Florida Department of Health, Bureau of HIV/AIDS, Tallahassee, FL 32399-1715, USA.
J Acquir Immune Defic Syndr. 2010 Aug;54(4):398-405. doi: 10.1097/QAI.0b013e3181d0c165.
Population-based HIV incidence, prevalence, and mortality rates among men who have sex with men (MSM) have been unavailable, limiting assessment of racial/ethnic disparities and epidemic dynamics.
Using estimated numbers of MSM aged >or=18 years by race/ethnicity as denominators, from models in our prior work, we estimated MSM HIV prevalence and mortality rates for 2006-2007 and HIV incidence rates for 2006 in Florida.
Overall, the estimated MSM HIV prevalence rates per 100,000 MSM were 7354.8 (2006), and 7758.3 (2007). With white MSM as the referent, MSM HIV prevalence rate ratios (RRs) equaled 3.7 for blacks in 2006 and 3.6 in 2007 and 1.7 for Hispanics in both years (all P < 0.001). Among all MSM with HIV, the mortality rates were 199.8 (2006) and 188.4 (2007), with RRs of 5.4 for blacks in 2006 and 4.9 in 2007, and 1.6 for Hispanics in 2006 and 1.4 in 2007 (all P < 0.001). In 2006, the estimated HIV incidence rate among all MSM was 656.1 per 100,000 MSM, with RRs of 5.5 (blacks) and 2.0 (Hispanics) (both P < 0.001). A sensitivity analysis indicated that error due to misclassification of minority MSM as males who are not MSM lowered rates and RRs for all the 3 indicators but racial/ethnic disparities persisted (all P < 0.001).
The impact of HIV by each measure was greater on black and Hispanic MSM than on white MSM. Quantifying estimates of HIV incidence, HIV prevalence, and mortality rates among MSM with HIV informs HIV surveillance, prevention, treatment, resource allocation, and community mobilization.
由于缺乏基于人群的男男性行为者(MSM)艾滋病毒发病率、流行率和死亡率数据,我们无法评估种族/民族差异和流行态势。
利用我们之前研究模型中按种族/民族估计的大于等于 18 岁 MSM 人数作为分母,我们估算了 2006-2007 年佛罗里达州 MSM 艾滋病毒流行率和死亡率,以及 2006 年 MSM 艾滋病毒发病率。
总体而言,每 10 万名 MSM 艾滋病毒流行率估计值分别为 2006 年 7354.8 和 2007 年 7758.3。以白人 MSM 为参照,2006 年和 2007 年黑人 MSM 艾滋病毒流行率比值(RR)分别为 3.7 和 3.6,2006 年和 2007 年西班牙裔 MSM 分别为 1.7(均 P < 0.001)。所有 HIV 阳性 MSM 中,死亡率分别为 2006 年 199.8 和 2007 年 188.4,2006 年和 2007 年黑人 MSM 的 RR 分别为 5.4 和 4.9,西班牙裔 MSM 分别为 1.6 和 1.4(均 P < 0.001)。2006 年,所有 MSM 的艾滋病毒估计发病率为每 10 万名 MSM 656.1,黑人 MSM 的 RR 为 5.5,西班牙裔 MSM 的 RR 为 2.0(均 P < 0.001)。敏感性分析表明,由于将少数族裔 MSM 错误分类为非 MSM 男性,低估了所有 3 项指标的发病率和 RR,但种族/民族差异仍然存在(均 P < 0.001)。
每一项措施对黑人 MSM 和西班牙裔 MSM 的 HIV 影响都大于白人 MSM。量化 HIV 阳性 MSM 的艾滋病毒发病率、流行率和死亡率估计数,可为 HIV 监测、预防、治疗、资源分配和社区动员提供信息。