Qin Qianqian, Guo Wei, Tang Weiming, Mahapatra Tanmay, Wang Liyan, Zhang Nanci, Ding Zhengwei, Cai Chang, Cui Yan, Sun Jiangping
National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
University of North Carolina Project-China, Guangzhou.
Clin Infect Dis. 2017 Apr 1;64(7):956-963. doi: 10.1093/cid/cix031.
Studies have shown a recent upsurge in human immunodeficiency virus (HIV) burden among men who have sex with men (MSM) in China, especially in urban areas. For intervention planning and resource allocation, spatial analyses of HIV/AIDS case-clusters were required to identify epidemic foci and trends among MSM in China.
Information regarding MSM recorded as HIV/AIDS cases during 2006-2015 were extracted from the National Case Reporting System. Demographic trends were determined through Cochran-Armitage trend tests. Distribution of case-clusters was examined using spatial autocorrelation. Spatial-temporal scan was used to detect disease clustering. Spatial correlations between cases and socioenvironmental factors were determined by spatial regression.
Between 2006 and 2015, in China, 120 371 HIV/AIDS cases were identified among MSM. Newly identified HIV/AIDS cases among self-reported MSM increased from 487 cases in 2006 to >30 000 cases in 2015. Among those HIV/AIDS cases recorded during 2006-2015, 47.0% were 20-29 years old and 24.9% were aged 30-39 years. Based on clusters of HIV/AIDS cases identified through spatial analysis, the epidemic was concentrated among MSM in large cities. Spatial-temporal clusters contained municipalities, provincial capitals, and main cities such as Beijing, Shanghai, Chongqing, Chengdu, and Guangzhou. Spatial regression analysis showed that sociodemographic indicators such as population density, per capita gross domestic product, and number of county-level medical institutions had statistically significant positive correlations with HIV/AIDS among MSM.
Assorted spatial analyses revealed an increasingly concentrated HIV epidemic among young MSM in Chinese cities, calling for targeted health education and intensive interventions at an early age.
研究表明，中国男男性行为者（MSM）中的人类免疫缺陷病毒（HIV）负担近期有所上升，尤其是在城市地区。为了进行干预规划和资源分配，需要对HIV/AIDS病例聚集情况进行空间分析，以确定中国男男性行为者中的疫情热点和趋势。
从国家病例报告系统中提取2006年至2015年期间记录为HIV/AIDS病例的男男性行为者信息。通过 Cochr an - Armitage趋势检验确定人口统计学趋势。使用空间自相关检查病例聚集的分布情况。使用时空扫描来检测疾病聚集。通过空间回归确定病例与社会环境因素之间的空间相关性。
2006年至2015年期间，中国男男性行为者中确诊了120371例HIV/AIDS病例。自我报告的男男性行为者中新确诊的HIV/AIDS病例从2006年的487例增加到2015年的超过30000例。在2006年至2015年期间记录的那些HIV/AIDS病例中，47.0%为20 - 29岁，24.9%为30 - 39岁。根据通过空间分析确定的HIV/AIDS病例聚集情况，疫情集中在大城市的男男性行为者中。时空聚集包括直辖市、省会城市以及北京、上海、重庆、成都和广州等主要城市。空间回归分析表明，人口密度、人均国内生产总值和县级医疗机构数量等社会人口统计学指标与男男性行为者中的HIV/AIDS存在统计学上显著的正相关。
各种空间分析表明，中国城市年轻男男性行为者中的HIV疫情日益集中，呼吁在早期进行有针对性的健康教育和强化干预。
