{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:17:11Z","timestamp":1788380231082,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&D Programme of China","doi-asserted-by":"publisher","award":["2022YFC2505100"],"award-info":[{"award-number":["2022YFC2505100"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Programme of China","doi-asserted-by":"publisher","award":["2022YFC2505103"],"award-info":[{"award-number":["2022YFC2505103"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Outstanding Young Scholars Support Program","award":["3111500001"],"award-info":[{"award-number":["3111500001"]}]},{"DOI":"10.13039\/501100002412","name":"Xi\u2019an Jiaotong University","doi-asserted-by":"publisher","award":["YX6J004"],"award-info":[{"award-number":["YX6J004"]}],"id":[{"id":"10.13039\/501100002412","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Education in China Humanities and Social Science Program","award":["24YJC840051"],"award-info":[{"award-number":["24YJC840051"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to identify subpopulations of Chinese men who have sex with men (MSM) with distinct sexual behavioral patterns and explore their correlations with sexually transmitted infections (STIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We recruited 892 eligible MSM in Xi'an, China, collecting sociodemographic, sexual behavior, and STI data. Cluster analysis identified distinct sexual behavioral patterns, allowing us to examine STI differences across clusters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 892 MSM analyzed, 3 clusters were identified. Cluster 1 (n = 157) exhibited high-risk sexual behavioral patterns, including the highest median number of sexual partners (5 vs 1 in cluster 2 vs 3 in cluster 3, P &amp;lt; .001), lowest consistent condom use for insertive anal sex (0% vs 64.12% vs 99.76%, P = .004) and receptive anal sex (9.22% vs 67.71% vs 98.91%, P = .006), highest uncertainty of partners' STIs (77.07% vs 57.89% vs 64.5%, P &amp;lt; .001), all recent partners being casual, longest length of sequential sexual acts (6 vs 5 vs 5, P = .045), and highest rates of gonorrhea (20.38% vs 10.09% vs 14.99%, P = .019) and chlamydia (16.56% vs 8.33% vs 13.21%, P = .045). Cluster 2 (n = 228) showed the lowest engagement in high-risk behaviors and STIs, characterized by the fewest sexual partners, highest certainty of partner's STIs, and all recent partners being regular. Cluster 3 (n = 507) showed moderate levels of high-risk behaviors and STIs, with the highest consistent condom use during anal sex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study identified 3 subpopulations of Chinese MSM with distinct sexual behavioral patterns. Targeted public health interventions to the most at-risk subpopulations of MSM are essential for STI prevention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae754","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T16:37:36Z","timestamp":1735317456000},"source":"Crossref","is-referenced-by-count":4,"title":["Identifying High-Risk Populations for Sexually Transmitted Infections in Chinese Men Who Have Sex With Men: A Cluster Analysis"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1194-9784","authenticated-orcid":false,"given":"Fang","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingyang","family":"She","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaixia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University , Xi'an, Shaanxi ,","place":["China"]},{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"Central Clinical School, Faculty of Medicine, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"2025013005312812600_ofae754-B1","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1016\/S1473-3099(17)30310-9","article-title":"Sexually transmitted infections: challenges ahead","volume":"17","author":"Unemo","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2025013005312812600_ofae754-B2","author":"World Health Organization"},{"key":"2025013005312812600_ofae754-B3","doi-asserted-by":"crossref","first-page":"e42820","DOI":"10.2196\/42820","article-title":"Spatiotemporal and seasonal trends of class A and B notifiable infectious diseases in China: retrospective analysis","volume":"9","author":"Zheng","year":"2023","journal-title":"JMIR Public Health Surveill"},{"key":"2025013005312812600_ofae754-B4","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/JD9.0000000000000099","article-title":"Epidemiology of genital chlamydial infection in China in 2019","volume":"3","author":"Yue","year":"2020","journal-title":"Int J Dermatol Venerol"},{"key":"2025013005312812600_ofae754-B5","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/QAI.0000000000000933","article-title":"Incidence of HIV infection and sexually transmitted infections and related risk factors among very young men who have sex with men","volume":"72","author":"Garofalo","year":"2016","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025013005312812600_ofae754-B6","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/OLQ.0000000000000767","article-title":"Patterns of sexual behavior and sexually transmitted infections in young men who have sex with men","volume":"45","author":"Vasilenko","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2025013005312812600_ofae754-B7","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1186\/s12889-022-13799-1","article-title":"Barriers and facilitators to utilisation of public sexual healthcare services for male sex workers who have sex with men (MSW-MSM) in the Netherlands: a qualitative study","volume":"22","author":"Peters","year":"2022","journal-title":"BMC Public Health"},{"key":"2025013005312812600_ofae754-B8","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1177\/0956462416688818","article-title":"Prevalence and the associated risk factors of HIV, STIs and HBV among men who have sex with men in Kunming, China","volume":"28","author":"Zhang","year":"2017","journal-title":"Int J STD AIDS"},{"key":"2025013005312812600_ofae754-B9","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1186\/s12879-019-4664-1","article-title":"Anatomical site prevalence and genotypes of Chlamydia trachomatis infections among men who have sex with men: a multi-site study in China","volume":"19","author":"Zhou","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2025013005312812600_ofae754-B10","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.2105\/AJPH.2004.046714","article-title":"The trouble with \u201cMSM\u201d and \u201cWSW\u201d: erasure of the sexual-minority person in public health discourse","volume":"95","author":"Young","year":"2005","journal-title":"Am J Public Health"},{"key":"2025013005312812600_ofae754-B11","doi-asserted-by":"crossref","first-page":"903","DOI":"10.2105\/AJPH.2012.301005","article-title":"Racial\/ethnic differences in patterns of sexual risk behavior and rates of sexually transmitted infections among female young adults","volume":"103","author":"Pflieger","year":"2013","journal-title":"Am J Public Health"},{"key":"2025013005312812600_ofae754-B12","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s10508-014-0258-6","article-title":"Patterns of adolescent sexual behavior predicting young adult sexually transmitted infections: a latent class analysis approach","volume":"44","author":"Vasilenko","year":"2015","journal-title":"Arch Sex Behav"},{"key":"2025013005312812600_ofae754-B13","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/OLQ.0000000000000302","article-title":"Intimate partner violence and correlates with risk behaviors and HIV\/STI diagnoses among men who have sex with men and men who have sex with men and women in China: a hidden epidemic","volume":"42","author":"Davis","year":"2015","journal-title":"Sex Transm Dis"},{"issue":"Suppl 8","key":"2025013005312812600_ofae754-B14","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1097\/01.aids.0000304697.39637.4c","article-title":"Risk factors of HIV infection and prevalence of co-infections among men who have sex with men in Beijing, China","volume":"21","author":"Zhang","year":"2007","journal-title":"AIDS"},{"issue":"Suppl 6","key":"2025013005312812600_ofae754-B15","doi-asserted-by":"crossref","first-page":"e25354","DOI":"10.1002\/jia2.25354","article-title":"The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission","volume":"22","author":"Chow","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"2025013005312812600_ofae754-B16","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1097\/OLQ.0000000000000800","article-title":"Associations between anorectal Chlamydia and oroanal sex or saliva use as a lubricant for anal sex: a cross-sectional survey","volume":"45","author":"Cornelisse","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2025013005312812600_ofae754-B17","doi-asserted-by":"crossref","first-page":"e033290","DOI":"10.1136\/bmjopen-2019-033290","article-title":"Sexual behaviour patterns and STI risk: results of a cluster analysis among men who have sex with men in Portugal","volume":"11","author":"Blondeel","year":"2021","journal-title":"BMJ Open"},{"key":"2025013005312812600_ofae754-B18","first-page":"1276","article-title":"Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men","volume":"44","author":"Wang","year":"2023","journal-title":"Chin J Epidemiol"},{"key":"2025013005312812600_ofae754-B19","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1023\/A:1001963413640","article-title":"The influence of gender on sex: a study of men's and women's self-reported high-risk sex behavior","volume":"29","author":"Cubbins","year":"2000","journal-title":"Arch Sex Behav"},{"key":"2025013005312812600_ofae754-B20","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1186\/s12916-020-01796-3","article-title":"Chlamydia trachomatis transmission between the oropharynx, urethra and anorectum in men who have sex with men: a mathematical model","volume":"18","author":"Xu","year":"2020","journal-title":"BMC Med"},{"key":"2025013005312812600_ofae754-B21","doi-asserted-by":"crossref","first-page":"3336","DOI":"10.1016\/j.eswa.2008.01.039","article-title":"A simple and fast algorithm for k-medoids clustering","volume":"36","author":"Park","year":"2009","journal-title":"Expert Syst Appl"},{"key":"2025013005312812600_ofae754-B22"},{"key":"2025013005312812600_ofae754-B23","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1016\/j.eswa.2013.08.068","article-title":"Gower distance-based multivariate control charts for a mixture of continuous and categorical variables","volume":"41","author":"Tuerhong","year":"2014","journal-title":"Expert Syst Appl"},{"key":"2025013005312812600_ofae754-B24","first-page":"50","article-title":"Clustering based feature selection using partitioning around medoids (PAM)","volume":"14","author":"Ismi","year":"2020","journal-title":"J Inform"},{"key":"2025013005312812600_ofae754-B25","doi-asserted-by":"crossref","first-page":"115265","DOI":"10.1016\/j.psychres.2023.115265","article-title":"An overview of clustering methods with guidelines for application in mental health research","volume":"327","author":"Gao","year":"2023","journal-title":"Psychiatry Res"},{"key":"2025013005312812600_ofae754-B26","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1080\/0094965031000136012","article-title":"A new partitioning around medoids algorithm","volume":"73","author":"Van der Laan","year":"2003","journal-title":"J Stat Comput Simul"},{"key":"2025013005312812600_ofae754-B27","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/978-3-030-32047-8_16","volume-title":"Similarity search and applications","author":"Schubert","year":"2019"},{"key":"2025013005312812600_ofae754-B28","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/QCO.0000000000000892","article-title":"Advances and challenges in sexually transmitted infections prevention among men who have sex with men in Asia","volume":"36","author":"Ma","year":"2023","journal-title":"Curr Opin Infect Dis"},{"key":"2025013005312812600_ofae754-B29","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12879-014-0738-2","article-title":"Risk factors for HIV and STI diagnosis in a community-based HIV\/STI testing and counselling site for men having sex with men (MSM) in a large German city in 2011\u20132012","volume":"15","author":"Marcus","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2025013005312812600_ofae754-B30","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jinf.2020.11.007","article-title":"Predicting the diagnosis of HIV and sexually transmitted infections among men who have sex with men using machine learning approaches","volume":"82","author":"Bao","year":"2021","journal-title":"J Infect"},{"key":"2025013005312812600_ofae754-B31","doi-asserted-by":"crossref","first-page":"e37850","DOI":"10.2196\/37850","article-title":"Web-based risk prediction tool for an individual's risk of HIV and sexually transmitted infections using machine learning algorithms: development and external validation study","volume":"24","author":"Xu","year":"2022","journal-title":"J Med Internet Res"},{"key":"2025013005312812600_ofae754-B32","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1136\/sextrans-2023-055978","article-title":"Assessing the effectiveness of HIV\/STI risk communication displays among Melbourne Sexual Health Centre attendees: a cross-sectional, observational and vignette-based study","volume":"100","author":"Latt","year":"2024","journal-title":"Sex Transm Infect"},{"key":"2025013005312812600_ofae754-B33","doi-asserted-by":"crossref","first-page":"3040","DOI":"10.1111\/j.1743-6109.2011.02438.x","article-title":"Sexual behaviors and situational characteristics of most recent male-partnered sexual event among gay and bisexually identified men in the United States","volume":"8","author":"Rosenberger","year":"2011","journal-title":"J Sex Med"},{"key":"2025013005312812600_ofae754-B34","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1136\/sextrans-2015-052502","article-title":"Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men, a new public health message: a cross-sectional survey","volume":"92","author":"Chow","year":"2016","journal-title":"Sex Transm Infect"},{"key":"2025013005312812600_ofae754-B35","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1128\/JCM.01186-16","article-title":"Neisseria gonorrhoeae bacterial DNA load in the pharynges and saliva of men who have sex with men","volume":"54","author":"Chow","year":"2016","journal-title":"J Clin Microbiol"},{"key":"2025013005312812600_ofae754-B36","doi-asserted-by":"crossref","first-page":"3128","DOI":"10.1007\/s10461-024-04398-9","article-title":"Examining the effects of PrEP use on sexual behaviors and sexually transmitted infections among Chinese men who have sex with men: a cross-sectional study","volume":"28","author":"She","year":"2024","journal-title":"AIDS Behav"},{"key":"2025013005312812600_ofae754-B37","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s41237-019-00092-6","article-title":"Special feature: dimension reduction and cluster analysis","volume":"46","author":"van de Velden","year":"2019","journal-title":"Behaviormetrika"},{"key":"2025013005312812600_ofae754-B38","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1037\/adb0000467","article-title":"The relationship between social norms and sexual risk-reduction intentions and behavior among men who have sex with men: findings from an eHealth intervention","volume":"33","author":"Basaran","year":"2019","journal-title":"Psychol Addict Behav"},{"key":"2025013005312812600_ofae754-B39","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/OLQ.0000000000000231","article-title":"Trends and patterns of sexual behaviors among adolescents and adults aged 14 to 59 years, United States","volume":"42","author":"Liu","year":"2015","journal-title":"Sex Transm Dis"},{"key":"2025013005312812600_ofae754-B40","doi-asserted-by":"crossref","first-page":"1184758","DOI":"10.3389\/fgene.2023.1184758","article-title":"Probing the genomic landscape of human sexuality: a critical systematic review of the literature","volume":"14","author":"Bragazzi","year":"2023","journal-title":"Front Genet"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofae754\/61286726\/ofae754.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/1\/ofae754\/61286726\/ofae754.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/1\/ofae754\/61286726\/ofae754.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T05:31:54Z","timestamp":1738215114000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofae754\/7933743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,23]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,12,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofae754","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,12,23]]},"article-number":"ofae754"}}