美国和波多黎各 2015-2019 年诊断为 HIV 且与男性发生性关系的男性的性伴侣特征。
Characteristics of Sexual Partnerships Among Men With Diagnosed HIV Who Have Sex With Men, United States and Puerto Rico-2015-2019.
机构信息
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Georgia State University School of Public Health, Atlanta, GA; and.
出版信息
J Acquir Immune Defic Syndr. 2020 Aug 15;84(5):443-452. doi: 10.1097/QAI.0000000000002388.
BACKGROUND
Understanding sexual partnerships of HIV-positive persons, particularly at the dyad level, can help in quantifying HIV transmission risk. We described sexual partnerships among HIV-positive men who have sex with men (MSM), including partnerships with a high risk for sexual HIV transmission.
SETTING
The Medical Monitoring Project is an annual, cross-sectional study that reports representative estimates on U.S. HIV-positive adults.
METHODS
During 2015-2019, we assessed sexual behaviors by interview, and viral load results from medical records. Among sexually active HIV-positive MSM (n = 4923), we described prevalence of high-risk sex, defined as: (1) not having sustained viral suppression, and (2) having condomless sex with an HIV-negative partner not known to be taking pre-exposure prophylaxis or an HIV-unknown partner. We described sexual partnerships among HIV-positive MSM (n = 13,024 partnerships among 4923 MSM). For HIV-discordant partnerships (n = 7768), we reported the proportion involved in high-risk sex, and associations with high-risk sex using prevalence ratios with predicted marginal means, controlling for age of the HIV-positive partner (P < 0.05).
RESULTS
More than half (66%) of sexually active HIV-positive MSM had condomless sex; 11% had high-risk sex. Blacks were more likely to have detectable viral loads, but less likely to have condomless sex, making prevalence of high-risk sex comparable between racial/ethnic groups. Dyad-level analyses among HIV-discordant partnerships indicated that prevalence of high-risk sex was higher among partnerships with HIV-positive white MSM, which was not observed using person-level data alone.
CONCLUSIONS
In the context of ending the HIV epidemic, behavioral and clinical surveillance data can help monitor HIV transmission risk and target prevention efforts to reduce transmission among populations at disproportionate risk.
背景
了解 HIV 阳性者的性伴侣关系，特别是在对偶水平上，有助于量化 HIV 传播风险。我们描述了 HIV 阳性男男性行为者（MSM）的性伴侣关系，包括具有高性传播 HIV 风险的伴侣关系。
地点
医学监测项目是一项年度横断面研究，报告了美国 HIV 阳性成年人的代表性估计数。
方法
在 2015-2019 年期间，我们通过访谈和病历中的病毒载量结果评估性行为。在有性行为的 HIV 阳性 MSM 中（n=4923），我们描述了高风险性行为的流行率，定义为：（1）未持续病毒抑制，（2）与 HIV 阴性伴侣发生无保护性行为，而该伴侣未被确认为服用暴露前预防或 HIV 未知伴侣。我们描述了 HIV 阳性 MSM 的性伴侣关系（n=4923 名 MSM 中的 13024 对性伴侣关系）。对于 HIV 不一致的伴侣关系（n=7768），我们报告了参与高风险性行为的比例，并使用具有预测边际均值的患病率比，控制 HIV 阳性伴侣的年龄（P<0.05），来报告与高风险性行为的关联。
结果
超过一半（66%）有性行为的 HIV 阳性 MSM 发生了无保护性行为；11%发生了高风险性行为。黑人更有可能检测到病毒载量，但不太可能发生无保护性行为，这使得不同种族/族裔群体之间的高风险性行为的流行率相当。在 HIV 不一致的伴侣关系中的对偶水平分析表明，HIV 阳性白人 MSM 的伴侣关系中高风险性行为的流行率更高，而仅使用个人水平数据则没有观察到这种情况。
结论
在结束 HIV 流行的背景下，行为和临床监测数据有助于监测 HIV 传播风险，并将预防工作重点放在传播风险不成比例的人群上。
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