| 陈潇潇,李玲玲,汪剡灵,许圆圆,李艳,陈君,何纳,林海江.男男性行为者个体HIV感染风险评估工具预测能力分析[J].中华流行病学杂志,2020,41(8):1324-1327 |
| 男男性行为者个体HIV感染风险评估工具预测能力分析 |
| Predictive ability of risk assessment tool regarding HIV infection for men who have sex with men |
| 收稿日期:2019-10-11 出版日期:2020-08-25 |
| DOI：10.3760/cma.j.cn112338-20191011-00728 |
| 中文关键词: 男男性行为者 HIV 风险评估 预测能力 |
| 英文关键词: Men who have sex with men HIV Risk assessment Predictive ability |
| 基金项目:浙江省自然科学基金（Y19H260001）；国家卫生健康委疾病预防控制局项目 |
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| 中文摘要: |
| 目的 通过浙江省台州市MSM哨点监测数据，评估MSM个体HIV感染风险评估工具的预测能力。方法 根据MSM个体HIV感染风险评估工具条目，对2013-2017年台州市MSM哨点监测数据中的相关问题与选项进行重新修订，计算个体风险得分，结合个体HIV感染情况，分析该工具的预测能力。结果 MSM研究对象1 944人，年龄（35.04±13.28）岁，未婚者占48.2%，多为场所招募（55.7%）。HIV阳性率为12.6%（245/1 944），HIV阳性者风险得分的中位数为23.99；HIV阴性者风险得分的中位数为20.36，不同HIV感染状态的研究对象风险得分差异有统计学意义（Mann-Whitney检验，P=0.007），HIV阳性者风险得分显著高于HIV阴性者。依据决策树原理，将研究对象按风险得分分为2类：≤18.66、>18.66，风险得分越高，HIV感染率越高（ χ2=13.102，P<0.001）。多因素logistic回归分析显示，个体风险得分越高，感染HIV的风险也越高（>18.66分与≤18.66分相比：aOR=1.72，95% CI：1.27～2.32，P<0.001）。对HIV感染预测的ROC曲线下的面积为0.553（95% CI：0.516～0.590，P=0.007），约登指数最大的点是风险得分为19.01的点，此时风险评估工具的灵敏度为0.69，特异度为0.43。结论 基于德尔菲法建立的MSM个体HIV感染风险评估工具可以在一定程度上预测个体HIV感染风险，风险得分越高，感染HIV的实际风险也越高。但还需要设计更加科学严谨的队列研究进行验证和相应调整评估工具条目。 |
| 英文摘要: |
| Objective To analyze the predictive ability of HIV infection risk assessment tool for men who have sex with men (MSM). Sentinel surveillance data of MSM in Taizhou prefecture of Zhejiang province was used. Methods MSM involved in AIDS sentinel surveillance program in Taizhou from 2013 to 2017 were included in the study and items listed in the HIV infection risk assessment tool for MSM was revised. Related data on questions and options involved in sentinel surveillance was collected and individual risk scores were calculated. We determined the predictive ability of this tool by comprehensive analyzing the HIV infection status and individual risk scores. Results A total of 1 944 MSM were included in the study, with an average age of (35.04±13.28)years old. Most of them were recruited from the venues (55.7%) and 48.2% were never married. Among these MSM, HIV infection rate was 12.6%(245/1 944) with the median of risk score as 23.99, versus 20.36 from the HIV negative ones. Significant differences appeared on the risk scores between the target populations that with different HIV status (Mann-Whitney test, P=0.007). According to the principle of decision tree, MSM were divided into two groups according to risk scores: ≤ 18.66 and >18.66. It appeared that the risk scores were in parallel with the rates of HIV infection (χ2=13.102, P<0.001). Results from the multivariate analysis showed that MSM with higher risk score were more likely to be infected with HIV (>18.66 vs. ≤ 18.66:aOR=1.72, 95%CI:1.27-2.32, P<0.001). Area under the ROC curve (AUC) for HIV infection was 0.553 (95%CI:0.516-0.590, P=0.007). At the point of risk score 19.01, Youden's index appeared the maximum, with sensitivity as 0.69 and specificity as 0.43, of this tool. Conclusions The HIV infection risk assessment tool for MSM developed based on Delphi method can predict the risk of HIV infection in MSM to some extent. MSM with higher risk score seemed likely to be infected with HIV. Items of this tool need to be adjusted for the verification of the tool through cohort studies in the near future. |
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