Characteristics Of Social Network And Initiator-leading And Peer-driven Behavior Intervention Among Young Men Who Have Sex With Men

Objectives To describe the characteristics of social network, and to determine the associations between HIV/STDs transmission and characteristics of social network, and to examine the feasibility and effectiveness of initiator-leading and peer-driven behavior intervention among young men who have sex with men.Methods 193 eligible young MSM( aged 18 to 25, and having anal or oral sex with men in last year) were recruited to participate in the study by Respondent-Driven Smapling way in Hefei. An informed consent was administered and only those who agreed to participate were interviewed on face to face. Trained interviewers using questionnaires collected information on participants'sociodemographic characteristics, and number of homosexual partners and sexual behavior during the previous 6 months. Core social networks were enumerated and network size and density were calculated. Additionally, participants were collected 5 ml blood specimen for HIV snd syphilis anti-body testing. Logistic regression was used to analyze the associations between HIV-risk behaviors and HIV & syphilis infection and chacteristics of social network.Based on study above, initiator-leading and peer-driven behavior intervention was conducted among young MSM in Hefei. The 16 young MSM were selected as initiators in MSM venues. Through their peer referral chains, 223 eligible MSM (aged 18 to 25, and having anal or oral sex with men in last year) were recruited to participate in intervention cohort. All participants were divided into 10 intervention groups based on intitiators and their recruitment chains. Baseline survey was self-administered before intervention. Six MSM volunteers were trained by following guidance of intervention and then they conducted four session intervention programme with every group within one month. Assessment was surveyed after two months of intervention finished. Effectiveness evaluation of the intervention was made by comparing baseline with assessement.Results Proportions of network sizes for 2,3,4,5 and 6 were 5.7%,16.6%,19.1%,14.0%,44.6% respectively. Mean of network density was 0.76(SD=0.23). Proportion of networks which consisted of male member only was 52.3%, and member under 25 years old only was 58.5%, and member under college education level only was 13.5%. There no homosexual orientation among member of network accounted for 10.9%. The proportion of social networks with one type of relationship between participant and his network member was 60.6%. Of 193 participants, 46.6% reported having sex with their members of social network, and 53.4%disclosed their same-sexorientation to member of social network. 43.0% participants acquired support for their same-sexorientation from their member of social network.Of characteristics of social network, factors associated with number of anal sex partners including (1) the proportion of male member, (2) the number of sorts of relationship between participant and his network member, (3) the proportion of member accepted college education, (4) the proportion of member fully supporting same-sexorientaion, and (5) having sex with his network member or not. Factors could increase the likelihood of having unprotected anal intercourse involving in the proportion of male member which reached to50% and not to100%, and having sex with his network member. Risk factors of infection of HIV & syphilis were determined as having 2 and more male sexual partners during the previous 6 months and having unprotected anal intercourse as well as network size was 6 during the previous 6 months.The results revealed that IPBI could increase the knowledge related to HIV/AIDS and promote condom use with variety of male partner in the last three anal sex and the last anal sex. Meanwhile, IPBI could increase the rate of having regular male partner and decrease the rate of having 3 and more male sexual partners and the rate of having casual male partner during previous 2 months. IPBI also could promote HIV testing .Conclusions Young MSM's social network played an important role in HIV/STDs transmission."Initiator-Leading and Peer-driven Behavior Intervention"model could be acceptable among young MSM and could increase condom use and decrease number of male sexual partners and promot HIV testing.