Running Backwards: Consequences of Current HIV Incidence Rates for the Next Generation of Black MSM in the United States.
Running Backwards: Consequences of Current HIV Incidence Rates for the Next Generation of Black MSM in the United States.
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DOI：
10.1007/s10461-015-1158-z
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发表时间：
2016-01
影响因子：
4.4
通讯作者：
POWER Study Team
中科院分区：
文献类型：
--
作者：
Matthews DD;Herrick AL;Coulter RW;Friedman MR;Mills TC;Eaton LA;Wilson PA;Stall RD;POWER Study Team
在美国，与男性发生性关系的黑人男性（MSM）受到艾滋病毒的影响不成比例。为了更好地了解这一公共卫生问题，我们回顾了文献，以计算估计的艾滋病毒发病率在黑人男男性行为者。我们用这个比率来模拟一个模拟队列中随时间推移的艾滋病毒流行率，随后将其与基于社区的样本的流行率进行比较。我们检索了所有可通过PubMed访问的数据库，以及逆转录病毒和病毒感染会议摘要，以估计黑人MSM中的HIV发病率。使用随机效应模型计算HIV发病率和95%置信区间（CI）。使用平均发病率，我们模拟了18岁至40岁的黑人男男性行为者（一开始都是HIV阴性）的模拟队列中的HIV流行率。基于五种发病率共计2898名黑人MSM，加权平均发病率为每年4.16%（95%CI 2.76-5.56）。使用这一年发病率，我们的模型预测，在模拟队列中，39.94%的黑人男男性行为者在30岁时将是艾滋病毒阳性，40岁时将是60.73%。预测结果与在以社区为基础的黑人男男性行为者样本中发现的艾滋病毒流行率相似。艾滋病毒的高流行率将持续整个生命过程中的黑人男男性行为者，除非有效的预防和治疗工作增加，大大减少艾滋病毒的传播这一服务不足和边缘化的人口。
Black men who have sex with men (MSM) in the United States are disproportionately impacted by HIV. To better understand this public health problem, we reviewed the literature to calculate an estimate of HIV incidence among Black MSM. We used this rate to model HIV prevalence over time within a simulated cohort, which we subsequently compared to prevalence from community-based samples. We searched all databases accessible through PubMed, and Conference on Retroviruses and Opportunistic Infections abstracts for HIV incidence estimates among Black MSM. Summary HIV incidence rates and 95 % confidence intervals (CIs) were calculated using random effects models. Using the average incidence rate, we modeled HIV prevalence within a simulated cohort of Black MSM (who were all HIV-negative at the start) from ages 18 through 40. Based on five incidence rates totaling 2898 Black MSM, the weighted mean incidence was 4.16 % per year (95 % CI 2.76–5.56). Using this annual incidence rate, our model predicted that 39.94 % of Black MSM within the simulated cohort would be HIV-positive by age 30, and 60.73 % by 40. Projections were similar to HIV prevalence found in community-based samples of Black MSM. High HIV prevalence will persist across the life-course among Black MSM, unless effective prevention and treatment efforts are increased to substantially reduce HIV transmission among this underserved and marginalized population.