Incidence of HIV Infection and Sexually Transmitted Infections and Related Risk Factors Among Very Young Men Who Have Sex With Men.
Incidence of HIV Infection and Sexually Transmitted Infections and Related Risk Factors Among Very Young Men Who Have Sex With Men.
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DOI：
10.1097/qai.0000000000000933
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发表时间：
2016-05-01
期刊：
影响因子：
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通讯作者：
Mustanski B
中科院分区：
文献类型：
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作者：
Garofalo R;Hotton AL;Kuhns LM;Gratzer B;Mustanski B
在美国，艾滋病毒流行病继续不成比例地影响男男性行为者（MSM），超过三分之一的男男性行为者新感染病例发生在年轻男性中。很少有研究报告了年轻男男性行为者，特别是18岁以下未成年人的艾滋病毒和性传播感染发病率及相关风险。本文分析的数据来自芝加哥450名年龄在16-20岁的年轻男同性恋者的艾滋病风险纵向研究，通过受访者驱动的抽样招募，并随访两年，每年进行艾滋病和性传播感染检测。我们使用Kaplan-Meier方法报告了24个月随访期间HIV和STI的累计发病率，并使用Cox比例风险回归评估了与事件感染的关联。最终的分析样本主要是非怀特（83%）；中位年龄为19岁；25%的样本年龄在18岁以下。在632人-年的随访中发现了26例新的艾滋病毒感染。艾滋病发病率为4.11/100人年（95% CI= 2.80-6.04），性传播感染发病率为6.22/100人年（95% CI= 4.54-8.51）。24个月的累计HIV感染率为7.32% (95% CI= 5.05-10.57)，其中少数民族/种族的感染率更高。在多变量分析中，非白人种族和最近的性伴侣并发性与HIV和STI感染相关；艾滋病毒检测史和与艾滋病毒阳性伴侣的性行为与艾滋病毒感染风险增加有关。非常年轻的男男性行为者中艾滋病毒感染率和性传播感染发生率高，发病率与种族/民族、并发性行为和伴侣特征之间的关系表明未来干预的潜在重点，需要继续保持警惕。
The HIV epidemic continues to disproportionately affect men who have sex with men (MSM) in the US, with over a third of new infections in MSM occurring in younger men. Very few studies have reported on HIV and STI incidence and related risks among younger MSM, particularly among minors under 18 years of age. Data analyzed herein are from a longitudinal study of HIV-risk among 450 very young MSM in Chicago ages 16–20, recruited via respondent-driven sampling and followed for two years, with annual HIV and STI testing. We report estimated cumulative HIV and STI incidence over the 24-month follow-up using Kaplan-Meier methods and evaluated associations with incident infections using Cox Proportional Hazards regression. The final analytic sample was primarily non-White (83%); median age was 19; 25% of the sample was under age 18. 26 new HIV infections were detected over 632 person-years of follow-up. HIV incidence was 4.11/100 person years (95% CI=2.80–6.04) and STI incidence was 6.22/100 person-years (95% CI=4.54–8.51). Cumulative HIV incidence over 24 months of follow-up was 7.32% (95% CI= 5.05–10.57), with higher incidence among racial/ethnic minorities. In multivariate analyses, non-White race and recent sexual partner concurrency were associated with both HIV and STI infection; HIV testing history and sex with an HIV-positive partner were associated with increased risk of HIV infection. High rates of incident HIV infection and STIs among very young MSM and the relationship between incidence and race/ethnicity, concurrency and partner characteristics indicate potential focal points of future intervention and the need for continued vigilance.