Trends of sexual behaviors and related factors in high-risk MSM from 2010 to 2023: a repeated cross-sectional study in Zhejiang, China

作者：Wenwen Liu, Xiaoxiao Chen, Shanling Wang, Yating Wang, Haijiang Lin, Ye Yao · 发表于：BMC Public Health · 年份：2025 · DOI：10.1186/s12889-025-25517-8 · 被引用次数：1 · 研究领域：HIV/AIDS Research and Interventions、Reproductive tract infections research、Adolescent Sexual and Reproductive Health

BACKGROUND: Specific high-risk subgroups of men who have sex with men (MSM) play crucial roles in sexually transmitted infection (STI) transmission. This study investigated temporal trends in sexual behaviors and associated factors among bisexual MSM, active MSM, and active MSM in bisexuality. METHODS: From 2010 to 2023, MSM were recruited in Zhejiang, China, through multiple strategies, including community popular opinion leader (CPOL) outreach, venue-based sampling (VBS), HIV voluntary counseling and testing (VCT) clinics, and online platforms. MSM who reported anal sex in the past six months and completed a standardized survey were classified into three high-risk subgroups. We used chi-square trend tests and weighted multivariable logistic regression analyses to assess temporal trends and associated factors. Additionally, SHapley Additive exPlanations (SHAPs) were applied to evaluate the relative importance of predictors. RESULTS: Among the 4197 MSM, 2709 were classified as high-risk, with the proportions of the three high-risk subgroups showing gradual declines but remaining above 20%. Significantly, the rate of consistent condom use has decreased since COVID-19. Weighted logistic regression revealed that bisexual MSM were less likely to be recruited from networks (OR 0.70, 95% CI: 0.21–0.89), younger (OR 0.97, 95% CI: 0.96–0.98), and married (OR 12.68, 95% CI: 10.38–15.33). Active MSM were more likely to be recruited from public bathhouses/sauna rooms/foot spas/massage s...