High HIV prevalence and incidence among MSM across 12 cities in India.
High HIV prevalence and incidence among MSM across 12 cities in India.
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DOI：
10.1097/qad.0000000000000602
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发表时间：
2015-03-27
期刊：
影响因子：
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通讯作者：
Celentano DD
中科院分区：
文献类型：
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作者：
Solomon SS;Mehta SH;Srikrishnan AK;Vasudevan CK;Mcfall AM;Balakrishnan P;Anand S;Nandagopal P;Ogburn EL;Laeyendecker O;Lucas GM;Solomon S;Celentano DD
描述印度12个城市男男性行为者中艾滋病毒感染的流行率、发病率和相关因素。2012年9月至2013年6月，采用响应者驱动抽样（RDS）的横断面样本，共招募了12，022名MSM（每个城市1000人）。受试者必须≥18岁，自认为是男性，并报告在前一年与男性发生过口交/肛交。艾滋病毒感染诊断使用3个快速测试。使用多检测算法估计横断面HIV发病率。所有估计数都包含RDS-II加权数。中位年龄为25岁，45.0%的人自称为“panthi”（主要是插入式肛交），30.6%的人报告与女性结婚。加权艾滋病毒流行率为7.0%（范围：1.7%至13.1%）。在多变量分析中，年龄较大、教育程度较低、单纯接受肛交或接受和插入性行为以及HSV-2阳性者的HIV感染几率显著较高。在1 147名艾滋病毒检测呈阳性的男男性行为者中，有53人被确定为最近感染艾滋病毒（年发病率= 0.87%;范围= 0至2.2%）。在多变量分析中，过去6个月内注射毒品、梅毒、男性伴侣数量较多和女性伴侣数量较少与最近感染艾滋病毒显着相关。我们观察到印度男男性行为者的艾滋病负担很高，在流行率、发病率和危险行为方面存在巨大的差异。特别是，我们观察到在流行率相对较低的地区发病率较高，这表明在以前未被认为艾滋病毒负担高的地区正在出现流行病。
To characterize prevalence, incidence and associated correlates of HIV infection among MSM in 12 cities across India. Cross-sectional sample using respondent-driven sampling (RDS) from September 2012-June 2013 A total 12,022 MSM (∼1000 per city) were recruited. Participants had to be ≥18 years, self-identify as male and report oral/anal intercourse with a man in the prior year. HIV infection was diagnosed using 3 rapid tests. Cross-sectional HIV incidence was estimated using a multi-assay algorithm. All estimates incorporate RDS-II weights. Median age was 25 years, 45.0% self-identified as “panthi” (predominantly penetrative anal intercourse) and 30.6% reported being married to a woman. Weighted HIV prevalence was 7.0% (range: 1.7% to 13.1%). In multivariate analysis, significantly higher odds of HIV infection was observed among those who were older, had lower educational attainment, were practicing purely receptive anal sex or both receptive and penetrative sex and those who were HSV-2 positive. Of 1,147 MSM who tested HIV positive, 53 were identified as recent HIV infections (annualized incidence = 0.87%; range = 0 to 2.2%). In multivariate analysis, injecting drugs in the prior 6 months, syphilis, higher number of male partners and fewer female partners were significantly associated with recent HIV infection. We observed a high burden of HIV among MSM in India with tremendous diversity in prevalence, incidence and risk behaviors. In particular, we observed high incidence in areas with relatively low prevalence suggesting emerging epidemics in areas not previously recognized to have high HIV burden.