Singh Sonia, Mitsch Andrew, Wu Baohua
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Morb Mortal Wkly Rep. 2017 Sep 22;66(37):969-974. doi: 10.15585/mmwr.mm6637a2.
Gay, bisexual, and other men who have sex with men (collectively referred to as MSM) represent approximately 2% of the U.S. population (1), yet in 2015, MSM accounted for 70% of all diagnoses of human immunodeficiency virus (HIV) infection, including 3% who also were persons who inject drugs (2). During 2008-2014, incidence of HIV infection decreased for groups in all transmission categories except MSM (3). Testing, linkage to and retention in care, and viral suppression are important in reducing HIV transmission. National HIV Surveillance System (NHSS)* data are used to monitor progress toward reaching national goals. To better guide prevention measures, CDC analyzed data from NHSS for MSM aged ≥13 years (excluding MSM who inject drugs) to determine stage at diagnosis of HIV infection and care outcomes. Among the 19,170 MSM with HIV infection diagnosed in 2015 in 38 jurisdictions with complete laboratory reporting, 3,666 (19.1%) had infection classified as stage 3 (acquired immunodeficiency syndrome [AIDS]) at diagnosis and 74.7% and 84.0% were linked to care within 1 month and 3 months, respectively. Among MSM living with diagnosed HIV infection at year-end 2014, 74.1% received any HIV care, 57.7% were retained in continuous care, and 61.2% had achieved viral suppression. Younger MSM and black or African American (black) MSM had the least favorable HIV care outcomes. Strengthening interventions that increase care and viral suppression among MSM, particularly those aged <25 years and black MSM with public and private partners is important.
男同性恋者、双性恋者以及其他与男性发生性行为的男性(统称为男男性行为者)约占美国人口的2%(1),然而在2015年,男男性行为者占所有人类免疫缺陷病毒(HIV)感染诊断病例的70%,其中3%同时也是注射毒品者(2)。在2008 - 2014年期间,除男男性行为者外,所有传播类别群体的HIV感染发病率均有所下降(3)。检测、与治疗的关联及治疗留存率以及病毒抑制对于减少HIV传播至关重要。国家HIV监测系统(NHSS)*数据用于监测实现国家目标的进展情况。为更好地指导预防措施,美国疾病控制与预防中心(CDC)分析了NHSS中年龄≥13岁的男男性行为者(不包括注射毒品的男男性行为者)的数据,以确定HIV感染诊断阶段及治疗结果。在2015年38个有完整实验室报告辖区内确诊感染HIV的19,170名男男性行为者中,3,666名(19.1%)在诊断时感染被分类为3期(获得性免疫缺陷综合征[AIDS]),分别有74.7%和84.0%在1个月和3个月内与治疗建立关联。在2014年末确诊感染HIV的男男性行为者中,74.1%接受了任何HIV治疗,57.7%持续接受治疗,61.2%实现了病毒抑制。较年轻的男男性行为者以及黑人或非裔美国(黑人)男男性行为者的HIV治疗结果最不理想。加强干预措施以提高男男性行为者,尤其是年龄<25岁的男男性行为者以及有公共和私人伴侣的黑人男男性行为者的治疗及病毒抑制水平非常重要。