Clusters of Sexual Behavior in Human Immunodeficiency Virus-positive Men Who Have Sex With Men Reveal Highly Dissimilar Time Trends.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
16 01 2020
Historique:
received: 30 11 2018
accepted: 08 03 2019
pubmed: 16 3 2019
medline: 7 1 2021
entrez: 16 3 2019
Statut: ppublish

Résumé

Separately addressing specific groups of people who share patterns of behavioral change might increase the impact of behavioral interventions to prevent transmission of sexually transmitted infections. We propose a method based on machine learning to assist the identification of such groups among men who have sex with men (MSM). By means of unsupervised learning, we inferred "behavioral clusters" based on the recognition of similarities and differences in longitudinal patterns of condomless anal intercourse with nonsteady partners (nsCAI) in the HIV Cohort Study over the last 18 years. We then used supervised learning to investigate whether sociodemographic variables could predict cluster membership. We identified 4 behavioral clusters. The largest behavioral cluster (cluster 1) contained 53% of the study population and displayed the most stable behavior. Cluster 3 (17% of the study population) displayed consistently increasing nsCAI. Sociodemographic variables were predictive for both of these clusters. The other 2 clusters displayed more drastic changes: nsCAI frequency in cluster 2 (20% of the study population) was initially similar to that in cluster 3 but accelerated in 2010. Cluster 4 (10% of the study population) had significantly lower estimates of nsCAI than all other clusters until 2017, when it increased drastically, reaching 85% by the end of the study period. We identified highly dissimilar behavioral patterns across behavioral clusters, including drastic, atypical changes. The patterns suggest that the overall increase in the frequency of nsCAI is largely attributable to 2 clusters, accounting for a third of the population.

Sections du résumé

BACKGROUND
Separately addressing specific groups of people who share patterns of behavioral change might increase the impact of behavioral interventions to prevent transmission of sexually transmitted infections. We propose a method based on machine learning to assist the identification of such groups among men who have sex with men (MSM).
METHODS
By means of unsupervised learning, we inferred "behavioral clusters" based on the recognition of similarities and differences in longitudinal patterns of condomless anal intercourse with nonsteady partners (nsCAI) in the HIV Cohort Study over the last 18 years. We then used supervised learning to investigate whether sociodemographic variables could predict cluster membership.
RESULTS
We identified 4 behavioral clusters. The largest behavioral cluster (cluster 1) contained 53% of the study population and displayed the most stable behavior. Cluster 3 (17% of the study population) displayed consistently increasing nsCAI. Sociodemographic variables were predictive for both of these clusters. The other 2 clusters displayed more drastic changes: nsCAI frequency in cluster 2 (20% of the study population) was initially similar to that in cluster 3 but accelerated in 2010. Cluster 4 (10% of the study population) had significantly lower estimates of nsCAI than all other clusters until 2017, when it increased drastically, reaching 85% by the end of the study period.
CONCLUSIONS
We identified highly dissimilar behavioral patterns across behavioral clusters, including drastic, atypical changes. The patterns suggest that the overall increase in the frequency of nsCAI is largely attributable to 2 clusters, accounting for a third of the population.

Identifiants

pubmed: 30874293
pii: 5381154
doi: 10.1093/cid/ciz208
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

416-424

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Auteurs

Luisa Salazar-Vizcaya (L)

Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland.

Katharina Kusejko (K)

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Switzerland.

Axel J Schmidt (AJ)

Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland.
Sigma Research, London School of Hygiene and Tropical Medicine, United Kingdom.

Germán Carrillo-Montoya (G)

Alpiq Energy AI, Olten, Solothurn.

Dunja Nicca (D)

Institute of Nursing Science, University of Basel, Switzerland.

Gilles Wandeler (G)

Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland.

Dominique L Braun (DL)

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Switzerland.

Jan Fehr (J)

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.

Katharine E A Darling (KEA)

Infectious Diseases Service, Department of Medicine, University Hospital of Lausanne (CHUV), Switzerland.

Enos Bernasconi (E)

Division of Infectious Diseases, Lugano Regional Hospital, Switzerland.

Patrick Schmid (P)

Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland.

Huldrych F Günthard (HF)

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Switzerland.

Roger D Kouyos (RD)

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Switzerland.

Andri Rauch (A)

Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland.

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