HIV prevalence and associated risks in young men who have sex with men
HIV prevalence and associated risks in young men who have sex with men
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DOI：
10.1001/jama.284.2.198
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发表时间：
2000-07-12
影响因子：
120.7
通讯作者：
Janssen, RS
中科院分区：
文献类型：
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作者：
Valleroy, LA;MacKellar, DA;Janssen, RS
20世纪80年代末对老年男男性行为者(MSM)中人类免疫缺陷病毒(HIV)感染的研究表明，艾滋病流行已经达到顶峰；然而，最近在年轻MSM中进行的研究表明，HIV感染仍在居高不下。目的通过评估大都市地区这一人群中HIV感染的流行率和相关风险，调查美国青少年和年轻成年MSM中HIV感染的现状。设计青年男性调查，这是一项从1994年到1998年进行的横断面、多点、基于地点的调查。在马里兰州巴尔的摩、德克萨斯州达拉斯、德克萨斯州达拉斯等地设置194个年轻MSM经常光顾的公共场所。受试者包括加利福尼亚州洛杉矶、佛罗里达州迈阿密、纽约州纽约、旧金山湾区和华盛顿州西雅图。受试者共3492名15至22岁的男男性接触者，他们同意接受采访和HIV检测。主要结果衡量HIV感染的流行率和相关特征和危险行为。结果HIV感染率很高(总体为7.2%；范围为7个地区，2.2%-12.1%)，并随着年龄的增长而上升，从15岁的0%上升到22岁的9.7%。与白人、亚裔美国人和太平洋岛民(OR，1.1；95%CI，0.5-2.8)相比，黑人(优势比[OR]，6.3；95%可信区间[CI]，4.1-9.8)、混血或其他种族青年男性(OR，4.8；95%CI，3.0-7.6)和西班牙裔(OR，2.3；95%CI，1.5-3.4)中多因素调整后的HIV感染患病率更高。与HIV感染最相关的因素是黑人、混血或其他种族；曾与男性发生过肛交(OR，5.0；95%CI，1.8-13.8)；或与20名或更多男性发生过性关系(OR，3.0；95%CI，2.0-4.7)。在249名艾滋病毒阳性男子中，只有46人(18%)在这项检测之前知道自己受到了感染；37人(15%)正在接受艾滋病毒的医疗护理，19人(8%)正在接受艾滋病毒的药物治疗。过去6个月无保护措施的肛交患病率很高(总体为41%，范围为33%-49%)。结论这些年轻男男性接触者中，HIV感染率很高，强调有必要评估和加强对年轻MSM，特别是黑人、混合种族或族裔男性、西班牙裔和青少年的预防工作。
Context Studies conducted in the late 1980s on human immunodeficiency virus (HIV) infection among older men who have sex with men (MSM) suggested the epidemic had peaked; however, more recent studies in younger MSM have suggested continued high HIV incidence.Objective To investigate the current state of the HIV epidemic among adolescent and young adult MSM in the United States by assessing the prevalence of HIV infection and associated risks in this population in metropolitan areas.Design The Young Men's Survey, a cross-sectional, multisite, venue-based survey conducted from 1994 through 1998.Setting One hundred ninety-four public venues frequented by young MSM in Baltimore, Md; Dallas, Tex; Los Angeles, Calif; Miami, Fla; New York, NY; the San Francisco (Calif) Bay Area; and Seattle, Wash.Subjects A total of 3492 15- to 22-year-old MSM who consented to an interview and HIV testing.Main Outcome Measures Prevalence of HIV infection and associated characteristics and risk behaviors.Results Prevalence of HIV infection was high (overall, 7.2%; range for the 7 areas, 2.2%-12.1%) and increased with age, from 0% among 15-year-olds to 9.7% among 22-year-olds. Multivariate-adjusted HIV infection prevalence was higher among blacks (odds ratio [OR], 6.3; 95% confidence interval [CI], 4.1-9.8), young men of mixed or other race (OR, 4.8; 95% CI, 3.0-7.6), and Hispanics (OR, 2.3; 95% CI, 1.5-3.4), compared with whites (referent) and Asian Americans and Pacific Islanders (OR, 1.1; 95% CI, 0.5-2.8). Factors most strongly associated with HIV infection were being black, mixed, or other race; having ever had anal sex with a man (OR, 5.0; 95% CI, 1.8-13.8); or having had sex with 20 or more men (OR, 3.0; 95% CI, 2.0-4.7). Only 46 (18%) of the 249 HIV-positive men knew they were infected before this testing; 37 (15%) were receiving medical care for HIV, and 19 (8%) were receiving medical drug therapy for HIV. Prevalence of unprotected anal sex during the past 6 months was high (overall, 41%; range, 33%-49%).Conclusions Among these young MSM, HIV prevalence was high, underscoring the need to evaluate and intensify prevention efforts for young MSM, particularly blacks, men of mixed race or ethnicity, Hispanics, and adolescents.