Mao X, Wang Z, Hu Q, Huang C, Yan H, Wang Z, Lu L, Zhuang M, Chen X, Fu J, Geng W, Jiang Y, Shang H, Xu J
Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, Shenyang, China.
Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
HIV Med. 2018 Jun 19;19(8):513-22. doi: 10.1111/hiv.12623.
The HIV epidemic is worsening among men who have sex with men (MSM) in China, especially among those who are younger than 25 years old [younger MSM (YMSM)]. The aim of the study was to compare the prevalences of HIV incidence and recent HIV infection as well as factors associated with recent HIV infection in YMSM and older MSM (OMSM).
A multicentre cross-sectional survey was conducted among 4496 MSM recruited from seven Chinese cities. YMSM were defined as those aged < 25 years. Data on demographics and sexual behaviours were collected using structural questionnaires. Blood samples were tested for recent HIV infection and other sexually transmitted infections.
Among the participants, 1313 were YMSM and 3183 were OMSM. Compared with OMSM, YMSM had a higher prevalence of recent HIV infection [5.4% (71 of 1313) for YMSM vs. 3.6% (115 of 3175) for OMSM; P = 0.006] and a higher HIV incidence [11.8 per 100 person-years (PY) (95% confidence interval (CI) 9.0-14.5) for YMSM vs. 7.6 per 100 PY (95% CI 6.3-9.0) for OMSM]. The incidence increased with age among YMSM, especially between the ages of 16 and 21 years. In contrast, the incidence declined with age among OMSM. Anal bleeding, recreational drug use, syphilis and herpes simplex virus 2 (HSV-2) infection were independent risk factors for recent HIV infection among YMSM. The prevalence of all these risk factors increased with age between the ages of 16 and 21 years. Anal bleeding (19.8%) and recreational drug use (19.5%) had the highest adjusted population attributable fractions (aPAFs) among YMSM. The highest aPAFs of anal bleeding (27.4%) and syphilis infection (25.5%) were found between the ages of 19 and 21 years.
The HIV incidence in Chinese YMSM was significantly higher than that in OMSM. YMSM aged 16-21 years had an extremely high risk of recent HIV infection.
在中国，男男性行为者（MSM）中的艾滋病病毒（HIV）疫情正在恶化，尤其是在25岁以下的人群中[年轻男男性行为者（YMSM）]。本研究旨在比较YMSM和年长男男性行为者（OMSM）中HIV新发感染率和近期HIV感染率，以及与近期HIV感染相关的因素。
对从中国七个城市招募的4496名MSM进行了一项多中心横断面调查。YMSM定义为年龄<25岁的人群。使用结构化问卷收集人口统计学和性行为数据。采集血样检测近期HIV感染及其他性传播感染。
在参与者中，1313人为YMSM，3183人为OMSM。与OMSM相比，YMSM近期HIV感染率更高[YMSM为5.4%（1313人中的71人），OMSM为3.6%（3175人中的115人）；P = 0.006]，HIV新发感染率也更高[YMSM为每100人年11.8例（95%置信区间（CI）9.0 - 14.5），OMSM为每100人年7.6例（95%CI 6.3 - 9.0）]。YMSM的感染率随年龄增长而升高，尤其是在16至21岁之间。相比之下，OMSM的感染率随年龄增长而下降。肛门出血、使用娱乐性药物、梅毒和单纯疱疹病毒2型（HSV - 2）感染是YMSM近期HIV感染的独立危险因素。所有这些危险因素的患病率在16至21岁之间随年龄增长而升高。肛门出血（19.8%）和使用娱乐性药物（19.5%）在YMSM中的调整人群归因分数（aPAF）最高。肛门出血（27.4%）和梅毒感染（25.5%）在19至21岁之间的aPAF最高。
中国YMSM的HIV新发感染率显著高于OMSM。16至21岁的YMSM近期HIV感染风险极高。
