Early Linkage to HIV Care and Antiretroviral Treatment among Men Who Have Sex with Men--20 Cities, United States, 2008 and 2011.
Early Linkage to HIV Care and Antiretroviral Treatment among Men Who Have Sex with Men--20 Cities, United States, 2008 and 2011.
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DOI：
10.1371/journal.pone.0132962
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
NHBS Study Group
中科院分区：
文献类型：
--
作者：
Hoots BE;Finlayson TJ;Wejnert C;Paz-Bailey G;NHBS Study Group
早期与护理和抗逆转录病毒治疗挂钩与减少艾滋病毒传播有关。男性对男性的性接触是美国最大的艾滋病毒传播类别;男男性行为者（MSM）是护理和治疗工作的重要重点。随着《国家艾滋病毒/艾滋病战略》的发布和艾滋病毒治疗准则的扩大，预计与护理和抗逆转录病毒药物治疗的早期联系将会增加。我们研究了2008年至2011年期间艾滋病毒阳性男男性行为者早期与护理和抗逆转录病毒治疗联系的流行率差异。数据来自国家艾滋病毒行为监测系统，该系统监测美国20个艾滋病负担高的城市中艾滋病毒感染高危人群的行为。MSM通过基于场所的时空抽样方法招募。使用线性混合模型估计了2011年至2008年的流行率。早期关联被定义为在诊断后3个月内到艾滋病毒诊所就诊。抗逆转录病毒治疗定义为在访谈时使用。2008年，早期与护理联系的患病率为79%（187/236），2011年为83%（241/291）。在多变量分析中，总体而言，早期连锁的患病率在不同年份之间没有显著差异（P = 0.44）。2008年抗逆转录病毒治疗的普及率为69%（790/1 142），2001年为79%（1 049/1 336）。在多变量分析中，抗逆转录病毒治疗总体（P = 0.0003）和大多数亚组增加。黑人男男性接触者比白色男男性接触者较少报告抗逆转录病毒治疗（P = 0.01）。虽然2008年至2011年期间早期与护理的联系没有显著增加，但大多数亚组的抗逆转录病毒治疗增加了。在让男男性行为者接受艾滋病毒治疗方面正在取得进展，但还需要作出更多努力，以缩小抗逆转录病毒药物覆盖率的差距。
Early linkage to care and antiretroviral (ARV) treatment are associated with reduced HIV transmission. Male-to-male sexual contact represents the largest HIV transmission category in the United States; men who have sex with men (MSM) are an important focus of care and treatment efforts. With the release of the National HIV/AIDS Strategy and expanded HIV treatment guidelines, increases in early linkage to care and ARV treatment are expected. We examined differences in prevalence of early linkage to care and ARV treatment among HIV-positive MSM between 2008 and 2011. Data are from the National HIV Behavioral Surveillance System, which monitors behaviors among populations at high risk of HIV infection in 20 U.S. cities with high AIDS burden. MSM were recruited through venue-based, time-space sampling. Prevalence ratios comparing 2011 to 2008 were estimated using linear mixed models. Early linkage was defined as an HIV clinic visit within 3 months of diagnosis. ARV treatment was defined as use at interview. Prevalence of early linkage to care was 79% (187/236) in 2008 and 83% (241/291) in 2011. In multivariable analysis, prevalence of early linkage did not differ significantly between years overall (P = 0.44). Prevalence of ARV treatment was 69% (790/1,142) in 2008 and 79% (1,049/1,336) in 2001. In multivariable analysis, ARV treatment increased overall (P = 0.0003) and among most sub-groups. Black MSM were less likely than white MSM to report ARV treatment (P = 0.01). While early linkage to care did not increase significantly between 2008 and 2011, ARV treatment increased among most sub-groups. Progress is being made in getting MSM on HIV treatment, but more efforts are needed to decrease disparities in ARV coverage.