Xian Yun, Zhu Bowen, Zhang Xuan, Ma Ping, Wei Ye, Xia Hongli, Jiang Wenjie, Yang Changqing, Meng Xiaojun, Peng Peng, Yang Yue, Jiang Liying, Chu Minjie, Zhuang Xun
Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Nantong City, Jiangsu Province, China.
Wuxi Centre for Disease Control and Prevention, Wuxi City, Jiangsu Province, China.
PLoS One. 2017 Feb 3;12(2):e0170635. doi: 10.1371/journal.pone.0170635. eCollection 2017.
To investigate the factors associated with sexually transmitted infection and Human Immunodeficiency Virus (STI-HIV) co-infection among men who have sex with men (MSM). A total of 357 HIV-infected participants (84 STI-HIV co-infection and 273 HIV infections only) were recruited from Jiangsu, China. Logistic regression analyses were used to estimate the related factors associated with STI-HIV co-infection. Marginal structural models were adopted to estimate the effect of transmission drug resistance (TDR) on STI-HIV co-infection. For all participants, logistic regression analyses revealed that those who diagnosed with HIV-1 for longer duration (≥1.8 years) were significantly associated with reduced STI-HIV co-infection risk (OR = 0.55, 95%CI: 0.32-0.96, P = 0.036). In further stratification analysis by antiretroviral therapy (ART), individuals with longer duration showed consistent significant associations with STI-HIV co-infection risk (OR = 0.46, 95%CI: 0.26-0.83, P = 0.010) among MSM with ART-naïve status. In addition, significant reduced risk for STI-HIV co-infection (OR = 0.98, 95%CI: 0.96-0.99, P = 0.010) were observed in younger (under the average age of 31.03) MSM of the same group. Interestingly, we also found TDR was significantly associated with an increased risk of STI-HIV co-infection risk (OR = 3.84, 95%CI: 1.05-14.03, P = 0.042) in ART-naïve group. Our study highlights a pattern of STI-HIV co-infection among MSM in China and indicates that targeted interventions aimed at encouraging TDR monitoring in MSM with early HIV infection are warranted.
为调查男男性行为者（MSM）中性传播感染与人类免疫缺陷病毒（STI-HIV）合并感染的相关因素。在中国江苏招募了357名HIV感染参与者（84例STI-HIV合并感染，273例仅为HIV感染）。采用逻辑回归分析来估计与STI-HIV合并感染相关的因素。采用边际结构模型来估计传播耐药性（TDR）对STI-HIV合并感染的影响。对于所有参与者，逻辑回归分析显示，那些诊断为HIV-1时间较长（≥1.8年）的人，其STI-HIV合并感染风险显著降低（OR = 0.55，95%CI：0.32 - 0.96，P = 0.036）。在进一步按抗逆转录病毒疗法（ART）进行分层分析时，在未接受过ART的MSM中，感染时间较长的个体与STI-HIV合并感染风险存在一致的显著关联（OR = 0.46，95%CI：0.26 - 0.83，P = 0.010）。此外，在同组较年轻（平均年龄31.03岁以下）的MSM中，观察到STI-HIV合并感染风险显著降低（OR = 0.98，95%CI：0.96 - 0.99，P = 0.010）。有趣的是，我们还发现，在未接受过ART的组中，TDR与STI-HIV合并感染风险增加显著相关（OR = 3.84，95%CI：1.05 - 14.03，P = 0.042）。我们的研究突出了中国MSM中STI-HIV合并感染的模式，并表明有必要针对早期HIV感染的MSM开展旨在鼓励进行TDR监测的针对性干预措施。
