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Peer-reviewedCC BY-NC-ND 4.0BMC Public Health

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

  • Song Fan1
  • Yingming Wang1
  • Ningjun Ren1
  • Maohe Yu2
  • Lin Ouyang3
  • Huachun Zou1,4,5,6
6 affiliations
  1. 1School of Public Health, Southwest Medical University, Luzhou, Sichuan China
  2. 2Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
  3. 3Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
  4. 4Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, 131 Dong’an Road, Shanghai, 200032 People’s Republic Of China
  5. 5Center for AIDS Research (CFAR), School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
  6. 6Melbourne Sexual Health Centre, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia
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Abstract

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.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28509-4.

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Cite

BibTeXRIS
BibTeX
@article{fan2026behavioral,
  title = {{Behavioral profiles associated with anal HPV infection among MSM attending university in China: a latent class analysis}},
  author = {Song Fan and Yingming Wang and Ningjun Ren and Maohe Yu and Lin Ouyang and Huachun Zou},
  journal = {BMC Public Health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12889-026-28509-4},
  url = {https://doi.org/10.1186/s12889-026-28509-4},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Behavioral profiles associated with anal HPV infection among MSM attending university in China: a latent class analysis
AU  - Song Fan
AU  - Yingming Wang
AU  - Ningjun Ren
AU  - Maohe Yu
AU  - Lin Ouyang
AU  - Huachun Zou
PY  - 2026
DA  - 2026/07/22
JO  - BMC Public Health
DO  - 10.1186/s12889-026-28509-4
UR  - https://doi.org/10.1186/s12889-026-28509-4
AB  - 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.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28509-4.
SN  - 1471-2458
ER  -