Institute for AIDS/STD Control and Prevention, Beijing Center for Disease Control and Prevention, Beijing Center for Preventive Medical Research, Beijing, China.
PLoS One. 2018 Aug 9;13(8):e0201953. doi: 10.1371/journal.pone.0201953. eCollection 2018.
BACKGROUND: Sexual transmission of HIV among men who have sex with men (MSM) increased markedly in China during the past decade. HIV incidence is a critical indicator in HIV surveillance and we use a HIV-1 BED-capture-enzyme immunoassay (BED-CEIA) to examine the incidence among MSM in Beijing from 2008 to 2016. Risk factors related to recent HIV infection were also assessed. METHODS: Consecutive cross-sectional surveys on MSM were conducted yearly from 2008 through 2016. Demographic and behaviors data were collected. HIV status was determined and HIV positive specimens were tested for recent infection using BED-CEIA. Specimens with ODn values≤0.8 were considered recently infected, HIV incidence rates and prevalence were then calculated. Risk factors associated with recent HIV infection were assessed by univariate and multivariable logistic regression. RESULTS: From 2008 to 2016, the numbers of eligible participants in the nine consecutive years ranged from 472 to 616. All the 261 eligible HIV-positive specimens were subjected to recent HIV infection testing. HIV prevalence ranged from 5.0% (3.3%-6.8%) to 10.2% (7.8%-12.7%), and incidence ranged from 1.57% (0.19%-2.95%) to 6.63% (3.65%-9.61%). MSM who never or sometimes used condoms during anal sex with men in the past 6 months (aOR = 1.515, 95%CI: 1.016-2.257, p = 0.041), or having syphilis infection (aOR = 1.561, 95%CI: 0.946-2.575, p = 0.081) were more likely to be recently infected with HIV. Being a Beijing resident (aOR = 0.409, 95%CI: 0.212-0.790, p = 0.008), or having only one male anal sex partner in the past 6 months (aOR = 0.467, 95%CI: 0.220-0.994, p = 0.048) were associated with a lower risk for recent HIV infection. CONCLUSIONS: The HIV incidence fluctuated among MSM in Beijing. Unprotected anal sex, having multiple sex partners, being a non-registered Beijing resident and having a syphilis infection play important roles in the recent HIV infection. Effective intervention measures for HIV and syphilis control and prevention should be continuously strengthened.
背景：过去十年间，中国男男性行为人群（MSM）中的 HIV 经性途径传播显著增加。HIV 发病率是 HIV 监测的一个重要指标，我们使用 HIV-1 BED 捕获酶免疫测定（BED-CEIA）来检测 2008 年至 2016 年期间北京 MSM 中的发病率。还评估了与近期 HIV 感染相关的风险因素。
方法：从 2008 年到 2016 年，每年对 MSM 进行连续的横断面调查。收集人口统计学和行为数据。确定 HIV 状态，并用 BED-CEIA 检测 HIV 阳性样本的近期感染情况。ODn 值≤0.8 的标本被认为是近期感染，然后计算 HIV 发病率和流行率。通过单因素和多因素逻辑回归评估与近期 HIV 感染相关的风险因素。
结果：2008 年至 2016 年的九年间，符合条件的参与者人数从 472 人到 616 人不等。所有 261 份符合条件的 HIV 阳性标本均进行了近期 HIV 感染检测。HIV 流行率范围为 5.0%（3.3%-6.8%）至 10.2%（7.8%-12.7%），发病率范围为 1.57%（0.19%-2.95%）至 6.63%（3.65%-9.61%）。在过去 6 个月中，与男性进行肛门性交时从未或偶尔使用安全套的 MSM（aOR = 1.515，95%CI：1.016-2.257，p = 0.041），或患有梅毒感染（aOR = 1.561，95%CI：0.946-2.575，p = 0.081）的人更有可能最近感染 HIV。作为北京居民（aOR = 0.409，95%CI：0.212-0.790，p = 0.008），或在过去 6 个月中仅有一个男性肛门性伴侣（aOR = 0.467，95%CI：0.220-0.994，p = 0.048），与近期 HIV 感染的风险较低相关。
结论：北京 MSM 的 HIV 发病率波动不定。无保护的肛交、有多个性伴侣、非北京户籍和梅毒感染在近期 HIV 感染中起着重要作用。应持续加强针对 HIV 和梅毒的有效防治干预措施。
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