Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands
This study identified subgroups of sexual behaviors associated with increased STI/HIV risk among those eligible for but not using pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake and prioritization in the context of restricted capacity. We used data from sexual health centers (SHCs) i...
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| Veröffentlicht in: | PloS one 2023-04, Vol.18 (4), p.e0284056-e0284056 |
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| creator | de la Court, Feline van Wees, Daphne van Benthem, Birgit Hoornenborg, Elske Prins, Maria Boyd, Anders |
| description | This study identified subgroups of sexual behaviors associated with increased STI/HIV risk among those eligible for but not using pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake and prioritization in the context of restricted capacity. We used data from sexual health centers (SHCs) in the Netherlands, including all visits of eligible but non-PrEP using men who have sex with men (MSM), men who have sex with men and women (MSMW) and transgender persons between July 2019 (start of the Dutch national PrEP pilot (NPP)) and June 2021. Using latent class analysis (LCA), we identified classes of sexual behaviors (number of partners, chemsex, group sex and sex work) and explored whether these classes were associated with STI diagnosis and sociodemographics. Across 45,582 visits of 14,588 eligible non-PrEP using individuals, the best fitting LCA model contained three classes of sexual behaviors. Classes were distinguished by seldomly reported sexual behaviors (class 1; 53.5%, n = 24,383), the highest proportions of ≥6 partners and group sex (class 2; 29.8%, n = 13,596), and the highest proportions of chemsex and sex work (class 3; 16.7% of visits, n = 7,603). Visits in classes 2 and 3 (vs. class 1) were significantly more often with individuals who were diagnosed with an STI, older (≥36 vs. ≤35 years), MSMW (vs. MSM), and visiting an urban (vs. non-urban) SHC; while these visits were significantly less often with individuals from an STI/HIV endemic area. The percentage of visits at which an STI was diagnosed was 17.07% (n = 4,163) in class 1, 19.53% (n = 2,655) in class 2 and 25.25% (n = 1,920) in class 3. The highest risk of STI, and thereby HIV, was in those engaging in specific subgroups of sexual behavior characterized by frequently reporting multiple partners, group sex, sex work or chemsex. PrEP uptake should be encouraged and prioritized for these individuals. |
| doi_str_mv | 10.1371/journal.pone.0284056 |
| format | Article |
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We used data from sexual health centers (SHCs) in the Netherlands, including all visits of eligible but non-PrEP using men who have sex with men (MSM), men who have sex with men and women (MSMW) and transgender persons between July 2019 (start of the Dutch national PrEP pilot (NPP)) and June 2021. Using latent class analysis (LCA), we identified classes of sexual behaviors (number of partners, chemsex, group sex and sex work) and explored whether these classes were associated with STI diagnosis and sociodemographics. Across 45,582 visits of 14,588 eligible non-PrEP using individuals, the best fitting LCA model contained three classes of sexual behaviors. Classes were distinguished by seldomly reported sexual behaviors (class 1; 53.5%, n = 24,383), the highest proportions of ≥6 partners and group sex (class 2; 29.8%, n = 13,596), and the highest proportions of chemsex and sex work (class 3; 16.7% of visits, n = 7,603). Visits in classes 2 and 3 (vs. class 1) were significantly more often with individuals who were diagnosed with an STI, older (≥36 vs. ≤35 years), MSMW (vs. MSM), and visiting an urban (vs. non-urban) SHC; while these visits were significantly less often with individuals from an STI/HIV endemic area. The percentage of visits at which an STI was diagnosed was 17.07% (n = 4,163) in class 1, 19.53% (n = 2,655) in class 2 and 25.25% (n = 1,920) in class 3. The highest risk of STI, and thereby HIV, was in those engaging in specific subgroups of sexual behavior characterized by frequently reporting multiple partners, group sex, sex work or chemsex. PrEP uptake should be encouraged and prioritized for these individuals.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0284056</identifier><identifier>PMID: 37023009</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Behavior ; Biology and Life Sciences ; Disease prevention ; Education ; Evaluation ; Female ; Gays & lesbians ; Group sex ; Health aspects ; Health facilities ; Health risks ; Hepatitis ; HIV ; HIV (Viruses) ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; Homosexuality, Male ; Human immunodeficiency virus ; Humans ; Infections ; Male ; Medical diagnosis ; Medical tests ; Medicine and Health Sciences ; Men ; Mens health ; MSM (Men who have sex with men) ; Netherlands - epidemiology ; People and Places ; Pre-Exposure Prophylaxis ; Prevention ; Probability ; Prophylaxis ; Sex ; Sex industry ; Sexual and Gender Minorities ; Sexual Behavior ; Sexual health ; Sexually transmitted diseases ; Social Sciences ; Sociodemographics ; STD ; Subgroups ; Syphilis ; Urban areas ; Variables</subject><ispartof>PloS one, 2023-04, Vol.18 (4), p.e0284056-e0284056</ispartof><rights>Copyright: © 2023 de la Court et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 de la Court et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 de la Court et al 2023 de la Court et al</rights><rights>2023 de la Court et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-7b355fe9ead7c57add58b2944e8b00f88d416f841e3f3d7377f26f750d27de6d3</cites><orcidid>0000-0001-6539-9364</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079044/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079044/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37023009$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mossong, Joel</contributor><creatorcontrib>de la Court, Feline</creatorcontrib><creatorcontrib>van Wees, Daphne</creatorcontrib><creatorcontrib>van Benthem, Birgit</creatorcontrib><creatorcontrib>Hoornenborg, Elske</creatorcontrib><creatorcontrib>Prins, Maria</creatorcontrib><creatorcontrib>Boyd, Anders</creatorcontrib><title>Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>This study identified subgroups of sexual behaviors associated with increased STI/HIV risk among those eligible for but not using pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake and prioritization in the context of restricted capacity. 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Visits in classes 2 and 3 (vs. class 1) were significantly more often with individuals who were diagnosed with an STI, older (≥36 vs. ≤35 years), MSMW (vs. MSM), and visiting an urban (vs. non-urban) SHC; while these visits were significantly less often with individuals from an STI/HIV endemic area. The percentage of visits at which an STI was diagnosed was 17.07% (n = 4,163) in class 1, 19.53% (n = 2,655) in class 2 and 25.25% (n = 1,920) in class 3. The highest risk of STI, and thereby HIV, was in those engaging in specific subgroups of sexual behavior characterized by frequently reporting multiple partners, group sex, sex work or chemsex. PrEP uptake should be encouraged and prioritized for these individuals.</description><subject>Analysis</subject><subject>Behavior</subject><subject>Biology and Life Sciences</subject><subject>Disease prevention</subject><subject>Education</subject><subject>Evaluation</subject><subject>Female</subject><subject>Gays & lesbians</subject><subject>Group sex</subject><subject>Health aspects</subject><subject>Health facilities</subject><subject>Health risks</subject><subject>Hepatitis</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>Homosexuality, Male</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical tests</subject><subject>Medicine and Health Sciences</subject><subject>Men</subject><subject>Mens health</subject><subject>MSM (Men who have sex with men)</subject><subject>Netherlands - 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We used data from sexual health centers (SHCs) in the Netherlands, including all visits of eligible but non-PrEP using men who have sex with men (MSM), men who have sex with men and women (MSMW) and transgender persons between July 2019 (start of the Dutch national PrEP pilot (NPP)) and June 2021. Using latent class analysis (LCA), we identified classes of sexual behaviors (number of partners, chemsex, group sex and sex work) and explored whether these classes were associated with STI diagnosis and sociodemographics. Across 45,582 visits of 14,588 eligible non-PrEP using individuals, the best fitting LCA model contained three classes of sexual behaviors. Classes were distinguished by seldomly reported sexual behaviors (class 1; 53.5%, n = 24,383), the highest proportions of ≥6 partners and group sex (class 2; 29.8%, n = 13,596), and the highest proportions of chemsex and sex work (class 3; 16.7% of visits, n = 7,603). Visits in classes 2 and 3 (vs. class 1) were significantly more often with individuals who were diagnosed with an STI, older (≥36 vs. ≤35 years), MSMW (vs. MSM), and visiting an urban (vs. non-urban) SHC; while these visits were significantly less often with individuals from an STI/HIV endemic area. The percentage of visits at which an STI was diagnosed was 17.07% (n = 4,163) in class 1, 19.53% (n = 2,655) in class 2 and 25.25% (n = 1,920) in class 3. The highest risk of STI, and thereby HIV, was in those engaging in specific subgroups of sexual behavior characterized by frequently reporting multiple partners, group sex, sex work or chemsex. PrEP uptake should be encouraged and prioritized for these individuals.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37023009</pmid><doi>10.1371/journal.pone.0284056</doi><tpages>e0284056</tpages><orcidid>https://orcid.org/0000-0001-6539-9364</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_2796897091 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Behavior Biology and Life Sciences Disease prevention Education Evaluation Female Gays & lesbians Group sex Health aspects Health facilities Health risks Hepatitis HIV HIV (Viruses) HIV Infections - epidemiology HIV Infections - prevention & control Homosexuality, Male Human immunodeficiency virus Humans Infections Male Medical diagnosis Medical tests Medicine and Health Sciences Men Mens health MSM (Men who have sex with men) Netherlands - epidemiology People and Places Pre-Exposure Prophylaxis Prevention Probability Prophylaxis Sex Sex industry Sexual and Gender Minorities Sexual Behavior Sexual health Sexually transmitted diseases Social Sciences Sociodemographics STD Subgroups Syphilis Urban areas Variables |
| title | Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T17%3A01%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Characterizing%20subgroups%20of%20sexual%20behaviors%20among%20men%20who%20have%20sex%20with%20men%20eligible%20for,%20but%20not%20using,%20PrEP%20in%20the%20Netherlands&rft.jtitle=PloS%20one&rft.au=de%20la%20Court,%20Feline&rft.date=2023-04-06&rft.volume=18&rft.issue=4&rft.spage=e0284056&rft.epage=e0284056&rft.pages=e0284056-e0284056&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0284056&rft_dat=%3Cgale_plos_%3EA744511708%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2796897091&rft_id=info:pmid/37023009&rft_galeid=A744511708&rft_doaj_id=oai_doaj_org_article_667a88d4735f4a1a85226a88696170fc&rfr_iscdi=true |