Cui Yan, Guo Wei, Li Dongmin, Wang Liyan, Shi Cynthia X, Brookmeyer Ron, Detels Roger, Ge Lin, Ding Zhengwei, Wu Zunyou
Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Division of Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
J Int AIDS Soc. 2016 Mar 16;19(1):20609. doi: 10.7448/IAS.19.1.20609. eCollection 2016.
HIV incidence is an important measure for monitoring the development of the epidemic, but it is difficult to ascertain. We combined serial HIV prevalence and mortality data to estimate HIV incidence among key affected populations (KAPs) in China.
Serial cross-sectional surveys were conducted among KAPs from 2010 to 2014. Trends in HIV prevalence were assessed by the Cochran-Armitage test, adjusted by risk group. HIV incidence was estimated from a mathematical model that describes the relationship between changes in HIV incidence with HIV prevalence and mortality.
The crude HIV prevalence for the survey samples remained stable at 1.1 to 1.2% from 2010 to 2014. Among drug users (DUs), HIV prevalence declined from 4.48 to 3.29% (p<0.0001), and among men who have sex with men (MSM), HIV prevalence increased from 5.73 to 7.75% (p<0.0001). Changes in HIV prevalence among female sex workers (FSWs) and male patients of sexually transmitted disease clinics were more modest but remained statistically significant (all p<0.0001). The MSM population had the highest incidence estimates at 0.74% in 2011, 0.59% in 2012, 0.57% in 2013 and 0.53% in 2014. Estimates of the annual incidence for DUs and FSWs were very low and may not be reliable.
Serial cross-sectional prevalence data from representative samples may be another approach to construct approximate estimates of national HIV incidence among key populations. We observed that the MSM population had the highest incidence for HIV among high-risk groups in China, and we suggest that interventions targeting MSM are urgently needed to curb the growing HIV epidemic.
艾滋病毒发病率是监测疫情发展的一项重要指标，但难以确定。我们结合系列艾滋病毒流行率和死亡率数据来估计中国主要受影响人群中的艾滋病毒发病率。
2010年至2014年期间对主要受影响人群开展了系列横断面调查。通过 Cochr an - Armitage检验评估艾滋病毒流行趋势，并按风险组进行调整。艾滋病毒发病率通过一个数学模型进行估计，该模型描述了艾滋病毒发病率变化与艾滋病毒流行率和死亡率之间的关系。
2010年至2014年期间，调查样本的艾滋病毒粗流行率保持在1.1%至1.2%的稳定水平。在吸毒者中，艾滋病毒流行率从4.48%降至3.29%（p<0.0001），在男男性行为者中，艾滋病毒流行率从5.73%升至7.75%（p<0.0001）。女性性工作者和性病门诊男性患者中的艾滋病毒流行率变化较为平缓，但仍具有统计学意义（均p<0.0001）。男男性行为人群的发病率估计最高，20??1年为0.74%，2012年为0.59%，2013年为0.57%，2014年为0.53%。吸毒者和女性性工作者的年发病率估计值很低，可能不可靠。
来自代表性样本的系列横断面流行率数据可能是构建主要人群中全国艾滋病毒发病率近似估计值的另一种方法。我们观察到，男男性行为人群在中国高危人群中艾滋病毒发病率最高，我们建议迫切需要针对男男性行为者采取干预措施，以遏制艾滋病毒疫情的不断蔓延。
