男男性行为者中艾滋病毒流行率及相关风险。青年男性调查研究小组。

HIV prevalence and associated risks in young men who have sex with men. Young Men's Survey Study Group.

作者信息

Valleroy L A, MacKellar D A, Karon J M, Rosen D H, McFarland W, Shehan D A, Stoyanoff S R, LaLota M, Celentano D D, Koblin B A, Thiede H, Katz M H, Torian L V, Janssen R S

机构信息

Division of HIV/AIDS Prevention/NCHSTP, Mailstop E-46, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA.

出版信息

JAMA. 2000 Jul 12;284(2):198-204. doi: 10.1001/jama.284.2.198.

DOI:10.1001/jama.284.2.198

PMID:10889593

Abstract

CONTEXT

Studies conducted in the late 1980s on human immunodeficiency virus (HIV) infection among older men who have sex with men (MSM) suggested the epidemic had peaked; however, more recent studies in younger MSM have suggested continued high HIV incidence.

OBJECTIVE

To investigate the current state of the HIV epidemic among adolescent and young adult MSM in the United States by assessing the prevalence of HIV infection and associated risks in this population in metropolitan areas.

DESIGN

The Young Men's Survey, a cross-sectional, multisite, venue-based survey conducted from 1994 through 1998.

SETTING

One hundred ninety-four public venues frequented by young MSM in Baltimore, Md; Dallas, Tex; Los Angeles, Calif; Miami, Fla; New York, NY; the San Francisco (Calif) Bay Area; and Seattle, Wash.

SUBJECTS

A total of 3492 15- to 22-year-old MSM who consented to an interview and HIV testing.

MAIN OUTCOME MEASURES

Prevalence of HIV infection and associated characteristics and risk behaviors.

RESULTS

Prevalence of HIV infection was high (overall, 7.2%; range for the 7 areas, 2.2%-12. 1%) and increased with age, from 0% among 15-year-olds to 9.7% among 22-year-olds. Multivariate-adjusted HIV infection prevalence was higher among blacks (odds ratio [OR], 6.3; 95% confidence interval [CI], 4.1-9.8), young men of mixed or other race (OR, 4.8; 95% CI, 3. 0-7.6), and Hispanics (OR, 2.3; 95% CI, 1.5-3.4), compared with whites (referent) and Asian Americans and Pacific Islanders (OR, 1. 1; 95% CI, 0.5-2.8). Factors most strongly associated with HIV infection were being black, mixed, or other race; having ever had anal sex with a man (OR, 5.0; 95% CI, 1.8-13.8); or having had sex with 20 or more men (OR, 3.0; 95% CI, 2.0-4.7). Only 46 (18%) of the 249 HIV-positive men knew they were infected before this testing; 37 (15%) were receiving medical care for HIV, and 19 (8%) were receiving medical drug therapy for HIV. Prevalence of unprotected anal sex during the past 6 months was high (overall, 41%; range, 33%-49%).

CONCLUSIONS

Among these young MSM, HIV prevalence was high, underscoring the need to evaluate and intensify prevention efforts for young MSM, particularly blacks, men of mixed race or ethnicity, Hispanics, and adolescents. JAMA. 2000;284:198-204

摘要

背景

20世纪80年代末针对与男性发生性行为的老年男性（男男性行为者）进行的人类免疫缺陷病毒（HIV）感染研究表明，该流行病已达顶峰；然而，最近针对年轻男男性行为者的研究表明，HIV发病率持续居高不下。

目的

通过评估美国大都市地区该人群中HIV感染的患病率及相关风险，调查美国青少年及青年男男性行为者中HIV流行的现状。

设计

1994年至1998年开展的一项横断面、多地点、基于场所的青年男性调查。

地点

马里兰州巴尔的摩、得克萨斯州达拉斯、加利福尼亚州洛杉矶、佛罗里达州迈阿密、纽约市、加利福尼亚州旧金山湾区和华盛顿州西雅图的194个年轻男男性行为者常去的公共场所。

研究对象

总共3492名年龄在15至22岁之间且同意接受访谈和HIV检测的男男性行为者。

主要观察指标

HIV感染的患病率及相关特征和风险行为。

结果

HIV感染患病率很高（总体为7.2%；7个地区的范围为2.2% - 12.1%），且随年龄增长而升高，从15岁者中的0%升至22岁者中的9.7%。经多变量调整后，黑人（优势比[OR]为6.3；95%置信区间[CI]为4.1 - 9.8）、混血或其他种族的年轻男性（OR为4.8；95% CI为3.0 - 7.6）以及西班牙裔（OR为2.3；95% CI为1.5 - 3.4）的HIV感染患病率高于白人（参照组）、亚裔美国人和太平洋岛民（OR为1.1；95% CI为0.5 - 2.8）。与HIV感染关联最密切的因素是黑人、混血或其他种族；曾与男性发生过肛交（OR为5.0；95% CI为1.8 - 13.8）；或与20名或更多男性发生过性行为（OR为3.0；95% CI为2.0 - 4.7）。在249名HIV阳性男性中，只有46名（18%）在此次检测前知道自己已感染；37名（15%）正在接受HIV医疗护理，19名（8%）正在接受HIV药物治疗。过去6个月中无保护肛交的患病率很高（总体为41%；范围为33% - 49%）。