The Classification Of The Infection Risk And Risk Factors For Human Papillomavirus Among Men Who Have Sex With Men Based Trajectory Model

Objective:To classify the infection risk of human papillomavirus?HPV?among human immunodeficiency virus?HIV?negative men who have sex with men?MSM?using group-based trajectory modeling?GBTM?.Methods:From March 1st,2016 to December 31th,2016,MSM were recruited as the research objects by the snowballing method,and they were followed up every 6 months.Questionnaires,HPV detection and HIV tests were completed at both baseline and follow-up visits.Using questionnaire to collect data on demographic and sex characteristics,and the investigators used a cotton swab to collect the cells from the anal canal to detect HPV,while using two blood vessels to collect 3ml of blood samples for HIV initial screening and infection diagnosis.HPV infection status was susceptible to change,presenting multiple types of infection.This study used GBTM to match the trend of infection rate of different HPV infection types,and then categorized the research objects on this basis.Used the accumulative infection numbers of different types of HPV as the primary outcome,and the follow-up visits as the predicator to build GBTM.The study subjects were divided into 1,2,3 and 4subgroups.Using three evaluation index,the bayesian information criterion?BIC?,the bayes factor(2 log_e(B₁₀)),and the average posteriori probability?AvePP?to judge fitting effect of different subgroups GBTM,to select the optimal model.Results:There were500 eligible HIV-negative participants at baseline,as of September 30th,2017,MSM were followed-up at most three times,at least once.Evaluated model fitting effect comprehensively by the evaluation index of BIC,2 log_e(B₁₀)and AvePP,the types of HPV infection and the change trend of each type of infection,and the simple principle.Finally,three trajectory model was identified as the best-fitted model that the research objects were divided into three subgroups.One-trajectory model with individuals who were persist negative and infection clearance,accounting for 44.6%?161/361?of the sample,showed a declining pattern with visit and defined as low-risk?LR?group;two-trajectory model with individuals who were persist positive,new infection and other situation,accounting for 49.6%?179/361?,showed a flat pattern and defined as moderate-risk?MR?group;three-trajectory model with individuals who were persist positive,accounting for 5.8%?21/361?,showed an up-trend and regarded as high-risk?HR?group.Compared with LR group,risk factors for MR group included receptive anal intercourse?AOR:2.25,95%CI:1.36-3.70?,occasional condom use in anal sex during past six months?AOR:1.91,95%CI:1.16-3.15?,experience of transactional sex with male in the past year?AOR:3.62,95%CI:1.13-3.70?,and substance use?AOR:1.80,95%CI:1.07-3.04?.Risk factors for HR group included receptive anal intercourse?AOR:2.82,95%CI:1.03-7.70?,occasional condom use in anal sex during past six months?AOR:3.84,95%CI:1.38-10.64?,and disease history of other STIs?AOR:5.23,95%CI:1.30-21.10?.Conclusion:GBTM can effectively categorize and visualize the trend of HPV infection status in MSM,and the results of this study will be the best when the objects were divided into three subgroups.