Background:Recent upsurge of new HIV infections among men who have sex with men(MSM)is a major concern in China.Paucity of national-level information regarding the burden and predictors of this progressive epidemic of...Background:Recent upsurge of new HIV infections among men who have sex with men(MSM)is a major concern in China.Paucity of national-level information regarding the burden and predictors of this progressive epidemic of new infections called for a multi-centric,timely and comprehensive investigation.Methods:Mixed methods were used to recruit MSM from seven cities in China between 2012 and 2013.Recent and established HIV infections were estimated by Western Blot and BED HIV-1 capture enzyme immunoassay.Syphilis and herpes simplex virus-2(HSV-2)were also tested.Results:A total of 4496 eligible MSM were recruited.The majority was aged≤35 years(77.5%),migrants(60.3%),never married(69.8%),and played receptive role in anal sex(70.5%).The HIV prevalence was 9.9%,and 41.9%were recently infected,with sensitivity/specificity adjusted HIV incidence of 8.9(95%CI:7.6-10.2)/100 Person-Years.The prevalence of history HSV-2 and syphilis were 12.5%and 8.5%,respectively.Recent HIV infection was associated with having multiple male partners(aOR=1.4,95%CI 1.1-1.9),recreational drug use(aOR=2.2,95%CI 1.6-3.0),anal bleeding(aOR=2.1,95%CI 1.4-3.0),syphilis infection(aOR=2.8,95%CI 1.9-4.3)and history HSV-2 infection(aOR=2.3,95%CI 1.5-3.3).Conclusion:High rate of recent HIV infection is potentially resulting in progressive deterioration of the overall HIV epidemic among MSM in China.Targeted interventions to address high-risk MSM including those having multiple partners,history of recreational drug use and syphilis or HSV-2 infection seemed to be the need of the hour.展开更多
目的限制性抗原亲和力方法(简称LAg)与BED捕获酶联免疫试验(简称BED)在四川省男男性行为者(Men who have sex with men,简称MSM)人群中新发感染检测结果的比较,为该方法在四川省的推广应用和可能存在的问题提供参考。方法收集四川省2015...目的限制性抗原亲和力方法(简称LAg)与BED捕获酶联免疫试验(简称BED)在四川省男男性行为者(Men who have sex with men,简称MSM)人群中新发感染检测结果的比较,为该方法在四川省的推广应用和可能存在的问题提供参考。方法收集四川省2015年10个MSM哨点的新发感染检测样本274份,分别用LAg和BED进行检测,2检验分析两种方法新发感染结果判定的一致性,根据Mc Dougal法的中点公式分别计算并比较2种方法的HIV-1新发感染率。结果 274份纳入新发感染检测的样本,LAg判定为新发感染81人(29.56%,81/274),BED判定为新发感染111(40.51%,111/274)。2种方法判定结果的调整一致率为86.72%,2检验分析发现2种方法判定结果一致性差异有统计学意义(P<0.05),BED检出率较高。LAg的HIV-1新发感染率为7.14%(95%CI:5.58%-8.69%),BED的HIV-1新发感染率为7.54%(95%CI:6.13%-8.94%)。结论对于四川省2015年274例MSM哨点样本,LAg判定新发感染比例低于BED,用Mc Dougal法的中点公式计算2种方法的HIV-1新发感染率结果基本一致。HIV-1新发感染率的观察不易采信绝对数值,应以观察变化趋势为宜。展开更多
目的系统分析中国男男性行为人群(MSM)艾滋病病毒(HIV)新发感染率及其影响因素,为制定艾滋病防控策略提供依据。方法检索中国知网、万方数据、维普资讯中文期刊服务平台、PubMed、Web of Science、Embase和Cochrane Library等中英文数据...目的系统分析中国男男性行为人群(MSM)艾滋病病毒(HIV)新发感染率及其影响因素,为制定艾滋病防控策略提供依据。方法检索中国知网、万方数据、维普资讯中文期刊服务平台、PubMed、Web of Science、Embase和Cochrane Library等中英文数据库,收集建库至2021年5月发表的中国MSM人群HIV新发感染的队列研究文献,对HIV新发感染率及其影响因素进行Meta分析,采用漏斗图和Egger's检验分析发表偏倚,采用敏感性分析评价结局指标的稳定性。结果检索文献850篇,最终纳入分析43篇(44项研究),MSM人群HIV合并新发感染率为4.93/100人年(95%CI:4.15/100人年~5.72/100人年)。Egger's检验显示存在发表偏倚(t=2.411,P=0.021)。华东(5.21/100人年)、华北(5.30/100人年)和西南(4.84/100人年)地区合并新发感染率较高,西北地区(2.87/100人年)最低;一线城市(5.12/100人年)合并新发感染率高于非一线城市(3.89/100人年)。梅毒感染(HR=3.41),无保护性肛交(HR=2.52),多性伴(HR=3.51),在酒吧、浴室、公园寻找性伴(HR=3.44),>25岁(HR=0.44),汉族(HR=0.35),知晓艾滋病相关知识(HR=0.20)和有艾滋病预防服务(HR=0.18)是MSM人群HIV新发感染的影响因素。其中涉及梅毒感染(t=4.841,P<0.001)、无保护性肛交(t=4.114,P=0.006)和民族(t=-5.018,P=0.038)的研究存在发表偏倚。结论中国MSM人群HIV新发感染率仍处于较高水平。应针对可控影响因素制定干预措施,降低MSM人群HIV新发感染率。展开更多
基金supported by the Mega-Projects of national science research for the 12th Five-Year Plan(2012ZX10001-006)China-Gates Foundation(2012)+1 种基金Liaoning Educational Department project(LZ2014038)NIH(NIAID 1R01AI114310,FIC 1D43TW009532).
文摘Background:Recent upsurge of new HIV infections among men who have sex with men(MSM)is a major concern in China.Paucity of national-level information regarding the burden and predictors of this progressive epidemic of new infections called for a multi-centric,timely and comprehensive investigation.Methods:Mixed methods were used to recruit MSM from seven cities in China between 2012 and 2013.Recent and established HIV infections were estimated by Western Blot and BED HIV-1 capture enzyme immunoassay.Syphilis and herpes simplex virus-2(HSV-2)were also tested.Results:A total of 4496 eligible MSM were recruited.The majority was aged≤35 years(77.5%),migrants(60.3%),never married(69.8%),and played receptive role in anal sex(70.5%).The HIV prevalence was 9.9%,and 41.9%were recently infected,with sensitivity/specificity adjusted HIV incidence of 8.9(95%CI:7.6-10.2)/100 Person-Years.The prevalence of history HSV-2 and syphilis were 12.5%and 8.5%,respectively.Recent HIV infection was associated with having multiple male partners(aOR=1.4,95%CI 1.1-1.9),recreational drug use(aOR=2.2,95%CI 1.6-3.0),anal bleeding(aOR=2.1,95%CI 1.4-3.0),syphilis infection(aOR=2.8,95%CI 1.9-4.3)and history HSV-2 infection(aOR=2.3,95%CI 1.5-3.3).Conclusion:High rate of recent HIV infection is potentially resulting in progressive deterioration of the overall HIV epidemic among MSM in China.Targeted interventions to address high-risk MSM including those having multiple partners,history of recreational drug use and syphilis or HSV-2 infection seemed to be the need of the hour.
文摘目的限制性抗原亲和力方法(简称LAg)与BED捕获酶联免疫试验(简称BED)在四川省男男性行为者(Men who have sex with men,简称MSM)人群中新发感染检测结果的比较,为该方法在四川省的推广应用和可能存在的问题提供参考。方法收集四川省2015年10个MSM哨点的新发感染检测样本274份,分别用LAg和BED进行检测,2检验分析两种方法新发感染结果判定的一致性,根据Mc Dougal法的中点公式分别计算并比较2种方法的HIV-1新发感染率。结果 274份纳入新发感染检测的样本,LAg判定为新发感染81人(29.56%,81/274),BED判定为新发感染111(40.51%,111/274)。2种方法判定结果的调整一致率为86.72%,2检验分析发现2种方法判定结果一致性差异有统计学意义(P<0.05),BED检出率较高。LAg的HIV-1新发感染率为7.14%(95%CI:5.58%-8.69%),BED的HIV-1新发感染率为7.54%(95%CI:6.13%-8.94%)。结论对于四川省2015年274例MSM哨点样本,LAg判定新发感染比例低于BED,用Mc Dougal法的中点公式计算2种方法的HIV-1新发感染率结果基本一致。HIV-1新发感染率的观察不易采信绝对数值,应以观察变化趋势为宜。
文摘目的系统分析中国男男性行为人群(MSM)艾滋病病毒(HIV)新发感染率及其影响因素,为制定艾滋病防控策略提供依据。方法检索中国知网、万方数据、维普资讯中文期刊服务平台、PubMed、Web of Science、Embase和Cochrane Library等中英文数据库,收集建库至2021年5月发表的中国MSM人群HIV新发感染的队列研究文献,对HIV新发感染率及其影响因素进行Meta分析,采用漏斗图和Egger's检验分析发表偏倚,采用敏感性分析评价结局指标的稳定性。结果检索文献850篇,最终纳入分析43篇(44项研究),MSM人群HIV合并新发感染率为4.93/100人年(95%CI:4.15/100人年~5.72/100人年)。Egger's检验显示存在发表偏倚(t=2.411,P=0.021)。华东(5.21/100人年)、华北(5.30/100人年)和西南(4.84/100人年)地区合并新发感染率较高,西北地区(2.87/100人年)最低;一线城市(5.12/100人年)合并新发感染率高于非一线城市(3.89/100人年)。梅毒感染(HR=3.41),无保护性肛交(HR=2.52),多性伴(HR=3.51),在酒吧、浴室、公园寻找性伴(HR=3.44),>25岁(HR=0.44),汉族(HR=0.35),知晓艾滋病相关知识(HR=0.20)和有艾滋病预防服务(HR=0.18)是MSM人群HIV新发感染的影响因素。其中涉及梅毒感染(t=4.841,P<0.001)、无保护性肛交(t=4.114,P=0.006)和民族(t=-5.018,P=0.038)的研究存在发表偏倚。结论中国MSM人群HIV新发感染率仍处于较高水平。应针对可控影响因素制定干预措施,降低MSM人群HIV新发感染率。