Behavioral profiles associated with anal HPV infection among MSM attending university in China: a latent class analysis

OBJECTIVE: Human papillomavirus (HPV) is a prevalent sexually transmitted infection (STI) among men who have sex with men (MSM) attending university. Our study aimed to identify distinct behavioral profiles for anal HPV infection in this population using Latent Class Analysis (LCA) and assess factors associated with high-risk behavior. METHODS: We recruited MSM attending university in the University Student HIV Test Intervention Study (UniTest Study) between January and April 2019 in China. Participants completed a self-administered online questionnaire on socio-demographic and sexual behavior characteristics. Participants self-collected anal swabs for HPV genotyping. LCA classified individuals into high and low-risk groups for anal HPV infection based on sexual and related risk behaviors. RESULTS: LCA identified two distinct groups among 292 MSM attending university. The class 2 group exhibited a significantly elevated anal HPV infection rate (52.90%, P < 0.001) compared to the class 1 group (25.55%). Notably, the class 2 group was characterized by higher engagement in casual sex (74.15% vs. 42.87%), having non-student sex partners (77.24% vs. 38.22%), involvement in drunken sex in the past year (26.40% vs. 10.90%), Novel Psychoactive Substances (NPS) use sex history (53.13% vs. 12.88%), and a higher prevalence of HIV testing history (98.80% vs. 81.44%). These findings indicate that the higher-risk behavioral profile was associated with a higher observed prevalence of anal HPV infection. CONCLUSION: Our study identified distinct behavioral profiles associated with anal HPV infection among MSM attending university in China. Tailored interventions addressing substance use (alcohol and NPS), sexual health education emphasizing consistent condom use, and the promotion of HPV vaccination within student health programs are warranted. On-campus HPV testing services represent a potentially valuable service model, but their feasibility, acceptability, and integration into existing health infrastructure require further evaluation before routine implementation. TRIAL REGISTRATION: Chinese Clinical Trial Registry, www.chictr.org.cn : ChiCTR1900020645. Date of Registration: 2019.09.11.