中国七大城市大学生、非大学生青年和老年男男性行为者中人类免疫缺陷病毒发病率和耐药性的差异：一项横断面研究。
Disparity of human immunodeficiency virus incidence and drug resistance in college student, non-student youth and older men who have sex with men: a cross-sectional study from seven major cities of China.
机构信息
NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China.
Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China.
出版信息
Chin Med J (Engl). 2020 Dec 5;133(23):2778-2786. doi: 10.1097/CM9.0000000000001161.
BACKGROUND
Human immunodeficiency virus (HIV) prevalence among student men who have sex with men (MSM) in college is more than 5.0% and keeps on increasing in China. This study aims to clarify the proportion of HIV recent infection, its propeller and the source among college student MSM.
METHODS
We conducted a multicenter cross-sectional study in seven major Chinese cities during 2012-2013. HIV recent infections (≤ 168 days) and incidence was measured and estimated by BED HIV-1 capture enzyme immunoassay (BED-CEIA) testing strategy. HIV-related behaviors and transmitted drug resistance (TDR) were investigated and compared between the college student MSM, <25-year-old non-student youth MSM (NSYM), and ≥25-year-old non-student non-youth MSM (NSNYM), using structured survey, and analyses of drug resistance.
RESULTS
Overall, 4,496 (4496/4526, 99.3%) were eligible for enrollment, comprising 565 college student MSM, 1,094 NSYM, and 2,837 NSNYM. The proportion of HIV recent infection were 70.3% (26/37), 50.8% (65/128) and 35.1% (95/271), the HIV incidence rate were 10.0 (95% CI: 6.2-13.9)/100PY, 12.9 (95% CI: 9.8-16.1)/100PY, 6.8 (95% CI: 5.4-8.2)/100PY, and TDR prevalence were 7.4% (2/27), 2.0%, (2/98) and 4.9% (11/226), among student MSM, NSYM, and NSNYM, respectively. Among HIV positive student MSM with age< 21-year-old, the proportion of HIV recent infection is 90.9% (10/11). Factors independently associated with HIV recent infection in student MSM was usage of recreational drug in the past 6 months (AOR: 2.5; 95% CI: 1.0-5.8).
CONCLUSIONS
College student MSM had higher proportion of HIV recent infection and TDR than the youth and older MSM in China during 2012-2013. The HIV infections were more likely to happen during the early year of college life among student MSM.
背景
在中国，大学生男男性行为者（MSM）中的 HIV 感染率超过 5.0%，且呈持续上升趋势。本研究旨在明确大学生 MSM 中 HIV 近期感染的比例、其驱动因素和来源。
方法
我们在 2012-2013 年期间在中国七个主要城市进行了一项多中心横断面研究。采用 BED HIV-1 捕获酶免疫测定（BED-CEIA）检测策略，对 HIV 近期感染（≤168 天）和发病率进行了测量和估计。通过结构调查和耐药性分析，比较了大学生 MSM、<25 岁非学生青年 MSM（NSYM）和≥25 岁非学生非青年 MSM（NSNYM）之间的 HIV 相关行为和传播耐药性（TDR）。
结果
总体而言，共有 4496 人（4496/4526，99.3%）符合入组条件，包括 565 名大学生 MSM、1094 名 NSYM 和 2837 名 NSNYM。HIV 近期感染率分别为 70.3%（26/37）、50.8%（65/128）和 35.1%（95/271），HIV 发病率分别为 10.0（95%CI：6.2-13.9）/100PY、12.9（95%CI：9.8-16.1）/100PY 和 6.8（95%CI：5.4-8.2）/100PY，TDR 患病率分别为 7.4%（2/27）、2.0%（2/98）和 4.9%（11/226），在大学生 MSM、NSYM 和 NSNYM 中分别为 7.4%、2.0%和 4.9%。在年龄<21 岁的 HIV 阳性大学生 MSM 中，HIV 近期感染率为 90.9%（10/11）。与大学生 MSM 中 HIV 近期感染相关的独立因素为过去 6 个月内使用娱乐性药物（AOR：2.5；95%CI：1.0-5.8）。
结论
2012-2013 年，中国大学生 MSM 的 HIV 近期感染率和 TDR 均高于青年和老年 MSM。在大学生 MSM 中，HIV 感染更可能发生在大学生活的早期。
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