Changing trend of HIV, Syphilis and Hepatitis C among Men Who Have Sex with Men in China.
Changing trend of HIV, Syphilis and Hepatitis C among Men Who Have Sex with Men in China.
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DOI：
10.1038/srep31081
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发表时间：
2016-08-18
影响因子：
4.6
通讯作者：
Sun J
中科院分区：
文献类型：
--
作者：
Qin Q;Tang W;Ge L;Li D;Mahapatra T;Wang L;Guo W;Cui Y;Sun J
在全国范围内未充分研究的高风险中国男男性行为者（MSM）样本中，缺乏关于艾滋病毒、梅毒和丙型肝炎（HCV）趋势和相关性的信息，需要进行全面的系列横断面研究。采用多阶段混合方法策略，对中国大陆30个省107个市/县的171311名男男性行为者进行了访谈和测试。采用SAS 9.2进行描述性、双变量、多变量和Cochran-Armitage趋势分析。2009- 2013年期间，近期（71.5%至78.6%,p < 0.001）和一贯（40.4%至48.8%,p < 0.001）避孕套的使用以及商业肛交期间避孕套的使用（46.5%至55.0%,p < 0.001）都在增加。相比之下，男性商业性肛交（11.9% ~ 7.1%,p < 0.001）和吸毒（1.9% ~ 0.8%,p < 0.001）随时间减少。随着时间的推移，HIV患病率逐渐上升（5.5% ~ 7.3%,p < 0.001），而梅毒患病率（9.0% ~ 6.3%,p < 0.001）和HCV患病率（1.5% ~ 0.7%,p < 0.001）逐渐下降。HIV与梅毒患病率呈正相关（r = 0.38）。艾滋病毒感染与艾滋病毒相关知识、服务和注射吸毒有关。2009 - 2013年，中国男男性行为者艾滋病病毒感染率呈上升趋势。虽然危险行为的逐渐减少以及梅毒和丙型肝炎病毒的流行有助于扩大检测和预防服务，但日益增加的艾滋病毒负担要求进行更深入的专题调查。
Dearth of information regarding the trend and correlates of HIV, syphilis and Hepatitis C (HCV) in a country-wide sample of understudied though high-risk Chinese men who have sex with men (MSM) called for a comprehensive serial cross-sectional study. Using a multistage mixed-method strategy, 171,311 MSM from 107 selected cities/counties in 30 provinces of mainland China, were interviewed and tested. Descriptive, bivariate, multivariate and Cochran-Armitage trend analyses were conducted using SAS 9.2. During 2009-13, recent (71.5% to 78.6%, p < 0.001) and consistent (40.4% to 48.8%, p < 0.001) condom use as well as condom use during commercial anal sex (46.5% to 55.0%, p < 0.001) were increasing. In contrast, commercial anal sex with male (11.9% to 7.1%, p < 0.001) and drug use (1.9% to 0.8%, p < 0.001) were decreasing over time. HIV prevalence increased gradually (5.5% to 7.3%, p < 0.001), while syphilis (9.0% to 6.3%, p < 0.001) and HCV prevalence (1.5% to 0.7%, p < 0.001) decreased over time. A positive correlation was observed between HIV and syphilis prevalence (r = 0.38). HIV infection was associated with HIV-related knowledge, services and injecting drug use. An increasing trend of HIV prevalence was observed during 2009–13 among MSM in China. While gradual reduction of risk behaviors along with syphilis and HCV prevalence supported expansion of testing and prevention services, increasing HIV burden called for deeper thematic investigations.