| Objective Learning the characteristics of intimate social network and sexual network among HIV-infected middle-aged and elderly males(over 50 years old)and healthy group,and uncovering the role of intimate social network and sexual network in HIV infection of middle-aged and elderly males,and providing theoretical and empirical support for improving intervention strategies of HIV prevention and high-risk sexual behavior,to help prevent the spread of HIV among the elderly or slow it down.Methods This study uses the method of case-control study.By analyzing the symptoms,in a county-level city in Chengdu,with a large number of HIV-infected people and a rapid incrase in the epidemic situation among males aged≥50 years,using a case group of HIV-infected males aged≥50 years who were newly identified as positive and not receiving antiretroviral therapy from April 2019 to October 2020,and a control group of healthy males aged≥50 years with negative HIV antibody test results,questionnaires and personal in-depth interviews were conducted to collect information on their intimate social and sexual networks.Through social network analysis,the size of the survey respondents’ intimate social network and sexual network,the composition of the network,the demographic characteristics of network members,and the degree of intimacy with network members are generally described,and the overall network is central analyzed.Network density,centrality,and core-periphery analysis are carried out for geographic networks.A logistic regression model was established,and the demographic characteristics,intimate social network characteristics and sexual network characteristics with P<0.20 in the univariate analysis were included as independent variables into the model.According to the AOR value,the high-risk factors of HIV infection in middle-aged and elderly males were determined.Results The number of intimate social network members ≥ 4 of case group(63.16%)more than control group(23.40%).The cumulative number of sexual partners ≥4 of case group(96.49%)more than control group(11.58%).35.09% of the case group had multiple sex partners,more than the control group(1.18%).The intimate social network and sexual network of 80.61% of the control group completely overlapped,more than the case group(13.16%),and the intimate social network and sexual network of 50.88% of the case group were completely non-overlapping,more than the control group(17.73%).Registered permanent residence not located in this county(OR=3077.677,95%CI:1.193-7938541.428),the monthly personal income more than RMB 3,000(OR=729.043,95%CI :1.253-424082.391),the number of intimate social network members ≥4(OR=10323.367,95%CI : 2.881-36991169.88),the cumulative number of sexual partners ≥4(OR=76700.943,95%CI : 11.265-522252034.1),and the presence of multiple sexual partners(OR=4698.871,95%CI:1.594-13849837.64)are risk factors for HIV infection in middle-aged and elderly males.And high sexual satisfaction with the first sexual partner(OR=0.001,95%CI:0-0.286)is a protective factor for HIV infection in them.When intimate social network overlaps with sexual network,high-risk behaviors can be reduced,so that the formation of healthy sexual beliefs can be promoted,and the risk of HIV infection can be reduced.Middle-aged and elderly males lack the concept of reproductive health care and risk awareness,do not fully understand the disease prevention function of condoms,and the use rate of condoms is low(1.49%-13.83%).Middle-aged and old males were relatively open to sexual concepts and attitudes,and the incidence of non-marital sexual behavior was high.Street shops and flower tea shops are high-frequency places for commercial sexual activity,with degree centrality of 0.544 and 0.532,and betweenness centrality of0.580 and 0.498.The staff of township health centers and CDCs are the "key communicators" of HIV prevention and control knowledge,with degree centrality of0.469 and 0.246,and betweenness centrality of 0.326 and 0.060;About 50% of the people who knew that the case group was infected with HIV expressed their acceptance and support,and the problem of social discrimination against AIDS needs to be solved.Suggestions Firstly,the whole society should face up to the sexual needs of middle-aged and elderly males,establish correct social cognition,guide them to form healthy sexual concepts,and help families understand and accept their normal needs.Secondly,systematically and comprehensively popularize sex-related knowledge and increase the awareness;carry out warning sex education pertinently,and cultivate healthy sexual morality concept;increase the promotion and use of condoms,and advocate safe sex education;strengthen anti-discrimination education and create a tolerant social environment.Thirdly,the means of publicity and the target of publicity should be diversified,and the publicity and education of key places and key groups should be done well.Fourthly,help middle-aged and elderly males to build a good and stable intimate social network and sexual network to meet their the social interaction needs. |
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