MMWR Morb Mortal Wkly Rep. 2020 Sep 25;69(38):1337-1342. doi: 10.15585/mmwr.mm6938a1.
During 2018, gay, bisexual, and other men who have sex with men (MSM) accounted for 69.4% of all diagnoses of human immunodeficiency virus (HIV) infection in the United States (1). Moreover, in all 42 jurisdictions with complete laboratory reporting of CD4 and viral load results,* percentages of MSM linked to care within 1 month (80.8%) and virally suppressed (viral load <200 copies of HIV RNA/mL or interpreted as undetected) within 6 months (68.3%) of diagnosis were below target during 2018 (2). African American/Black (Black), Hispanic/Latino (Hispanic), and younger MSM disproportionately experience HIV diagnosis, not being linked to care, and not being virally suppressed. To characterize trends in these outcomes, CDC analyzed National HIV Surveillance System data from 2014 to 2018. The number of diagnoses of HIV infection among all MSM decreased 2.3% per year (95% confidence interval [CI] = 1.9-2.8). However, diagnoses did not significantly change among either Hispanic MSM or any MSM aged 13-19 years; increased 2.2% (95% CI = 1.0-3.4) and 2.0% (95% CI = 0.6-3.3) per year among Black and Hispanic MSM aged 25-34 years, respectively; and were highest in absolute count among Black MSM. Annual percentages of linkage to care within 1 month and viral suppression within 6 months of diagnosis among all MSM increased (2.9% [95% CI = 2.4-3.5] and 6.8% [95% CI = 6.2-7.4] per year, respectively). These findings, albeit promising, warrant intensified prevention efforts for Black, Hispanic, and younger MSM.
在 2018 年,男同性恋者、双性恋者和其他与男性发生性关系的男性(MSM)占美国所有人类免疫缺陷病毒(HIV)感染诊断的 69.4%(1)。此外,在所有 42 个具有完整 CD4 和病毒载量结果实验室报告的司法管辖区中,*在诊断后 1 个月内(80.8%)和 6 个月内(68.3%)联系到治疗和病毒载量抑制(病毒载量<200 拷贝 HIV RNA/mL 或解释为未检测到)的 MSM 比例低于目标(2)。非裔美国人/黑人(黑人)、西班牙裔/拉丁裔(西班牙裔)和年轻的 MSM 不成比例地经历 HIV 诊断、未联系到治疗和未病毒抑制。为了描述这些结果的趋势,CDC 分析了 2014 年至 2018 年国家 HIV 监测系统的数据。所有 MSM 中 HIV 感染的诊断数量每年减少 2.3%(95%置信区间[CI] = 1.9-2.8)。然而,西班牙裔 MSM 或任何 13-19 岁的 MSM 中的诊断并没有显著变化;25-34 岁的黑人 MSM 和西班牙裔 MSM 分别每年增加 2.2%(95% CI = 1.0-3.4)和 2.0%(95% CI = 0.6-3.3);黑人 MSM 的绝对数量最高。所有 MSM 中,在诊断后 1 个月内联系治疗和在 6 个月内病毒抑制的年百分比均有所增加(分别为 2.9%[95% CI = 2.4-3.5]和 6.8%[95% CI = 6.2-7.4])。这些发现虽然很有希望,但需要加强对黑人、西班牙裔和年轻 MSM 的预防工作。