巴西男男性行为者中的艾滋病毒流行率：第二次采用应答者驱动抽样的全国性调查结果。
HIV prevalence among men who have sex with men in Brazil: results of the 2nd national survey using respondent-driven sampling.
作者信息
Kerr Ligia, Kendall Carl, Guimarães Mark Drew Crosland, Salani Mota Rosa, Veras Maria Amélia, Dourado Inês, Maria de Brito Ana, Merchan-Hamann Edgar, Pontes Alexandre Kerr, Leal Andréa Fachel, Knauth Daniela, Castro Ana Rita Coimbra Motta, Macena Raimunda Hermelinda Maia, Lima Luana Nepomuceno Costa, Oliveira Lisangela Cristina, Cavalcantee Maria do Socorro, Benzaken Adele Schwartz, Pereira Gerson, Pimenta Cristina, Pascom Ana Roberta Pati, Bermudez Ximena Pamela Diaz, Moreira Regina Célia, Brígido Luis Fernando Macedo, Camillo Ana Cláudia, McFarland Willi, Johnston Lisa G
机构信息
Faculdade de Medicina, Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA, Faculdade de Medicina da Universidade Federal do Ceará, Saúde Comunitária, Fortaleza, CE Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, MG Departamento de Estatística e Matemática Aplicada, Universidade Federal do Ceará, Fortaleza, CE Departamento de Saúde Coletiva, Faculdade de Ciências Medicas da Santa Casa de São Paulo, São Paulo, SP Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA Centro de Pesquisas Aggeu Magalhaes, Recife, PE Centro de Ciências da Saúde - Departamento de Saúde Coletiva, Universidade de Brasília Faculdade de Ciências da Saúde, Brasília Instituto de Psicologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro Departamento de Sociologia Departamento de Medicina Social, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS FIOCRUZ - Unidade Mato Grosso do Sul, Universidade Federal do Mato Grosso do Sul, Campo Grande, MS Faculdade de Medicina da Universidade Federal do Ceará, Faculdade de Medicina - Departamento de Fisioterapia, Fortaleza, CE Instituto Evandro Chagas, Ananindeua, PA Centro Universitário Autônomo do Brasil, Curitiba, PR Secretaria de Saúde do Estado do Ceará, Secretaria de Saúde do Município de Fortaleza, Fortaleza, CE Departamento de IST e HIV/AIDS e Hepatites Virais, Ministério da Saúde, Brasília Centro de Ciências da Saúde, Universidade de Brasília, Brasília, DF Instituto Adolfo Lutz, São Paulo - SP Fundação Alfredo da Matta, Manaus, AZ, Brasil Center for Global Health, University of California, San Francisco, CA Tulane School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences, New Orleans, LA, USA.
出版信息
Medicine (Baltimore). 2018 May;97(1S Suppl 1):S9-S15. doi: 10.1097/MD.0000000000010573.
This paper reports human immuno-deficiency virus (HIV) prevalence in the 2nd National Biological and Behavioral Surveillance Survey (BBSS) among men who have sex with men (MSM) in 12 cities in Brazil using respondent-driven sampling (RDS).Following formative research, RDS was applied in 12 cities in the 5 macroregions of Brazil between June and December 2016 to recruit MSM for BBSS. The target sample size was 350 per city. Five to 6 seeds were initially selected to initiate recruitment and coupons and interviews were managed online. On-site rapid testing was used for HIV screening, and confirmed by a 2nd test. Participants were weighted using Gile estimator. Data from all 12 cities were merged and analyzed with Stata 14.0 complex survey data analysis tools in which each city was treated as its own strata. Missing data for those who did not test were imputed HIV+ if they reported testing positive before and were taking antiretroviral therapy.A total of 4176 men were recruited in the 12 cities. The average time to completion was 10.2 weeks. The longest chain length varied from 8 to 21 waves. The sample size was achieved in all but 2 cities.A total of 3958 of the 4176 respondents agreed to test for HIV (90.2%). For results without imputation, 17.5% (95%CI: 14.7-20.7) of our sample was HIV positive. With imputation, 18.4% (95%CI: 15.4-21.7) were seropositive.HIV prevalence increased beyond expectations from the results of the 2009 survey (12.1%; 95%CI: 10.0-14.5) to 18.4%; CI95%: 15.4 to 21.7 in 2016. This increase accompanies Brazil's focus on the treatment to prevention strategy, and a decrease in support for community-based organizations and community prevention programs.
本文报告了在巴西12个城市中，通过应答驱动抽样（RDS）对男男性行为者（MSM）进行的第二次全国生物与行为监测调查（BBSS）中的人类免疫缺陷病毒（HIV）流行情况。在进行形成性研究之后，于2016年6月至12月期间在巴西5个宏观区域的12个城市应用RDS，为BBSS招募男男性行为者。每个城市的目标样本量为350人。最初选择5至6名种子参与者以启动招募工作，优惠券和访谈通过在线方式进行管理。现场快速检测用于HIV筛查，并通过第二次检测进行确认。参与者使用吉尔估计器进行加权。来自所有12个城市的数据进行合并，并使用Stata 14.0复杂调查数据分析工具进行分析，其中每个城市被视为一个独立的分层。对于未进行检测者的缺失数据，如果他们之前报告检测呈阳性且正在接受抗逆转录病毒治疗，则推断为HIV阳性。12个城市共招募了4176名男性。完成调查的平均时间为10.2周。最长的链条长度从8波到21波不等。除2个城市外，所有城市均达到了样本量。4176名受访者中共有3958人同意进行HIV检测（90.2%）。对于未进行数据插补的结果，我们样本中的17.5%（95%置信区间：14.7 - 20.7）HIV呈阳性。进行数据插补后，18.4%（95%置信区间：15.4 - 21.7）血清学呈阳性。HIV流行率从2009年调查结果（12.1%；95%置信区间：10.0 - 14.5）超出预期上升至2016年的18.4%；95%置信区间：15.4至21.7。这种上升伴随着巴西对治疗转预防策略的关注，以及对社区组织和社区预防项目支持的减少。
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