文章摘要
单多,宁镇,郑煌,黄大勇,于茂河,杨杰,刘惠,张大鹏.上海市和天津市男男性行为人群药物滥用者HIV新发感染队列研究[J].中华流行病学杂志,2021,42(12):2149-2155
上海市和天津市男男性行为人群药物滥用者HIV新发感染队列研究
A cohort study on the incidence of HIV infection in drug abusers among men who have sex with men in Shanghai and Tianjin
收稿日期:2021-07-15  出版日期:2021-12-16
DOI:10.3760/cma.j.cn112338-20210715-00551
中文关键词: 男男性行为人群;药物滥用;艾滋病病毒感染;队列
英文关键词: Men who have sex with men;Drug abuser;HIV infection;Cohort
基金项目:M.A.C.艾滋病基金(A-P-15-20660)
作者单位E-mail
单多 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
宁镇 上海市疾病预防控制中心 200336  
郑煌 上海心生 200023  
黄大勇 上海心生 200023  
于茂河 天津市疾病预防控制中心 300011  
杨杰 天津深蓝公共卫生咨询服务中心 300121  
刘惠 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
张大鹏 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206 zhangdapeng@chinaaids.cn 
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中文摘要:
      目的 通过队列研究分析上海市和天津市MSM药物滥用者HIV新发感染状况及影响因素,为在该人群中开展艾滋病预防干预提供基础。方法 采用队列研究设计,2016年6月至2018年6月采用滚雪球抽样方法招募最近6个月内有药物滥用史的MSM为研究对象,并建立MSM开放性队列,在完成基线调查和HIV检测的基础上开展随访调查和检测。调查内容包括人口学特征、艾滋病相关性行为和药物滥用行为情况等信息。以随访过程中"HIV阳转"为结局因变量,同时,将从研究对象进入队列到出现HIV阳转的时间作为时间因变量,应用Cox比例风险回归模型分析HIV新发感染的影响因素。结果 研究对象共455人,HIV新发感染16例,队列随访累积观察时间为586.08人年,HIV新发感染率为2.73/100人年。多因素Cox回归分析结果显示,相比于≥ 30岁年龄组、最近6个月与男性肛交时坚持使用安全套、无药物混合滥用情况,<25岁年龄组(HR=5.01,95%CI:1.09~23.11)、最近6个月与男性肛交时未坚持使用安全套(HR=1.58,95%CI:1.04~2.41)和药物混合滥用者(HR=1.92,95%CI:1.08~3.40)发生HIV感染风险较高。结论 MSM药物滥用者中,HIV新发感染的危险因素包括年龄<25岁、与男性肛交时未坚持使用安全套和药物混合滥用,应持续加强MSM药物滥用者的HIV预防和干预。
英文摘要:
      Objective To analyze the incidence of HIV infection and identify associated risk factors in drug abusers among men who have sex with men (MSM) in Tianjin and Shanghai through a cohort study and provide a basis for HIV prevention in this population. Methods A prospective cohort study was conducted among MSM who had a history of drug abuse in the past six months from June 2016 to June 2018 in the two cities. MSM were investigated to obtain information on sociodemographic characteristics, HIV-related sexual behaviors, and drug abuse. Follow-up investigation and HIV testing were carried out based on the baseline survey and testing. Cox regression analysis was conducted to identify the risk factors for HIV infection. Results There were 455 eligible subjects, and 16 new HIV infection cases were identified in the 2-year follow-up survey. The cumulative follow-up time was 586.08 person-years, and the incidence of HIV infection was 2.73/100 person-years. The multivariate Cox regression analysis results showed that compared with those aged ≥ 25 years, consistent condom use during anal sex with men in the past six months, without mixed-use of drugs, these aged <25 years (HR=5.01, 95%CI:1.09-23.11), inconsistent condom use during anal sex with men in the past six months (HR=1.58, 95%CI:1.04-2.41) and mixed-use of drugs (HR=1.92, 95%CI:1.08-3.40) were significantly associated with HIV infection in this cohort. Conclusions The younger age, inconsistent condom use during anal sex with men, and mixed drug use appeared as risk factors of new HIV infection in drug abusers among MSM. HIV prevention and intervention in this population should be further strengthened.
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