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[90-90-90目标及暴露前预防对中国男男性行为者中HIV传播与消除的影响:一项数学建模研究]

[Impact of the 90-90-90 goal and pre-exposure prophylaxis on HIV transmission and elimination in men who have sex with men in China: A mathematical modeling study].

作者信息

Wang K R, Peng L P, Gu J, Hao C, Zou H C, Hao Y T, Li J H

机构信息

School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.

School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China;Sun Yat-Sen Global Health Institute, Guangzhou 510080, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Nov 10;39(11):1507-1514. doi: 10.3760/cma.j.issn.0254-6450.2018.11.017.

Abstract

To establish a dynamic compartmental model to predict the impact of HIV testing and treatment and pre-exposure prophylaxis (PrEP) on the annual incidence of HIV infection in men who have sex with men (MSM) in China from 2018 to 2037. A dynamic compartmental model was developed to describe the HIV epidemic in MSM in China. The model was parameterized using data from the literature available. We used MATLAB 7.0 software for data simulation and graphics rendering. We analyzed HIV transmission among MSM and estimated the impact of expanded HIV testing and treatment and PrEP on HIV elimination in MSM. Under the current policy, the number of new HIV infections would reach 770 000, the infection rate would reach 11.1% and the incidence rate would reach 0.72/100 person years in MSM in the next 20 years. Under the 90%-90%-90% goal, 440 000 new infections (57.7%) would be reduced, the HIV infection rate would decline to 5.7% and the incidence rate would decline to 0.24/100 person years in the next 20 years, but it is still unlikely to achieve the goal of HIV elimination. With 100% PrEP compliance, the required PrEP coverage rates for achieving HIV elimination in the next 10, 15 and 20 years would be 65%, 32% and 19%, respectively. It is necessary to strengthen the comprehensive intervention in MSM, continue to expand HIV testing and treatment, and improve PrEP adherence and coverage to further control and eliminate the epidemic of HIV/AIDS in MSM.

摘要

建立一个动态分区模型,以预测2018年至2037年中国男男性行为者(MSM)中艾滋病毒检测与治疗及暴露前预防(PrEP)对艾滋病毒年感染发病率的影响。开发了一个动态分区模型来描述中国男男性行为者中的艾滋病毒流行情况。该模型使用现有文献中的数据进行参数化。我们使用MATLAB 7.0软件进行数据模拟和图形绘制。我们分析了男男性行为者中的艾滋病毒传播情况,并估计了扩大艾滋病毒检测与治疗及暴露前预防对男男性行为者中消除艾滋病毒的影响。在当前政策下,未来20年男男性行为者中新发艾滋病毒感染人数将达到77万,感染率将达到11.1%,发病率将达到0.72/100人年。在90%-90%-90%目标下,未来20年将减少44万例新感染(57.7%),艾滋病毒感染率将降至5.7%,发病率将降至0.24/100人年,但仍不太可能实现消除艾滋病毒的目标。若暴露前预防依从率为100%,在未来10年、15年和20年实现消除艾滋病毒所需的暴露前预防覆盖率分别为65%、32%和19%。有必要加强对男男性行为者的综合干预,继续扩大艾滋病毒检测与治疗,并提高暴露前预防的依从性和覆盖率,以进一步控制和消除男男性行为者中的艾滋病毒/艾滋病流行。

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