Using latent class analysis to identify money boys at highest risk of HIV infection

• Published in: Public health (London) Vol. 177; pp. 57 - 65
• Main Authors: Yu, M.-H., Guo, C.-M., Gong, H., Li, Y., Li, C.-P., Liu, Y., Guo, M., Zhao, Y.-Q., Xu, J., Li, Z., Gao, Y.-J., Yang, J., Cui, Z.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2019; Elsevier Science Ltd
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Anal intercourse; Anal sex; Antiviral drugs; Boys; China - epidemiology; Condoms; Cross-Sectional Studies; Data collection; Drug abuse; Employment; Health risks; High-risk sexual behavior; HIV; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infections; Intervention; Interviews; Latent Class Analysis; LCA; Male; Money; Money boys; Prostitution; Residence; Risk; Risk Assessment - methods; Risk behavior; Risk taking; Safe sexual practices; Sampling; Sampling methods; Sex; Sex industry; Sex Workers - psychology; Sex Workers - statistics & numerical data; Sexual abuse; Sexual behavior; Sexual Behavior - psychology; Sexual partner-seeking; Sexual partners; Sexual Partners - psychology; Sexually transmitted diseases; STD; Subgroups; Substance abuse; Substance-Related Disorders - epidemiology; Tests; Viruses; Young Adult; China; Sexual partner-seeking; Money boys; LCA; High-risk sexual behavior; Sexual behavior
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2019.07.020

Limited research has been conducted to investigate the characteristics of money boys (MBs) in China. This study was aimed to identify the subgroups of MBs based on sexual behaviors, Net-based venue sex-seeking, and substance abuse. Cross-sectional study. Convenience sampling was used to recruit MBs from December 2014 to June 2015 in Tianjin, China. Face-to-face interviews were conducted for 330 MBs, and trained interviewers collected data. The laboratory-confirmed human immunodeficiency virus (HIV)–positive rate was 11.52% among 330 MBs. Four classes were identified through latent class analysis (LCA) method: ‘relatively safe behavior’ group, ‘higher sexual risk’ group, ‘multiple sexual-partners’ group, and ‘unprotected sex and substance abuse’ group, and there is a significant difference based on the HIV status. Significant differences were found in original residence, monthly income, duration in sex trade, employment, history of sexually transmitted infection (STI), HIV testing, knowledge of free antiviral treatment policy, and awareness of free AIDS testing between the four latent classes (P < 0.05). MBs who used Net-based venues to seek sexual partners; who have inconsistent condom use, substance abuse, a longer duration in sex trade, multiple sexual clients, and multiple anal sex; and who were full-time employed had the highest risk of HIV infection. The utility of LCA to identify subgroups based on risky behaviors attributes to formulating targeted intervention strategy. •Latent class analysis was conducted to uncover underlying categories in a population based on individual responses to the distinct patterns of multiple human immunodeficiency virus (HIV) risk factors.•This was the first study to categorize money boys (MBs) into groups based on their sex-trading venue, sexual behaviors, and substance abuse.•Four classes were identified, and there is a significant difference between them based on HIV status.•MBs who have inconsistent condom usage, Net-based venue sex-seeking, substance abuse, multiple sexual partners, and multiple anal sexes were at highest risk of HIV infection.