HIV incidence among street youth in Montreal, Canada
HIV incidence among street youth in Montreal, Canada
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DOI：
10.1097/00002030-200305020-00017
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发表时间：
2003-05-02
期刊：
影响因子：
3.8
通讯作者：
Boivin, JF
中科院分区：
文献类型：
--
作者：
Roy, E;Haley, N;Boivin, JF
目的：估计蒙特利尔街头青年的HIV发病率并确定血清转化的预测因素。方法：对1995 ~ 2000年14 ~ 25岁的街头青年进行前瞻性队列研究。每半年进行一次访谈，包括抗艾滋病毒抗体检测。在研究开始时HIV检测为阴性且至少接受两次访谈的受试者中，使用Cox回归确定HIV血清转化的预测因子。被认为是潜在预测因素的变量包括年龄、性别、注射毒品使用情况、是否报告有男性性伴侣以及生存性别。结果：研究共招募了1013名青少年。研究开始时艾滋病毒感染率为1.4%[95%可信区间（CI） 0.8-2.4]，在6年的招募期间保持稳定。在863名受试者中，66.7%为男孩，47.2%在研究开始时曾注射过药物，25.7%曾进行过生存性行为。选定的参与者累积了2327人-年的随访，观察到16例HIV血清转化，发病率为0.69 / 100人-年（95% CI 0.39-1.11）。在单因素分析中，注射药物使用[危险比（HR）， 7.0]和参与生存性别（HR, 4.0）与HIV发病率相关。在多变量分析中，仅保留注射用药。结论：在蒙特利尔街头青年中，注射吸毒是HIV血清转化的最强预测因子。预防开始注射吸毒必须成为公共卫生的优先事项。(C) 2003利平科特·威廉姆斯·威尔金斯。
Objectives: To estimate HIV incidence and identify predictors of seroconversion among Montreal street youth.Methods: From 1995 to 2000, street youth aged 14-25 years were recruited in a prospective cohort study. Interviews were conducted semiannually and included anti-HIV antibody testing. Among subjects who tested HIV negative at study entry and were interviewed at least twice, predictors of HIV seroconversion were identified using Cox regression. Variables considered as potential predictors were age, sex, injection drug use, being a male reporting male sexual partners, and survival sex.Results: Overall, 1013 youth were recruited in the study. HIV prevalence at study entry was 1.4% [95% confidence interval (CI) 0.8-2.4] and was stable over the 6 recruitment years. Among the 863 subjects selected for the incidence analysis, 66.7% were boys, 47.2% had ever injected drugs at study entry, and 25.7% had ever engaged in survival sex. The selected participants cumulated 2327 person-years of follow-up and 16 HIV seroconversions were observed, for an incidence rate of 0.69 per 100 person-years (95% CI 0.39-1.11). In univariate analysis, injection drug use [hazard ratio (HR), 7.0] and involvement in survival sex (HR, 4.0) were associated with HIV incidence. In the multivariate analysis, only injection drug use was retained.Conclusions: Among Montreal street youth, injection drug use was the strongest predictor of HIV seroconversion. Prevention of initiation into injection drug use must become a public health priority. (C) 2003 Lippincott Williams Wilkins.