Yang Hong, Chen Maogang, Hu Ying, Xu Mengjiao, Li Yiping, Liu Lunhao, Yuan Dan, Yuan Fengshun, Li Ling, Ye Li, Zhou Chang, Zhang Yan, Liang Shu, Su Ling
Department of AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People's Republic of China.
Department of Microbiology, Liangshan Yi Autonomous Prefecture Center for Disease Control and Prevention, Xichang, People's Republic of China.
HIV AIDS (Auckl). 2024 Mar 6;16:83-93. doi: 10.2147/HIV.S448096. eCollection 2024.
Men who have sex with men (MSM) is one main type of high-risk activities facilitating HIV-1 transmission in Sichuan province. Previous works on HIV-1 incidence and prevalence among MSM only concentrated before 2018, the situation after that is unknown. In addition, the distribution of hot-spots related to current HIV-1 epidemic is also rarely known among MSM in Sichuan.
To update trends of HIV-1 prevalence and incidence and to visualize hot-spots of ongoing transmission in Sichuan province during surveillance period among MSM between 2018 and 2022.
Limiting Antigen Avidity assay was performed to detect recent infection within new HIV-1 diagnoses founded during surveillance period among MSM. The HIV-1 prevalence and incidence were calculated according to an extrapolation method proposed by publications and guidelines. Trend tests were performed using χ tests with linear-by-linear association. The spatial analysis was conducted with ArcGIS 10.7 to figure hot-spots of HIV-1 recent infections among MSM.
Between 2018 and 2022, 16,697 individuals participated in HIV-1 MSM sentinel surveillance program, of which 449 samples (98.25%) were tested with LAg-Avidity EIA, and 230 samples were classified as recent infection. Respectively, the overall prevalence and incidence were 2.74% and 3.69% (95% CI: 3.21, 4.16) and both had significant declining trends (p < 0.001). Luzhou city had a highest HIV-1 incidence (10.74%, 95% CI: 8.39, 13.10) over the study period and was recognized as a hot-spot for recent HIV-1 infection among MSM.
During the surveillance period, both HIV-1 prevalence and incidence were declining. However, Luzhou city had an unusually high HIV-1 incidence and became an emerging hot-spot of recent HIV-1 infection among MSM. This finding suggested focused attention, cross-regional intervention strategies, and prevention programs are urgently required to curb the spread of ongoing transmission.
男男性行为者（MSM）是四川省促进HIV-1传播的主要高危行为类型之一。以往关于MSM中HIV-1发病率和流行率的研究仅集中在2018年之前，之后的情况尚不清楚。此外，四川省MSM中与当前HIV-1流行相关的热点分布也鲜为人知。
更新2018年至2022年监测期间四川省MSM中HIV-1流行率和发病率的趋势，并直观呈现正在传播的热点地区。
采用限量抗原亲和力检测法检测监测期间新诊断的HIV-1病例中的近期感染情况。根据出版物和指南提出的外推法计算HIV-1流行率和发病率。使用具有线性-线性关联的χ检验进行趋势检验。利用ArcGIS 10.7进行空间分析，以确定MSM中HIV-1近期感染的热点地区。
2018年至2022年期间，16697人参与了HIV-1 MSM哨点监测项目，其中449份样本（98.25%）进行了LAg-Avidity EIA检测，230份样本被归类为近期感染。总体流行率和发病率分别为2.74%和3.69%（95%CI：3.21，4.16），且均呈显著下降趋势（p<0.001）。在研究期间，泸州市的HIV-1发病率最高（10.74%，95%CI：8.39，13.10），被认定为MSM中近期HIV-1感染的热点地区。
在监测期间，HIV-1流行率和发病率均呈下降趋势。然而，泸州市的HIV-1发病率异常高，成为MSM中近期HIV-1感染的一个新兴热点地区。这一发现表明，迫切需要集中关注、跨区域干预策略和预防项目来遏制正在传播的疫情。
