罗马成年人中的 HIV 流行率：MeDi（衡量 HIV 预防中的健康差距）调查结果。第二部分。

HIV prevalence among adults in Rome: results of the MeDi (Measuring health Disparities in HIV prevention) survey. Part 2.

机构信息

Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.

Unità di Epidemiologia,Azienda Sanitaria Locale Torino 3 (Asl TO3), Turin, Italy.

出版信息

Ann Ist Super Sanita. 2020 Jan-Mar;56(1):30-37. doi: 10.4415/ANN_20_01_06.

DOI:10.4415/ANN_20_01_06

PMID:32242533

Abstract

BACKGROUND

In Italy, out of 60 millions of inhabitants, 3000 (2700-4000) new HIV infections are estimated each year. As combined antiretroviral therapy (ART) prolongs life for HIV sufferers, the prevalence of HIV-infection is likely to increase over time. Few studies have assessed factors associated with being HIV positive in people accessing public outpatient clinics and, in particular, the influence of socio-economic circumstances on HIV prevalence. This study aims to evaluate the association between subjects' serostatus and socio-economic determinants measured at the individual and neighbourhood levels.

METHODS

Data from a large anonymous survey performed in 2012-2014 on more than 10 000 individuals 18-59 years old who underwent 21 public ambulatories in Rome were analysed. Subjects' socio-demographic characteristics, sexual orientation, number of sexual partners, HIV risk behaviour and HIV testing uptake were collected by a self-administered questionnaire. Level of area deprivation was measured at the postal code level by the index of social disadvantage (ISD). Multilevel Poisson regressions were carried out to take heterogeneity between clusters (post code and clinics) into account.

RESULTS

Self-reported HIV-prevalence was 2.0% among subjects ever been tested (13.7% for the homosexual/lesbians 7.0% for the bisexual and 1.3% for the heterosexual). About 1% of subjects self-identified as low risk was HIV infected. This prevalence increased up to 2% in the age group 18-34 and up to 5% in the non-heterosexuals (i.e. self- identified homosexuals/lesbians and bisexuals). At the individual level, HIV-prevalence decreased linearly from lowest to highest levels of education. Living in a deprived neighbourhood was not associated with HIV-infection.

CONCLUSIONS

Our study confirms high HIV prevalences among homosexuals/lesbians. Some infections occur in subjects who do not report high risk behaviours for HIV transmission.

摘要

背景

在意大利，估计每年有 3000 例（2700-4000 例）新的 HIV 感染病例，在 6000 万居民中。随着联合抗逆转录病毒疗法（ART）延长 HIV 感染者的寿命，HIV 感染的流行率可能会随着时间的推移而增加。很少有研究评估过在接受公共门诊治疗的人群中与 HIV 阳性相关的因素，特别是社会经济状况对 HIV 流行率的影响。本研究旨在评估个体和社区层面的社会经济决定因素与个体 HIV 阳性状态之间的关联。

方法

对 2012-2014 年间在罗马的 21 家公共门诊接受治疗的 10000 多名 18-59 岁个体进行了一项大型匿名调查，分析了这些数据。通过自填问卷收集了个体的社会人口统计学特征、性取向、性伴侣数量、HIV 风险行为和 HIV 检测情况。通过社会劣势指数（ISD），在邮政编码层面上衡量了区域贫困程度。为了考虑到聚类（邮政编码和诊所）之间的异质性，进行了多水平泊松回归分析。

结果

在曾接受过检测的个体中，自我报告的 HIV 流行率为 2.0%（同性恋者为 13.7%，双性恋者为 7.0%，异性恋者为 1.3%）。约 1%的自我认定为低危的个体感染了 HIV。在 18-34 岁年龄组中，这一比例上升到 2%，在非异性恋者（即自我认定的同性恋者/女同性恋者和双性恋者）中上升到 5%。在个体层面上，HIV 流行率从受教育程度最低到最高呈线性下降。居住在贫困社区与 HIV 感染无关。