โครงสร้างเครือข่ายของการนัดพบคู่นอนของกลุ่มชายที่มีเพศสัมพันธ์กับชายในจังหวัดเชียงใหม่โดยใช้การวิเคราะห์เครือข่ายทางสังคม

Abstract

In 2019, the Joint United Nations Program on human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (UNAIDS) reported that 4.7 hundred thousand people were living with HIV in Thailand. In 2007, the Department of Disease Control in Thailand initiated surveillance of the HIV prevalence and associated risk behaviors among men who have sex with men (MSMs) in Bangkok, Chiang Mai, and Phuket. The HIV prevalence has increased over time in both Chiang Mai and Phuket, and in 2016, Bangkok had the highest prevalence of HIV among MSM followed by Chiang Mai Province. Chiang Mai University The aim of this study was to identify the network structure of sex-partner meeting places frequented by the MSM community and relationships between the relevant factors pertaining to MSM. A total of 194 participants were mostly aged 18-24 years old (70.62%), had obtained a bachelor's degree (88.14%), and were students (65.46%). The MSM participants used multiple online apps to communicate with their sexual partners, the most frequently used being Line. Other purposes for using online applications besides hooking up were to find new friends (35.05%) or a partner (30.93%). In the past 3 months, most of them had only had 1 sexual partner (51.55%), sometimes wore a condom (46.39%), and were aware of pre-exposure prophylaxis (PrEP) (62.89%) but did not use it (47.42%). Interestingly, half of them (52.06%) had very poor knowledge about HIV. The results of a Social Network Analysis (SNA) of the networks among MSMs indicate that the majority (n = 194) were members of up to 17 hookup sites/apps in the affiliation network. The centrality metrics indicate that young MSMs meet sex partners within a tight network, with two core hookup sites (Blued Tinder and Grindr) accounting for the majority of connections. Thus, identifying venues most centrally connected within a sexual network may help to identify MSMs most at risk of contracting HIV. Multiple Correspondence Analysis (MCA) of the risk behaviors among MSMs in Chiang Mai identified relationships between age and risk factors such as HIV knowledge, the number of concurrent sex partners, and condom use. Indeed, younger MSMs engage with more concurrent sex partners, do not always use condoms, and have poor HIV knowledge, thereby placing them at a higher risk of contracting HIV. A better understanding of the demographics and behaviors of MSMs who meet partners on these sites can facilitate the development and targeting of effective public health promotion messages We found that the majority of Chiang Mai MSMs use social networks to seek sex partners and are likely to engage in unsafe sex. Blued Tinder and Grindr are the core online sites/apps most used to connect with other MSMs. Understanding the pattern of how MSMs meet sex partners is important for identifying risk behavior and prioritizing HIV testing, care, and prevention.