在高效抗逆转录病毒治疗时代，低艾滋病毒感染率人群中男男性行为者的艾滋病毒血清转化决定因素。

Determinants of HIV seroconversion among men who have sex with men living in a low HIV incidence population in the era of highly active antiretroviral therapies.

作者信息

Lavoie Elaine, Alary Michel, Remis Robert S, Otis Joanne, Vincelette Jean, Turmel Bruno, Lavoie René, Masse Benoît R, Le Clerc Roger

机构信息

Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Québec, Canada.

出版信息

Sex Transm Dis. 2008 Jan;35(1):25-9. doi: 10.1097/OLQ.0b013e31814fb113.

DOI:10.1097/OLQ.0b013e31814fb113

PMID:17898678

Abstract

OBJECTIVE

To estimate human immunodeficiency virus (HIV) incidence and associated risk factors among men who have sex with men (MSM) participating in the Omega Cohort Study in Montreal, 1996-2003.

METHODS

Longitudinal study of 1587 MSM seronegative at baseline with > or =1 six-month follow-up visit. Multivariate Cox regression with time-dependent variables was used for data analysis.

RESULTS

HIV incidence was 0.62 per 100 person-years (95% confidence interval: 0.41-0.84). In multivariate analyses compared with subjects not reporting any anal sex with serodiscordant or casual partners, those reporting anal sex with such partners (all P values <0.05), whether consistently protected [hazard ratio (HR) = 3.4], or unprotected exclusively receptive (HR = 12.0), exclusively insertive (HR = 4.7), or both receptive and insertive (HR = 8.3), were at increased risk of seroconversion. Sexual behaviors with seroconcordant regular partners were not associated with seroconversion.

CONCLUSION

These results observed in a cohort of MSM with low HIV incidence provide new insights regarding the debate about harm-reduction strategies to prevent sexual HIV transmission.

摘要

目的

评估1996 - 2003年参与蒙特利尔欧米伽队列研究的男男性行为者（MSM）中人类免疫缺陷病毒（HIV）的发病率及相关危险因素。

方法

对1587名基线血清学阴性且有≥1次为期6个月随访的MSM进行纵向研究。采用含时变量的多变量Cox回归进行数据分析。

结果

HIV发病率为每100人年0.62例（95%置信区间：0.41 - 0.84）。在多变量分析中，与未报告与血清学不一致或临时性伴侣发生肛交的受试者相比，报告与这类伴侣发生肛交的受试者（所有P值<0.05），无论是否持续采取保护措施[风险比（HR）= 3.4]，或无保护的仅被动肛交（HR = 12.0）、仅主动肛交（HR = 4.7）或主动与被动肛交兼有（HR = 8.3），血清转化风险均增加。与血清学一致的固定伴侣的性行为与血清转化无关。