and clusters.The analysis further identified high-risk communicators in the HIV molecular transmission network.Statistical analysis was performed using STATA 15.0 software.Results: A total of 165 questionnaires were obtained in this study.After the quality check,18 invalid questionnaires and 2 duplicate questionnaires were eliminated.A total of 145 qualified and valid questionnaires were obtained.A total of 145 HIV-1 positive men who have sex with men were included in this study.They nominated 468 same-sex men and women,and formed 145 individual-centric sexual networks and 118 individual-centric dangerous relationships.The size of the individual central relationship network is mainly 2 and 3,and the size of the individual central risk relationship network is 1 and 2.Compared with people with elementary education and below,people in high school or junior college and college or college are more likely to choose same-sex partners with a high degree of similarity with their education level.a OR and 95% CL are: 79.18(17.19-364.73)and 39.61(10.63-147.61).Compared with the 18-25 year olds,the 31-40 year olds are more likely to choose homosexual partners with high similarity in their monthly income levels.The a OR and 95% CL are: 2.51(1.14-5.55);and Compared with those earning between 0 and 999 yuan,those with monthly incomes of 1,000 to3999 yuan,4000 to 6999 yuan,and 7000 to 9999 yuan may choose homosexual partners with high similarity to their monthly income level.a OR And 95% CL were: 2.47(1.09-5.61),4.31(1.94-9.55),4.75(1.84-12.24);compared with the 18-25 age group,the 26-30 age group chose similarity to their marriage The probability of high homosexual partners is lower,a OR and95% CL are: 0.42(0.19-0.95).Compared with choosing a relationship with a boyfriend(fixed partner),the respondents were less likely to choose a temporary partner to develop UAI.The a OR and 95% CL were0.39(0.26-0.59).The 145 HIV-1 antibody-positive sera included in this study,after nucleic acid extraction and PCR amplification,yielded 135 HIV-1 pol region genes,of which 37 were linked to other sequences to participate in the construction of HIV molecular transmission clusters.Cluster analysis found that people between the ages of 31-40 years were less likely to connect with other people to construct HIV molecular transmission clusters.a OR and 95% CL were: 0.17(0.03-1);those who were divorced(separated,widowed),and Others are more likely to connect to construct HIV molecular transmission clusters,with a OR and 95% CL of13.77(1.22-155.95);use a value of 3 equal to 3 as the defining point for high-risk communicators.Twelve high-risk communicators of the HIV molecular network in this study were obtained.Conclusion: In general,the MSM population has certain similarities in the choice of sexual partners.The MSM population has a tendency to choose people similar to themselves as sexual partners.The education level,marital status,and income level will affect the MSM population and sexuality.Similarity between partners.Combined with the 2015 new HIV infection sequence in Guangzhou,only 37 samples in this study participated in the construction of the HIV molecular transmission network.In order to propose a more accurate intervention strategy,the sample size needs to be increased.There are 12high-risk communicators in the transmission network.Epidemiological investigations and interventions can improve the precise control of HIV infection in MSM people.