应用EPP和Spectrum模型估计预测浙江省台州地区艾滋病疫情

Estimation and projection on HIV/AIDS through application of Estimation and Projection Package and Spectrum models, in Taizhou prefecture, Zhejiang province

目的探讨运用艾滋病疫情估计和预测软件（EPP）及Spectrum模型估计与预测浙江省台州地区艾滋病疫情以及抗病毒治疗对疫情的影响。方法以浙江省台州地区为研究现场，收集整理该地人口和社会信息以及艾滋病疫情数据，应用EPP、Spectrum模型拟合以估计和预测该地区艾滋病流行趋势，同时考察抗病毒治疗对疫情的潜在影响。结果根据EPP和Spectrum模型估计，台州地区处于艾滋病低流行阶段，男男性行为人群和静脉注射毒品人群HIV感染率较高且增幅明显；2010年该地区现存活HIV感染者和艾滋病患者（HIV／AIDS）共计1773例（95％CI：1384～2449），HIV感染率为0．03％（95％CI：0．02％～0．04％）；抗病毒治疗可降低HIV新发感染者数和艾滋病死亡数，但不影响人群总HIV感染率、现存HIV／AIDS数以及成年人抗病毒治疗需求数。结论综合运用EPP和Spectrum模型可以估计预测台州地区艾滋病疫情，并发现抗病毒治疗有助于控制疫情，为其他艾滋病相对低流行地区的疫情评估提供参考。

Objective To apply Estimation and Projection Package （EPP） and Spectrum models for the estimation and projection on HIV/AIDS epidemics in areas with relatively low HIV/ AIDS prevalence in China, and to explore the influences of antiretroviral therapy （ART） on the outputs of the models. Methods Taizhou prefecture in Zhejiang province was selected as the study site. Social and demographic data as well as all the information on HIV/AIDS epidemics in Taizhou prefecture were collected, managed, input to EPP and Spectrum models to estimate and project the HIV/AIDS epidemic in Taizhou prefecture. Impact of ART on the HIV/AIDS epidemic was also assessed. Results According to the estimates from both EPP and Spectrum model, the HIV/AIDS epidemic in Taizhou prefecture was at a relatively low level. HIV prevalence rates among men having sex with men （MSM） and injection drug users （IDU） were relatively high and rapidly increasing. It was estimated that 1773 （1384-2449） people were living with HIV in 2010 in Taizhou prefecture, with an overall HIV prevalence of 0.03% （0.02%-0.04%）. ART had reduced and would continue to reduce new HIV infections and AIDS deaths, but had no significant impact on the overall HIV prevalence and the numbers of people living with HIV and adults who were in need of ART. Conclusion EPP and Spectrum models seemed to be suitable and useful tools for estimation and projection on HIV/AIDS in Taizhou prefecture, and the results could provide reference for the timber studies in other areas with a relatively low epidemic level of HIV/AIDS. ART appeared effective for HIV/AIDS prevention and control.