Rosenberg P S, Gail M H, Schrager L K, Vermund S H, Creagh-Kirk T, Andrews E B, Winkelstein W, Marmor M, Des Jarlais D C, Biggar R J
Epidemiologic Methods Section, National Cancer Institute, Rockville, MD 20892.
J Acquir Immune Defic Syndr (1988). 1991;4(4):392-401.
After mid-1987 fewer than the expected number of cases of AIDS were reported in the United States in some demographic and transmission groups but not in others. Gay men (regardless of intravenous drug use), adults with hemophilia, and transfusion recipients exhibited fewer cases than expected based on previously reliable models. These favorable trends could not be explained by assuming earlier cessation of human immunodeficiency virus (HIV) infection. Favorable AIDS incidence trends were not found in heterosexual intravenous drug users or in persons infected through heterosexual contact. White gay men from New York City, Los Angeles, and San Francisco experienced markedly favorable trends, whereas little changes was observed for nonwhite gay men from nonurban areas. AIDS incidence trends were quantitatively consistent with the fraction of AIDS-free persons with severe immunodeficiency who received zidovudine in three cohorts. Gay men in San Francisco used zidovudine more frequently than did adults with hemophilia, while little was used by intravenous drug users in New York City. Data describing the initial national distribution of zidovudine (March 31-September 18, 1987) indicated relatively high use by patients with severe immunodeficiency in those groups, such as urban white gay men, that subsequently experienced fewer cases of AIDS than expected. Available data suggest that zidovudine, perhaps in combination with other therapies, has been one factor contributing to favorable AIDS incidence trends in some groups. Broader application of therapy might further retard the incidence of AIDS, especially in intravenous drug users, persons infected through heterosexual contact, minorities, women, and persons diagnosed outside major metropolitan areas.
1987年年中以后，在美国，某些人口统计学和传播途径组报告的艾滋病病例数低于预期，但其他组并非如此。男同性恋者（无论是否使用静脉注射毒品）、成年血友病患者和输血接受者的病例数低于根据先前可靠模型预期的数量。这些有利趋势无法通过假设人类免疫缺陷病毒（HIV）感染较早停止来解释。在异性性传播静脉注射毒品使用者或通过异性接触感染的人群中未发现有利的艾滋病发病趋势。来自纽约市、洛杉矶和旧金山的白人男同性恋者经历了明显有利的趋势，而来自非城市地区的非白人男同性恋者变化不大。艾滋病发病趋势在数量上与三个队列中接受齐多夫定治疗的无艾滋病且有严重免疫缺陷者的比例一致。旧金山的男同性恋者比成年血友病患者更频繁地使用齐多夫定，而纽约市的静脉注射毒品使用者使用量很少。描述齐多夫定初始全国分布的数据（1987年3月31日至9月18日）表明，在那些随后艾滋病病例数低于预期的群体中，如城市白人男同性恋者，严重免疫缺陷患者的使用量相对较高。现有数据表明，齐多夫定，可能与其他疗法联合使用，是导致某些群体艾滋病发病趋势有利的一个因素。更广泛地应用治疗可能会进一步延缓艾滋病的发病率，尤其是在静脉注射毒品使用者、通过异性接触感染的人群、少数族裔、女性以及在主要大都市地区以外被诊断出的人群中。
