Ongoing HIV-1 transmission among men who have sex with men in Amsterdam: a 25-year prospective cohort study
Ongoing HIV-1 transmission among men who have sex with men in Amsterdam: a 25-year prospective cohort study
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DOI：
10.1097/qad.0b013e328342fbe9
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发表时间：
2011-02-20
期刊：
影响因子：
3.8
通讯作者：
Stolte, Ineke G.
中科院分区：
文献类型：
--
作者：
Jansen, Iralice A. V.;Geskus, Ronald B.;Stolte, Ineke G.
背景资料：为了研究男男性行为者（MSM）中HIV流行的可能性，我们研究了1984年至2009年阿姆斯特丹队列研究中MSM中HIV-1发病率、性风险行为、HIV-1血清转换的风险因素和HIV-1感染来源的趋势。使用Poisson回归研究了HIV-1发病率和HIV-1感染危险因素的趋势。性风险行为的趋势进行了评估，使用逻辑回归，通过广义估计方程校正个体内的相关性。HIV-1感染源的趋势通过logistic regression.Results建模：在1642 HIV-1阴性个体，217在随访期间血清转化。HIV-1发病率从1985年的8.6/100人-年大幅下降至1992年的1.3/100人-年; 1992年至1996年期间保持相对稳定，约为1.0/100人-年，2009年缓慢上升至2.0/100人-年（P = 0.14; 1996-2009年呈线性趋势）。自1996年起，无保护肛交（UAI）的报告显著增加。HIV-1血清转换与接受性UAI与临时合作伙伴，超过5个性伴侣，淋病史（所有在过去6个月），和较低的教育水平。目前，男男性接触者更有可能从偶然的合作伙伴比从稳定的合作伙伴感染HIV-1，但近年来的趋势表明，稳定的合作伙伴成为一个不断增长的来源，随着年龄的增长.Conclusions：从1996年起，在性风险行为增加后，HIV-1继续在男男性接触者中传播。有针对性的预防信息应继续侧重于与临时伴侣的性行为，但也要侧重于稳定关系中的性行为。(C)2011威科健康垂直酒吧Lippincott威廉姆斯& Wilkins
Background: To examine the suggested resurgence of the HIV epidemic among men who have sex with men (MSM), we studied trends in HIV-1 incidence rates, sexual risk behaviour, risk factors for HIV-1 seroconversion, and source of HIV-1 infection among MSM in the Amsterdam Cohort Studies from 1984 to 2009.Methods: Trends in HIV-1 incidence and risk factors for HIV-1 infection were studied using Poisson regression. Trends in sexual risk behaviour were evaluated using logistic regression, correcting for intra-individual correlation via generalized estimating equations. Trends in the source of HIV-1 infection were modelled via logistic regression.Results: Of 1642 HIV-1-negative individuals, 217 seroconverted during follow-up. HIV-1 incidence rates strongly decreased from 8.6/100 person-years in 1985 to 1.3/100 person-years in 1992; remained relatively stable around 1.0/100 person-years between 1992 and 1996, and slowly increased to 2.0/100 person-years in 2009 (P = 0.14; linear trend 1996-2009). Reports of unprotected anal intercourse (UAI) increased significantly from 1996 onwards. HIV-1 seroconversion was associated with receptive UAI with casual partners, more than five sexual partners, a history of gonorrhoea (all in the preceding 6 months), and a lower educational level. Currently, MSM are more likely to have contracted HIV-1 from casual partners than from steady partners, but trends of recent years suggest that steady partners became a growing source with increasing age.Conclusions: Following increases in sexual risk behaviour from 1996 onwards, HIV-1 continues to spread among MSM. Targeted prevention messages should continue to focus on sexual behaviour with casual partners, but also on sexual behaviour within steady relationships. (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins