EPP模型估计湖南省艾滋病疫情的现状和发展趋势

Estimation of HIV/ADIS epidemic status and trend in Hunan province with Estimation and Projection Package(EPP) model

目的对湖南省艾滋病(AIDS)疫情进行估计,并对未来5年的疫情进行预测。方法利用常规监测资料与文献资料中的数据,运用"估计和预测软件包"(EPP)模型进行估计与预测,并依据专家意见对结果进行调整。结果湖南省艾滋病疫情呈现为整体水平较低但快速增长的趋势,1999年前艾滋病病毒(HIV)感染率在低水平缓慢增加,2000-2005年HIV感染率增速加快,其后有所放缓,2009年后再度出现快速增长;各人群中HIV感染率最高的为注射吸毒者和男男性行为人群(MSM),其他人群的HIV感染率均在1%以下。在疫情发展的早期,注射吸毒者中HIV感染率快速增加,在2006年达到最高值后逐渐缓慢下降,在较长时间内维持在一个较高的水平。2006年后,MSM中HIV感染率增长十分迅速,2013年后将成为高危人群中HIV感染率最高的人群。2000年后,暗娼中HIV感染率曾经有过一次小幅度的上升;嫖客中HIV感染率一直缓慢升高,2010年后逐渐稳定在0.5%左右。一般人群中HIV感染率非常低。注射吸毒者中新发HIV感染是早期疫情的最主要组成部分,MSM在2000年后新发感染数量增幅大,2007年后成为新发感染数最多的高危人群。结论湖南省艾滋病疫情在经历了缓慢增长阶段后将再次出现疫情的快速增长,未来应将控制同性间HIV传播作为干预重点。

Objective To estimate and predict the epidemic status of HIV infection in Hunan province in the coming 5 years with Estimation and Projection Package（EPP） model.Methods AIDS/HIV surveillance data and data from the published literature were used as the data sources,and estimation and predictions were performed using EPP model.Results The HIV prevalence in Hunan province was relatively low and was growing rapidly on the whole.The HIV prevalence was growing slowly before 1999.There was a rapid increase in the number of people living with HIV/AIDS from 2000 to 2005,and the increase slowed down afterwards.A second rapid growth was recorded after 2009.The HIV prevalence was high among IDUs and MSM.The HIV prevalence in other population groups was less than 1%.The HIV prevalence in IDUs was increasing rapidly during the early period,and reached the peak in 2006 and declined gradually afterwards and remained at a high level.The growth of HIV infection among MSM was very fast and MSM would become the population with the highest HIV prevalence after 2013.There was a slight increase in the sex workers after 2000.The HIV prevalence in sex worker clients kept growing slowly and stabilized at about 0.5% after 2010.The HIV prevalence in the general population was very low.IDUs were the main source of new infection during the early period.After 2000 the growth of new HIV infection among MSM was very fast.It was not until 2007 that MSM became the largest source of new infection.Conclusions It was found that after a moderate growth period,there will be another rapid growth in the number of people infected with HIV in Hunan province.It is necessary to take effective preventive measures for reducing homosexual transmission to control the spread of HIV.