Trends in Serosorting and the Association With HIV/STI Risk Over Time Among Men Who Have Sex With Men.
Trends in Serosorting and the Association With HIV/STI Risk Over Time Among Men Who Have Sex With Men.
复制标题
DOI：
10.1097/qai.0000000000000947
复制
发表时间：
2016-06-01
期刊：
影响因子：
--
通讯作者：
Golden MR
中科院分区：
文献类型：
--
作者：
Khosropour CM;Dombrowski JC;Swanson F;Kerani RP;Katz DA;Barbee LA;Hughes JP;Manhart LE;Golden MR
文本中提供了补充数字内容。男男性行为者 (MSM) 中的血清分选很常见，但最近描述血清分选趋势的数据有限。血清分选如何影响人群中艾滋病毒和其他性传播感染 (STI) 风险的趋势目前尚不清楚。作为常规护理的一部分，我们收集了参加华盛顿州西雅图性传播疾病诊所（2002-2013 年）和社区艾滋病毒/性传播疾病检测中心（2004-2013 年）的 MSM 的数据。 MSM 被问及过去 12 个月内与 HIV 阳性、HIV 阴性和身份不明的伴侣使用安全套的情况。我们将行为分为 4 个相互排斥的类别：禁止肛交（AI）；始终使用安全套（AI 时始终使用安全套）；血清分类[仅与艾滋病病毒一致的伴侣进行无安全套肛交（CAI）]；和不一致的 CAI（与 HIV 不一致/身份未知的伴侣的 CAI；NCCAI）。 49,912 次就诊的行为数据是完整的。在研究期间，艾滋病毒阳性和艾滋病毒阴性男性的血清分选显着增加。血清分选的增加与 HIV 阴性 MSM 中 NCCAI 的减少同时发生，但 HIV 阳性 MSM 中持续使用安全套的情况有所减少。调整自上次 HIV 阴性检测以来的时间，在研究期间报告 NCCAI（7.1%–2.8%；P=0.02）、血清分选（2.4%–1.3%；P=0.17）和无 CAI（1.5%–0.7%；P=0.01）的 MSM 中 HIV 检测呈阳性的风险降低。与 NCCAI 相比，血清分选可将 HIV 检测呈阳性的风险降低 47%（调整后患病率 = 0.53；95% 置信区间：0.45 至 0.62）。 2002 年至 2013 年间，西雅图 MSM 中的血清分类有所增加，而 NCCAI 有所减少。这些变化与 MSM 中 HIV 检测阳性率的下降同时发生。
Supplemental Digital Content is Available in the Text. Serosorting among men who have sex with men (MSM) is common, but recent data to describe trends in serosorting are limited. How serosorting affects population-level trends in HIV and other sexually transmitted infection (STI) risk is largely unknown. We collected data as part of routine care from MSM attending a sexually transmitted disease clinic (2002–2013) and a community-based HIV/sexually transmitted disease testing center (2004–2013) in Seattle, WA. MSM were asked about condom use with HIV-positive, HIV-negative, and unknown-status partners in the prior 12 months. We classified behaviors into 4 mutually exclusive categories: no anal intercourse (AI); consistent condom use (always used condoms for AI); serosorting [condom-less anal intercourse (CAI) only with HIV-concordant partners]; and nonconcordant CAI (CAI with HIV-discordant/unknown-status partners; NCCAI). Behavioral data were complete for 49,912 clinic visits. Serosorting increased significantly among both HIV-positive and HIV-negative men over the study period. This increase in serosorting was concurrent with a decrease in NCCAI among HIV-negative MSM, but a decrease in consistent condom use among HIV-positive MSM. Adjusting for time since last negative HIV test, the risk of testing HIV positive during the study period decreased among MSM who reported NCCAI (7.1%–2.8%; P= 0.02), serosorting (2.4%–1.3%; P = 0.17), and no CAI (1.5%–0.7%; P = 0.01). Serosorting was associated with a 47% lower risk of testing HIV positive compared with NCCAI (adjusted prevalence ratio = 0.53; 95% confidence interval: 0.45 to 0.62). Between 2002 and 2013, serosorting increased and NCCAI decreased among Seattle MSM. These changes paralleled a decline in HIV test positivity among MSM.