Application of multi-state Markov models to analyze transition of homosexual behavior in men who have sex with men and influencing factors in Shandong Province

• Published in: Zhōnghuá liúxíngbìng zázhì Vol. 46; no. 5; p. 820
• Main Authors: Fan, W Q, Lin, Y X, Wang, G Y, Liao, M Z, Ma, W, Jiao, K D
• Format: Journal Article
• Language: Chinese
• Published: China 10.05.2025
• Subjects: Adult; China; Homosexuality, Male - statistics & numerical data; Humans; Male; Markov Chains; Risk-Taking; Sexual Behavior - statistics & numerical data; Sexual Partners; Surveys and Questionnaires; Unsafe Sex - statistics & numerical data; Young Adult; China
• ISSN: 0254-6450
• DOI: 10.3760/cma.j.cn112338-20241202-00764

To analyze the transition patterns of anal sex and unprotected anal intercourse (UAI), estimate the transition intensity and probability, and identify factors influencing the transition patterns in men who have sex with men (MSM) in Shandong Province. In August 2019, MSM aged ≥18 years old were recruited as subjects from 11 cities in Shandong Province. The baseline survey were completed in December 2019, and followup surveys were conducted once every 3 mouths from June 2020 to March 2021. Time-continuous, state-discrete multi-state reversible Markov model was constructed based on the status of MSM's sexual behaviors with different types of sexual partners [anal sex occurred or not (S1=No, S2=Yes) and UAI occurred or not (S1=No,S2=Yes)] to analyze the transition patterns and the influencing factors. A total of 735 MSM were included. The transition intensity of starting anal sex with stable and casual partners was 1.935 times and 0.595 times higher than that of discontinuing this behavior, respectively. While t