The Expanding Epidemics of HIV Type 1 Among Men Who Have Sex With Men in Low- and Middle-Income Countries: Diversity and Consistency
The Expanding Epidemics of HIV Type 1 Among Men Who Have Sex With Men in Low- and Middle-Income Countries: Diversity and Consistency
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DOI：
10.1093/epirev/mxq011
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发表时间：
2010-04-01
影响因子：
5.5
通讯作者：
Sifakis, Frangiscos
中科院分区：
文献类型：
--
作者：
Beyrer, Chris;Baral, Stefan D.;Sifakis, Frangiscos
男男性行为者（MSM）在人类免疫缺陷病毒（HIV）感染方面承担了不成比例的负担，在全球范围内仍然是一个明显资源不足的人群。为了更好地描述低收入和中等收入国家男男性行为者中的艾滋病毒流行情况，作者对2000年1月1日（2000-2009年）之后发表和未发表的文献进行了系统回顾。共有来自50个国家的133项艾滋病毒流行率研究符合检索标准。数据被用来开发一种算法方法来对这些流行病进行分类。作者发现，低收入和中等收入国家的艾滋病毒流行病可以用以下4种情况来描述：1）男男性行为者是艾滋病毒病例的主要贡献者的环境; 2）在注射毒品使用者驱动的流行病背景下发生艾滋病毒在男男性行为者中传播的环境; 3）在异性恋者之间确定的艾滋病毒传播背景下发生艾滋病毒在男男性行为者中传播的环境;和4）性和非肠道方式都对艾滋病毒传播有重大影响的环境。作者重点介绍了秘鲁、乌克兰、肯尼亚和泰国，以描述拟议流行病情景之间的多样性和相似性。这一以哥伦比亚为基础的对男男性行为者中艾滋病毒流行病的分类可能有助于公共卫生机构和民间社会制定和实施更有针对性的艾滋病毒预防计划和干预措施。
Men who have sex with men (MSM) have borne a disproportionate burden of human immunodeficiency virus (HIV) infection and remain a markedly underresourced population globally. To better describe HIV epidemics among MSM in low- and middle-income countries, the authors conducted a systematic review of published and unpublished literature available after January 1, 2000 (2000-2009). A total of 133 HIV prevalence studies from 50 countries met the search criteria. Data were used to develop an algorithmic approach to categorize these epidemics. The authors found that the HIV epidemic in low- and middle-income countries may be described using the following 4 scenarios: 1) settings where MSM are the predominant contributor to HIV cases; 2) settings where HIV transmission among MSM occurs in the context of epidemics driven by injection drug users; 3) settings where HIV transmission among MSM occurs in the context of well-established HIV transmission among heterosexuals; and 4) settings where both sexual and parenteral modes contribute significantly to HIV transmission. The authors focused on Peru, Ukraine, Kenya, and Thailand to describe the diversity across and similarities between proposed epidemic scenarios. This scenario-based categorization of HIV epidemics among MSM may assist public health agencies and civil societies to develop and implement better-targeted HIV prevention programs and interventions.