泰国曼谷 Silom 社区诊所的 HIV 感染人数近期下降，与 HIV 预防工作的扩大相对应：2005-2018 年的开放队列评估。
Recent declines in HIV infections at Silom Community Clinic Bangkok, Thailand corresponding to HIV prevention scale up: An open cohort assessment 2005-2018.
机构信息
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA; Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
出版信息
Int J Infect Dis. 2020 Oct;99:131-137. doi: 10.1016/j.ijid.2020.07.007. Epub 2020 Jul 11.
OBJECTIVES
We assessed HIV-1 infection among men who have sex with men (MSM) attending Silom Community Clinic (SCC) in Bangkok, Thailand from 2005 to 2018. Since 2014, Thailand increased implementation of HIV prevention strategies including pre-exposure prophylaxis and Treatment as Prevention.
METHODS
MSM attending SCC were tested for HIV using rapid tests. We assessed trends in HIV prevalence, incidence and compared incidence before and after 2014.
RESULTS
From 2005 to 2018, 14,034 clients attended SCC for HIV testing. The HIV prevalence increased from 19.2% in 2005-2006 to 34-0% in 2010, remained stable until 2016 and decreased to 17.2% in 2018 (p<0.0001). The HIV incidence was 4.1 per 100 person-years (PY), with an inverted U-shape trend and a peak in 2009 (p<0.0001). Incidence among young MSM aged 13-21 years remained high at 10.0 per 100 PY. Among those aged 22-29 years, lower incidence was found from Q 3 2016, with a relative risk reduction of 46.2% (p<0.001); and a similar reduction among those aged ≥30 years from Q4 2014, corresponding to scale up of HIV prevention strategies.
CONCLUSION
We found a decline in HIV infection among Thai MSM. However, incidence remained high among young MSM.
目的
我们评估了 2005 年至 2018 年期间在泰国曼谷的 Silom 社区诊所（SCC）就诊的男男性行为者（MSM）中的 HIV-1 感染情况。自 2014 年以来，泰国加强实施了包括暴露前预防和治疗即预防在内的艾滋病预防策略。
方法
在 SCC 就诊的 MSM 使用快速检测进行 HIV 检测。我们评估了 HIV 流行率、发病率的趋势，并比较了 2014 年前后的发病率。
结果
从 2005 年至 2018 年，共有 14034 名客户在 SCC 接受 HIV 检测。HIV 流行率从 2005-2006 年的 19.2%上升到 2010 年的 34.0%，直到 2016 年保持稳定，然后在 2018 年降至 17.2%（p<0.0001）。HIV 发病率为每 100 人年 4.1 例，呈倒 U 型趋势，2009 年达到峰值（p<0.0001）。13-21 岁的年轻 MSM 发病率仍高达每 100 人年 10.0 例。22-29 岁的发病率从 2016 年第 3 季度开始下降，相对风险降低 46.2%（p<0.001）；≥30 岁的发病率从 2014 年第 4 季度开始下降，这与艾滋病预防策略的推广相对应。
结论
我们发现泰国 MSM 中的 HIV 感染呈下降趋势。然而，年轻 MSM 的发病率仍然很高。
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