Qian X H, Zheng M, Zheng Y Q, He J Y, Yao Y M, Tao R, Ma L, Li D M, Yuan Z
Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Apr 10;42(4):672-676. doi: 10.3760/cma.j.cn112338-20200923-01180.
To evaluate the prediction power of HIV infection risk assessment tool and the applicability in MSM in Guizhou province. MSM were recruited through snowball sampling method. Questionnaire surveys were conducted among the MSM using HIV infection risk assessment tool, and combined with HIV serologic test results, the risk prediction power of HIV infection risk assessment tool was evaluated. A total of 3 379 MSM were recruited from January 2018 to December 2019 in Guizhou. The HIV infection rate was 3.3%(111/3 379). The mean risk scores of HIV positive and HIV negative MSM were (12.15±3.08) and (12.07±3.07), respectively. The difference in risk score was significant between MSM with different HIV status (=8.69, <0.001). According to the principle of decision tree, individual risk scores were divided into following three categories: ≤11.96, 11.97-14.80 and >14.80, the HIV infection rate was 0.8%, 4.3% and 8.6% respectively, suggesting that the higher the individual risk score was, the higher the HIV infection rate was (trend =88.18, <0.001). Multivariate logistic regression analysis showed that the higher the individual risk score was, the higher the risk of HIV infection was. Compared to the total score ≤11.96, the a values at total scores of 11.97-14.80 and >14.80 were 6.34 (95%: 3.38-11.88) and 14.07(95%: 7.44-26.61), respectively. The risk of HIV infection in Miao ethnic group was higher than that in Han ethnic group (a=1.83, 95%1.04-3.21), and the risk of HIV infection in those with education level of primary school and below was higher than that in undergraduates or those with education level of junior college and above (a=2.50, 95%1.06-5.88), and the risk of HIV infection was higher in those who had bisexual behaviors than in those who had homosexual behaviors (a=1.95, 95%1.19-3.19). The risk of HIV infection was higher in those who had never received HIV testing (a=1.53, 95%1.01-2.33). The area under the receiver operating characteristic (ROC) curve and area under ROC (AUC) for HIV infection prediction was 0.751 (95%:0.710-0.792, <0.001). The maximum Youden's index was individual risk score of 12.56, and the sensitivity of the risk assessment tool was 0.838, and its specificity was 0.412. The results of HIV infection risk assessment tool in Guizhou indicated that in MSM the higher the individual risk score, the higher the risk of HIV infection is. The tool can be used to evaluate the risk of HIV infection in MSM, but the specificity should be improved.
评估艾滋病病毒（HIV）感染风险评估工具的预测能力及其在贵州省男男性行为者（MSM）中的适用性。通过滚雪球抽样方法招募MSM。使用HIV感染风险评估工具对MSM进行问卷调查，并结合HIV血清学检测结果，评估HIV感染风险评估工具的风险预测能力。2018年1月至2019年12月期间，在贵州省共招募了3379名MSM。HIV感染率为3.3%（111/3379）。HIV阳性和HIV阴性MSM的平均风险得分分别为（12.15±3.08）和（12.07±3.07）。不同HIV状态的MSM之间风险得分差异有统计学意义（=8.69，<0.001）。根据决策树原则，将个体风险得分分为以下三类：≤11.96、11.97 - 14.80和>14.80，HIV感染率分别为0.8%﹑4.3%和8.6%，表明个体风险得分越高，HIV感染率越高（趋势=88.18，<0.001）。多因素logistic回归分析显示，个体风险得分越高，HIV感染风险越高。与总分≤11.96相比，总分在11.97 - 14.80和>14.80时的a值分别为6.34（95%：3.38 - 11.88）和14.07（95%：7.44 - 26.61）。苗族人群的HIV感染风险高于汉族人群（a = 1.83，95% 1.04 - 3.21），小学及以下文化程度者的HIV感染风险高于本科及大专以上文化程度者（a = 2.50，95% 1.06 - 5.88），有双性行为者的HIV感染风险高于有同性性行为者（a = 1.95，95% 1.19 - 3.19）。从未接受过HIV检测者的HIV感染风险更高（a = 1.53，95% 1.01 - 2.33）。HIV感染预测的受试者工作特征（ROC）曲线下面积和ROC曲线下面积（AUC）为0.751（95%：0.710 - 0.792，<0.001）。最大约登指数对应的个体风险得分为12.56，风险评估工具的灵敏度为0.838，特异度为0.412。贵州省HIV感染风险评估工具的结果表明，在MSM中个体风险得分越高，HIV感染风险越高。该工具可用于评估MSM的HIV感染风险，但特异度有待提高。
