HIV and Syphilis Prevalence Among Men Who Have Sex With Men: A Cross-Sectional Survey of 61 Cities in China
HIV and Syphilis Prevalence Among Men Who Have Sex With Men: A Cross-Sectional Survey of 61 Cities in China
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DOI：
10.1093/cid/cit210
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发表时间：
2013-07-15
影响因子：
11.8
通讯作者：
Wang, Yu
中科院分区：
文献类型：
--
作者：
Wu, Zunyou;Xu, Jie;Wang, Yu
背景。近年来，人类免疫缺陷病毒（HIV）在中国男男性行为者（MSM）中迅速传播；疫情的严重程度尚不清楚。我们试图检验 3 个假设：(1) 中国 MSM 人群中 HIV 和梅毒的患病率较高，(2) 这两种流行病各自具有独特的地理分布，(3) 中国 MSM 人群的人口和性行为特征不同。方法。 2008年2月至2009年9月，来自中国61个城市的47231名男男性行为者参与了一项横断面调查。收集并分析了人口和行为数据，并对血液样本进行了艾滋病毒和梅毒检测。描述了更广泛的 MSM 样本中的三个亚组。主要结果指标是艾滋病毒和梅毒患病率。结果。 HIV 的总体患病率为 4.9%（2314/47 231；95% 置信区间 [CI]，4.7%-5.1%），梅毒的总体患病率为 11.8%（5552/47 231；95% CI，11.5%-12.0%）。梅毒阳性 MSM 的 HIV 患病率最高，为 12.5%（693/5552；95% CI，11.6%-13.4%）。然而，仅在 6 个地理区域中的 3 个发现了 HIV 和梅毒患病率之间的相关性（西北：r = 0.82，P = .0253；东部：r = 0.78，P = .0004；中南部：r = 0.63，P = .0276）。三个亚群——非本地 MSM、使用互联网的 MSM 和女性伴侣 MSM——被发现具有不同的特征和行为。结论。中国男男性行为者中艾滋病毒和梅毒的患病率很高，而且这两种流行病在地理上基本上是分开的。中国 MSM 人群的三个部分各自具有不同的人口和性风险“概况”，这表明跨地域、跨代和跨性别的桥接感染的可能性很大。
Background. Human immunodeficiency virus (HIV) has rapidly spread among men who have sex with men (MSM) in China in recent years; the magnitude of the epidemic is unclear. We sought to test 3 hypotheses: (1) The prevalence of both HIV and syphilis among MSM in China is high, (2) the 2 epidemics each have unique geographical distributions, and (3) demographic and sexual behavior characteristics are different among segments of the MSM population in China.Methods. A total of 47 231 MSM from 61 cities in China participated in a cross-sectional survey conducted from February 2008 to September 2009. Demographic and behavioral data were collected and analyzed and blood samples tested for HIV and syphilis. Three subgroups among the broader MSM sample were described. Main outcome measures were HIV and syphilis prevalence.Results. An overall prevalence of 4.9% (2314/47 231; 95% confidence interval [CI], 4.7%-5.1%) for HIV and 11.8% (5552/47 231; 95% CI, 11.5%-12.0%) for syphilis was found. Syphilis-positive MSM had the highest HIV prevalence, 12.5% (693/5552; 95% CI, 11.6%-13.4%). However, correlations between HIV and syphilis prevalence were found in only 3 of 6 geographical regions (Northwest: r = 0.82, P = .0253; East: r = 0.78, P = .0004; and South-central: r = 0.63, P = .0276). Three subgroups-nonlocal MSM, Internet-using MSM, and female-partnering MSM-were found to have different profiles of characteristics and behaviors.Conclusions. HIV and syphilis prevalences among MSM in China are high and the 2 epidemics are largely separate geographically. Three segments of the Chinese MSM population each have different demographic and sexual risk "profiles" that suggest high potential for bridging infection across geographies, generations, and sexes.