2019 - 2022年澳大利亚男同性恋和双性恋HIV感染者的出生国家、移民身份与HIV护理参与情况之间的关联
Associations between country of birth, migration status and engagement in HIV care among gay and bisexual men living with HIV in Australia, 2019-2022.
作者信息
Yu Simin, MacGibbon James, Bavinton Benjamin, Smith Anthony K J, Rule John, Mao Limin, Broady Timothy R, Holt Martin
机构信息
Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
出版信息
HIV Med. 2025 May;26(5):688-700. doi: 10.1111/hiv.13769. Epub 2025 Feb 19.
BACKGROUND
In the last decade, while HIV diagnoses have declined among Australian-born gay and bisexual men (GBM), they have declined much less among migrant GBM, with recently arrived GBM facing particular challenges, such as access to HIV treatment. This study assessed HIV care cascade (treatment) outcomes among GBM living with HIV in Australia by migration status.
METHODS
Data were collected in national cross-sectional behavioural surveillance surveys during 2019-2022. HIV cascade outcomes were stratified by country of birth and length of residency in Australia, examining HIV clinical appointments in the previous year, being on antiretroviral treatment (ART) and achieving an undetectable viral load. Percentages were calculated with the previous cascade step as the corresponding denominator.
RESULTS
Between 2019 and 2022, 32 236 GBM completed surveys, including 2533 (7.9%) people living with HIV (PLWH). Among 2188 PLWH reporting migration/residency status, 72.2% were Australian-born, 13.3% were from high-income English-speaking countries, 13.0% were non-recently arrived migrant GBM from other countries and 1.5% were recently arrived in Australia (<2 years). Median ages for the four groups were 50, 51, 41 and 34 years, respectively. Recently arrived PLWH were the most likely to be recently diagnosed (<2 years, 15.2% vs. <5% in the other groups). The HIV cascade of care, treatment, and viral suppression differed by migration status (p < 0.001): Australian-born, 92.5%, 96.9% and 94.6%, respectively; born in high-income-English-speaking countries, 91.8%, 97.4%,9 8.9%; non-recently arrived, 93.7%, 95.1%, 96.8%; and recently-arrived, 90.9%, 90.0%, 100%. Recently-arrived PLWH were less likely to be on treatment, but all those on treatment achieved viral suppression.
CONCLUSIONS
Engaging and supporting recently arrived PLWH in Australia to access ART and relinking PLWH disengaged from care remains crucial.
背景
在过去十年中，澳大利亚出生的男同性恋者和双性恋者（GBM）中的艾滋病毒诊断率有所下降，但移民GBM中的下降幅度要小得多，最近抵达的GBM面临着特殊挑战，例如获得艾滋病毒治疗。本研究按移民身份评估了澳大利亚感染艾滋病毒的GBM的艾滋病毒治疗级联（治疗）结果。
方法
在2019年至2022年期间的全国横断面行为监测调查中收集数据。艾滋病毒治疗级联结果按出生国家和在澳大利亚的居住时间分层，检查上一年的艾滋病毒临床预约情况、接受抗逆转录病毒治疗（ART）情况以及实现病毒载量不可检测的情况。百分比以前一级联步骤作为相应分母进行计算。
结果
2019年至2022年期间，32236名GBM完成了调查，其中包括2533名（7.9%）艾滋病毒感染者（PLWH）。在报告移民/居住身份的2188名PLWH中，72.2%为澳大利亚出生，13.3%来自高收入英语国家，13.0%为非近期抵达的来自其他国家的移民GBM，1.5%为最近抵达澳大利亚（<2年）的人。这四组人的年龄中位数分别为50岁、51岁、41岁和34岁。最近抵达的PLWH最有可能是最近被诊断出感染艾滋病毒的（<2年，15.2%，而其他组<5%）。艾滋病毒治疗级联的护理、治疗和病毒抑制情况因移民身份而异（p<0.001）：澳大利亚出生的分别为92.5%、96.9%和94.6%；出生于高收入英语国家的为91.8%、97.4%、98.9%；非近期抵达的为93.7%、95.1%、96.8%；最近抵达的为90.9%、90.0%、100%。最近抵达的PLWH接受治疗的可能性较小，但所有接受治疗的人都实现了病毒抑制。
结论
促使并支持澳大利亚最近抵达的PLWH获得抗逆转录病毒治疗，并使脱离护理的PLWH重新接受护理仍然至关重要。
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