一种定量识别新 HIV 感染增长热点地区的新策略,以进行有针对性的干预。
A New Strategy to Quantitatively Identify Hot-Spot Areas in Growth of New HIV Infections for Targeted Interventions.
机构信息
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
出版信息
Front Public Health. 2021 Jul 12;9:680867. doi: 10.3389/fpubh.2021.680867. eCollection 2021.
Previous geographic studies of HIV infection have usually used prevalence data, which cannot indicate the hot-spot areas of current transmission. To develop quantitative analytic measures for accurately identifying hot-spot areas in growth of new HIV infection, we investigated the geographic distribution features of recent HIV infection and long-term HIV infection using data from a whole-population physical examination in four key counties in Liangshan prefecture, which are most severely affected by HIV in China. Through a whole-population physical examination during November 2017- June 2018 in the four key counties, a total of 5,555 HIV cases were diagnosed and 246 cases were classified as recently infected by laboratory HIV recency tests. The geospatial patterns of recent and long-term HIV infected cases were compared using ordinary least squares regression and Geodetector. Further, geospatial-heterogeneity was quantified and indicated using a residual map to visualize hot-spot areas where new infection is increasing. The geographic location of HIV cases showed an uneven distribution along major roads and clustered at road intersections. The geographic mapping showed that several areas were clustered with more recently infected HIV cases than long-term infected cases. The quantitative analyses showed that the geospatial asymmetry between recent and long-term HIV infection was 0.30 and 0.31 in ordinary least squares regression and Geodetector analysis, respectively. The quantitative analyses found twenty-three townships showing an increase in the number of recent infections. Quantitative analysis of geospatial-heterogeneous areas by comparing between recent and long-term HIV infections allows accurate identification of hot-spot areas where new infections are expanding, which can be used as a potent methodological tool to guide targeted interventions and curb the spread of the epidemic.
先前的 HIV 感染地理研究通常使用流行率数据,而这些数据并不能显示当前传播的热点地区。为了开发定量分析措施来准确识别新 HIV 感染增长中的热点地区,我们利用中国受 HIV 影响最严重的凉山州四个重点县的整个人群体检数据,调查了近期 HIV 感染和长期 HIV 感染的地理分布特征。通过 2017 年 11 月至 2018 年 6 月在这四个重点县进行的整个人群体检,共诊断出 5555 例 HIV 病例,其中 246 例经实验室 HIV 近期检测被归类为近期感染。使用普通最小二乘法回归和地理探测器比较了近期和长期 HIV 感染病例的地理空间模式。此外,使用残差图对地理空间异质性进行了量化和可视化,以显示新感染增加的热点地区。HIV 病例的地理位置沿主要道路分布不均,并在道路交叉口聚集。地理映射显示,有几个区域聚集了比长期感染病例更多的近期感染 HIV 病例。定量分析表明,普通最小二乘法回归和地理探测器分析中,近期和长期 HIV 感染的地理空间不对称性分别为 0.30 和 0.31。定量分析发现 23 个乡镇近期感染病例数呈上升趋势。通过比较近期和长期 HIV 感染来分析地理空间异质性区域,可以准确识别新感染不断扩大的热点地区,这可以作为一种有效的方法工具,用于指导有针对性的干预措施,遏制疫情的传播。