Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.
PLoS One. 2012;7(12):e50873. doi: 10.1371/journal.pone.0050873. Epub 2012 Dec 31.
To examine the impacts of a multi-city HIV prevention public health program (China Global Fund Round 5 Project) on condom use and HIV infection, we analyzed four yearly cross-sectional surveys from 2006 through 2009 among 20,843 men who have sex with men (MSM) in 16 Chinese cities. Self-reported condom use at last sex with a male partner increased from 58% in 2006 to 81% in 2009 (trend test, P<0.001). HIV prevalence increased from 2.3% in 2006 to 5.3% in 2009 (P<0.001). Multivariable logistic regression analysis showed that self-reported receipt of interventions was an independent predictor of increased condom use at last sex with a male partner over time (adjusted odds ratio [aOR], 1.63 in 2006 to 2.33 in 2009; P<0.001), and lower HIV prevalence (aOR, 1.08 in 2006 to 0.45 in 2009; P<0.001). HIV prevalence increased from 2006-2009 for participants with no self-reported receipt of interventions (2.1% in 2006 to 10.3% in 2009) and less so for those with interventions (2.4% to 4.7%). This Chinese public health program had positive impacts on both behaviors and disease rate among MSM population. Escalation of the coverage and intensity of effective interventions is needed for further increasing condom use and for reversing the rising trend of HIV epidemic.
为了考察一个多城市艾滋病预防公共卫生项目（中国全球基金第五轮项目）对安全套使用和艾滋病感染的影响，我们分析了 2006 年至 2009 年期间来自中国 16 个城市的 20843 名男男性行为者（MSM）的 4 次年度横断面调查。与男性性伴最后一次性行为时报告使用安全套的比例从 2006 年的 58%增加到 2009 年的 81%（趋势检验，P<0.001）。艾滋病病毒感染率从 2006 年的 2.3%上升到 2009 年的 5.3%（P<0.001）。多变量逻辑回归分析显示，报告接受干预是与男性性伴最后一次性行为时使用安全套增加的独立预测因素（调整后比值比[OR]，2006 年为 1.63，2009 年为 2.33；P<0.001），且艾滋病病毒感染率降低（调整后 OR，2006 年为 1.08，2009 年为 0.45；P<0.001）。未报告接受干预的参与者中，艾滋病病毒感染率从 2006 年至 2009 年有所上升（2006 年为 2.1%，2009 年为 10.3%），而接受干预的参与者中，艾滋病病毒感染率上升幅度较小（2.4%至 4.7%）。中国公共卫生项目对 MSM 人群的行为和疾病发生率都产生了积极影响。需要扩大和加强有效的干预措施的覆盖面和力度，以进一步提高安全套使用率，并扭转艾滋病疫情上升趋势。
