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Identifying high risk subgroups of MSM: a latent class analysis using two samples.

M Kumi Smith1, Gabriella Stein2, Weibin Cheng3

  • 1Division of Epidemiology & Community Health, School of Public Health, University of Minnesota Twin Cities, 1300 South 2nd Street, Minneapolis, MN, 55454, USA. smi00831@umn.edu.

BMC Infectious Diseases
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Summary

Latent class analysis of Chinese men who have sex with men (MSM) revealed distinct risk groups. Online surveys captured a broader, more representative population than clinic-based samples, highlighting sampling biases in HIV intervention targeting.

Keywords:
HIV infectionLCAMSMVulnerable populations

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Area of Science:

  • Epidemiology
  • Biostatistics
  • Public Health

Background:

  • Latent class analysis (LCA) is increasingly utilized for targeted HIV interventions among men who have sex with men (MSM).
  • Generalizability of population structures identified through LCA across different settings remains under-explored.
  • This study compares LCA results from two distinct online samples of HIV-negative Chinese MSM to assess generalizability and the impact of sampling methods.

Purpose of the Study:

  • To compare latent class structures derived from two online samples of Chinese MSM.
  • To evaluate the generalizability of population structures identified by LCA.
  • To assess how sampling strategies influence the validity of LCA results for HIV intervention planning.

Main Methods:

  • Latent class analyses (LCAs) were conducted on two datasets: a nationwide online survey and a sentinel surveillance survey in Guangzhou (2014).
  • Both surveys included HIV-negative Chinese men who have sex with men (MSM).
  • Models were informed by common risk factors for HIV acquisition in MSM.

Main Results:

  • LCA of Guangzhou data identified two classes, primarily differing by group sex frequency.
  • LCA of the nationwide survey identified three classes, with two similar to Guangzhou's, distinguished by group sex.
  • The nationwide survey revealed an additional low-risk behavior class absent in the Guangzhou sample.

Conclusions:

  • The nationwide online sample appears more representative of the broader Chinese MSM population, including a distinct low-risk group.
  • Sentinel surveillance involving HIV/STI testing may oversample higher-risk MSM, potentially inflating risk perception.
  • Two higher-risk MSM groups emerged, differentiated by group sex behaviors, with the highest risk group showing increased odds of self-reported HIV infection, closeted tendencies, and gender fluidity.