Solomon Sunil S, Mehta Shruti H, Srikrishnan Aylur K, Vasudevan Canjeevaram K, Mcfall Allison M, Balakrishnan Pachamuthu, Anand Santhanam, Nandagopal Panneerselvam, Ogburn Elizabeth L, Laeyendecker Oliver, Lucas Gregory M, Solomon Suniti, Celentano David D
aDepartment of Medicine, Johns Hopkins School of Medicine bDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA cYR Gaitonde Centre for AIDS Research and Education, Chennai, India dNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
AIDS. 2015 Mar 27;29(6):723-31. doi: 10.1097/QAD.0000000000000602.
To characterize prevalence, incidence, and associated correlates of HIV infection among MSM in 12 cities across India.
Cross-sectional sample using respondent-driven sampling from September 2012 to June 2013.
A total 12022 MSM (~1000/city) were recruited. Participants had to be at least 18 years, self-identify as male, and report oral/anal intercourse with a man in the prior year. HIV infection was diagnosed using three rapid tests. Cross-sectional HIV incidence was estimated using a multiassay algorithm. All estimates incorporate respondent-driven sampling-II weights.
Median age was 25 years, 45% self-identified as 'panthi' (predominantly penetrative anal intercourse) and 30.6% reported being married to a woman. Weighted HIV prevalence was 7.0% (range: 1.7-13.1%). In multivariate analysis, significantly higher odds of HIV infection was observed among those who were older, had lower educational attainment, were practicing purely receptive anal sex or both receptive and penetrative sex, and those who were herpes simplex virus-2 positive. Of 1147 MSM who tested HIV positive, 53 were identified as recent HIV infections (annualized incidence = 0.87%; range = 0-2.2%). In multivariate analysis, injecting drugs in the prior 6 months, syphilis, and higher number of male partners and fewer female partners were significantly associated with recent HIV infection.
We observed a high burden of HIV among MSM in India with tremendous diversity in prevalence, incidence, and risk behaviors. In particular, we observed high incidence in areas with relatively low prevalence suggesting emerging epidemics in areas not previously recognized to have high HIV burden.
描述印度12个城市男男性行为者中艾滋病毒感染的流行率、发病率及相关关联因素。
2012年9月至2013年6月采用应答者驱动抽样的横断面样本。
共招募了12022名男男性行为者（每个城市约1000名）。参与者必须年满18岁，自我认定为男性，并报告前一年与男性有过口交/肛交。使用三种快速检测方法诊断艾滋病毒感染。采用多检测算法估计横断面艾滋病毒发病率。所有估计值均纳入应答者驱动抽样-II权重。
中位年龄为25岁，45%的人自我认定为“潘蒂”（主要是插入式肛交），30.6%的人报告与女性结婚。加权艾滋病毒流行率为7.0%（范围：1.7 - 13.1%）。在多变量分析中，年龄较大、教育程度较低、只进行被动肛交或既进行被动肛交又进行插入式肛交的人以及单纯疱疹病毒2型呈阳性的人感染艾滋病毒的几率显著更高。在1147名艾滋病毒检测呈阳性的男男性行为者中，有53人被确定为近期艾滋病毒感染（年化发病率 = 0.87%；范围 = 0 - 2.2%）。在多变量分析中，过去6个月内注射毒品、梅毒、男性性伴侣数量较多和女性性伴侣数量较少与近期艾滋病毒感染显著相关。
我们观察到印度男男性行为者中艾滋病毒负担沉重，流行率、发病率和风险行为存在巨大差异。特别是，我们在流行率相对较低的地区观察到高发病率，这表明在以前未被认为艾滋病毒负担较重的地区出现了新的疫情。
