Yang Hong, Li Yiping, Xu Mengjiao, Hu Ying, Yuan Fengshun, Liu Lunhao, Li Ling, Yuan Dan, Ye Li, Zhou Chang, Zhang Yan, Su Ling, Liang Shu
Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People's Republic of China.
Infect Drug Resist. 2023 Oct 4;16:6535-6548. doi: 10.2147/IDR.S428744. eCollection 2023.
Sichuan Province has gradually become a hot-spot for HIV/AIDS. Little is known about the HIV-1 incidence and prevalence among four sub-groups since 2015. Meanwhile, the distributions of hot-spot areas related to recent infection cases that indicate current transmission among the four subgroups are also rare.
The main purpose of this study was to assess the HIV-1 prevalence and incidence and to visualize the distributions of hot-spot areas of current transmission among four subgroups (people who inject drugs, male STD clinic attendees, female sex workers and men who had sex with men) during the surveillance period in Sichuan province between 2016 and 2022.
Of the 267,617 individuals, 2158 HIV-positive samples were tested with Lag-Avidity EIA, among which 493 samples were identified as recent infections. Among people who inject drugs (PWID), both HIV-1 prevalence (from 1.41% to 0.34%) and incidence (from 0.03% to 0.140%) showed a significant decreasing trend. Among men who had sex with men (MSM), female sex workers (FSWs), and male STD clinic attendees, HIV-1 prevalence indicated significant decreasing trends, whereas HIV-1 incidence showed no significant changes. Spatial analysis demonstrated the formation of hot-spots and clusters of current transmissions sharing regional differences, mainly concentrated in the southeast, and most of these were consecutive hot-spots.
The prevention and control were efficacious and persistent. However, among the other three subgroups, there is a need for a regional cooperative in prevention and control approaches and collaborative research in many aspects.
四川省已逐渐成为艾滋病热点地区。自2015年以来,关于四个亚组人群中HIV-1的发病率和流行率的情况鲜为人知。同时,与近期感染病例相关的热点地区分布情况也很少见,而这些热点地区能表明四个亚组人群当前的传播情况。
本研究的主要目的是评估2016年至2022年四川省监测期间四个亚组人群(注射吸毒者、男性性病门诊就诊者、女性性工作者和男男性行为者)中HIV-1的流行率和发病率,并直观呈现当前传播热点地区的分布情况。
在267,617名个体中,2158份HIV阳性样本采用滞后亲和力酶免疫测定法进行检测,其中493份样本被确定为近期感染。在注射吸毒者中,HIV-1流行率(从1.41%降至0.34%)和发病率(从0.03%升至0.140%)均呈显著下降趋势。在男男性行为者、女性性工作者和男性性病门诊就诊者中,HIV-1流行率呈显著下降趋势,而HIV-1发病率无显著变化。空间分析表明,当前传播的热点地区和聚集区形成存在区域差异,主要集中在东南部,且大多数为连续热点地区。
预防和控制措施有效且持续。然而,在其他三个亚组人群中,需要在预防和控制方法上开展区域合作,并在多个方面进行合作研究。