Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA.
Centers for Disease Control and Prevention, 1600 Clifton Road, MS E40, Atlanta, GA, 30333, USA.
AIDS Behav. 2018 Jul;22(7):2199-2213. doi: 10.1007/s10461-018-2088-3.
This study sought to determine why young men who have sex with men (MSM) have higher HIV incidence rates than older MSM in the United States. We developed hypotheses that may explain this disparity. Data came from peer-reviewed studies published during 1996-2016. We compared young and older MSM with respect to behavioral, clinical, psychosocial, and structural factors that promote HIV vulnerability. Compared with older MSM, young MSM were more likely to have HIV-discordant condomless receptive intercourse. Young MSM also were more likely to have "any" sexually transmitted infection and gonorrhea. Among HIV-positive MSM, young MSM were less likely to be virally suppressed, use antiretroviral therapy, and be aware of their infection. Moreover, young MSM were more likely than older MSM to experience depression, polysubstance use, low income, decreased health care access, and early ages of sexual expression. These factors likely converge to exacerbate age-associated HIV incidence disparities among MSM.
本研究旨在探究为何美国的年轻男男性行为者（MSM）比年长的 MSM 具有更高的 HIV 发病率。我们提出了一些假设，以解释这一差异。数据来自于 1996 年至 2016 年期间发表的同行评议研究。我们比较了年轻和年长的 MSM，研究了促进 HIV 易感性的行为、临床、心理社会和结构因素。与年长的 MSM 相比，年轻的 MSM 更有可能发生 HIV 不一致的无保护接受性行为。年轻的 MSM 也更有可能患有“任何”性传播感染和淋病。在 HIV 阳性的 MSM 中，年轻的 MSM 病毒抑制率较低，使用抗逆转录病毒疗法的比例较低，并且对感染的知晓率较低。此外，年轻的 MSM 比年长的 MSM 更有可能经历抑郁、多种物质使用、低收入、减少获得医疗保健的机会以及性表达的早期年龄。这些因素可能会加剧 MSM 中与年龄相关的 HIV 发病率差异。
