Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities
Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities
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DOI：
10.1097/qad.0b013e32832baa34
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发表时间：
2009-06-01
期刊：
影响因子：
3.8
通讯作者：
Sanchez, Travis H.
中科院分区：
文献类型：
--
作者：
Sullivan, Patrick S.;Salazar, Laura;Sanchez, Travis H.
背景：自2000年以来，美国男男性行为者（MSM）的艾滋病毒发病率一直在上升，并且MSM仍然是美国艾滋病毒流行中受影响最严重的风险群体。方法：我们使用来自美国5个城市的男男性行为者的数据（来自国家HIV行为监测系统）、HIVNET疫苗准备研究和其他已发表的数据，对HIV传播进行建模。每年的艾滋病毒传播是根据伴侣类型（主要或偶然）和性行为类型（接受性肛交、插入性肛交或口交）来估计的。结果：68%[95%可信区间（CI） 58-78]的HIV传播来自主要性伴侣，这是因为与主要性伴侣的性行为次数较多，与主要性伴侣肛交的接受角色较多，与主要性伴侣肛交时安全套使用率较低。按性别类型划分，69% （95% CI 59-79）的感染来自于接受性肛交，28% （95% CI 19-38）来自于插入性肛交，2% （95% CI 0-5）来自于口交。基于模型的估计HIV发病率为每年2.2% （95% CI 1.7-2.7）。敏感性分析表明，来自主要性伴侣的传播估计低至52% (95% CI 41-62)，高至74% （95% CI 68-80）。结论：根据我们的模型，在美国5个城市的男同性恋者中，大多数艾滋病病毒的传播来自主要的性伴侣。艾滋病毒预防工作应考虑到男性伙伴关系中艾滋病毒传播的风险，在美国艾滋病毒预防研究组合中，应优先考虑基于伴侣的男同性恋者艾滋病毒预防干预措施。(C) 2009年威科集团健康垂直条Lippincott Williams & Wilkins
Background: HIV incidence in the United States among men who have sex with men (MSM) has been increasing since 2000, and MSM remain the most heavily impacted risk group in the US HIV epidemic.Methods: We modeled HIV transmissions, using data from MSM in five US cities from the National HIV Behavioral Surveillance System, the HIVNET Vaccine Preparedness Study, and other published data. Annual HIV transmissions were estimated by partner type (main or casual) and by sex type (receptive anal intercourse, insertive anal intercourse, or oral sex).Results: Sixty-eight percent [95% confidence interval (CI) 58-78] of HIV transmissions were from main sex partners because of a higher number of sex acts with main partners, more frequent receptive roles in anal sex with main partners, and lower condom use during anal sex with main partners. By sex type, 69% (95% CI 59-79) of infections were from receptive anal intercourse, 28% (95% CI 19-38) were from insertive anal intercourse, and 2%, (95% CI 0-5) were from oral sex. The model-based estimated HIV incidence rate was 2.2% (95% CI 1.7-2.7) per year. Sensitivity analyses demonstrated estimates of transmission from main sex partners as low as 52% (95% CI 41-62) and as high as 74% (95% CI 68-80).Conclusion: According to our model, most HIV transmissions among MSM in five US cities are from main sex partners. HIV prevention efforts should take into account the risks of HIV transmissions in male partnerships, and couples-based HIV prevention interventions for MSM should be given high priority in the US HIV prevention research portfolio. (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins