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中国南京男男性行为人群 HIV 感染率及相关因素分析。

HIV incidence and associated factors in a cohort of men who have sex with men in Nanjing, China.

机构信息

Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, China.

出版信息

Sex Transm Dis. 2010 Apr;37(4):208-13. doi: 10.1097/OLQ.0b013e3181d13c59.

Abstract

BACKGROUND

Many surveys conducted in recent years reported the increasing trend of HIV infection among men who have sex with men (MSM), but limited data exists on HIV incidence by cohort study in China.

METHODS

A 6-month prospective cohort study was conducted. A total of 397 MSM found HIV seronegative at baseline study were followed-up for 6 months starting from May 2007 and re-evaluated seroconversions of HIV at 6 months. Questionnaire interviews were conducted to collect information about risk behaviors.

RESULTS

Of the 397 MSM who were found seronegative at the baseline study, 286 (72.0%) received the HIV antibody testing at month 6; 7 of them showed HIV seroconversions, yielding an incidence of 5.12 per 100 person-years. Significant predictors of seroconversion (Poisson regression analyses) included duration being MSM >10 years (relative risks [RR] = 3.08, 95% CI: 1.53-6.20), recruiting male sex partner mostly at saunas (RR = 2.35, 95% CI:1.09-5.08), positive syphilis diagnosis made at the baseline study (RR = 2.82, 95% CI: 1.31-6.09), having multiple male sex partners in the last 6 months (RR = 2.54, 95% CI: 1.18-5.49), having at least 1 casual male sex partner in the last 6 months (RR = 2.17, 95% CI: 1.00-4.70), and having unprotected anal sex with a regular male sex partner in the last 6 months (RR = 2.22, 95% CI: 1.10-4.49).

CONCLUSIONS

The incidence of HIV among MSM is very high; many new infections would hence occur in China. Effective interventions are warranted. The risk factors reported in this study give some insights for designing relevant prevention programs.

摘要

背景

近年来,许多调查显示男男性接触者(MSM)中的 HIV 感染呈上升趋势,但中国关于队列研究中 HIV 发病率的数据有限。

方法

进行了一项为期 6 个月的前瞻性队列研究。共有 397 名在基线研究中发现 HIV 血清阴性的 MSM 从 2007 年 5 月开始随访 6 个月,并在 6 个月时重新评估 HIV 血清转换情况。进行问卷调查以收集有关风险行为的信息。

结果

在基线研究中发现血清阴性的 397 名 MSM 中,有 286 名(72.0%)在第 6 个月接受了 HIV 抗体检测;其中 7 人出现 HIV 血清转换,发病率为 5.12/100 人年。血清转换的显著预测因素(泊松回归分析)包括:作为 MSM 的时间>10 年(相对风险 [RR] = 3.08,95%CI:1.53-6.20)、主要在桑拿浴室招募男性性伴侣(RR = 2.35,95%CI:1.09-5.08)、基线研究时诊断出梅毒阳性(RR = 2.82,95%CI:1.31-6.09)、在过去 6 个月中有多个男性性伴侣(RR = 2.54,95%CI:1.18-5.49)、在过去 6 个月中有至少 1 个偶然的男性性伴侣(RR = 2.17,95%CI:1.00-4.70)和在过去 6 个月中与固定男性性伴侣发生无保护肛交(RR = 2.22,95%CI:1.10-4.49)。

结论

MSM 中的 HIV 发病率非常高;因此,中国会出现许多新的感染病例。需要采取有效的干预措施。本研究报告的危险因素为设计相关预防方案提供了一些思路。

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