The denominator problem: estimating MSM-specific incidence of sexually transmitted infections and prevalence of HIV using population sizes of MSM derived from Internet surveys.
The denominator problem: estimating MSM-specific incidence of sexually transmitted infections and prevalence of HIV using population sizes of MSM derived from Internet surveys.
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DOI：
10.1186/1471-2458-9-181
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发表时间：
2009-06-11
影响因子：
4.5
通讯作者：
Hamouda O
中科院分区：
文献类型：
--
作者：
Marcus U;Schmidt AJ;Kollan C;Hamouda O
在男男性行为者（MSM）等难以接触到的人群中，测量性传播感染的患病率和发病率受到未知人口规模和区域分布的阻碍。基于社区样本和研究的测量常常充满了参与偏差，并且不允许将结果推广到其他地区或整个男男性行为者群体。我们使用了德国大型网络调查中MSM参与者的区域比例分布，以及由一般人口调查得出的MSM人口估计，以估计区域人口规模。根据监测数据的传播群体类别和各地区MSM人群规模，计算各地区新诊断HIV感染和梅毒的人群特异性发病率。对于艾滋病毒流行率，我们比较了基于监测数据模型的MSM中流行艾滋病毒感染估计值与混合模型，其中我们使用了来自调查的艾滋病毒阳性参与者的比例区域分布和基于监测模型的估计流行艾滋病毒感染总数。假设调查参与者的区域分布与男男性行为者人口的整体分布相似，则可以估计出男男性行为者在一般人口中的区域比例。以估计的男男性行为者人口为分母，以国家监测数据为分子计算区域发病率，结果显示，新诊断的艾滋病毒感染和梅毒的区域最高发病率为每1,000名男男性行为者7-8人。与以总（男性）人口为分母的计算相比，都市和农村地区之间的梯度大大缩小。在这两个模型中，区域艾滋病毒流行率估计值具有可比性。考虑到通过其他抽样方法难以获得具有区域代表性的男男性行为者数据，在西方后工业化国家，基于互联网的调查可能提供一种简单和低成本的工具来估计区域人口分布。有了对传播群体进行分类的国家监测数据，就可以估计可报告性传播感染的区域特定人群发病率。区域性男男性行为者人口的艾滋病毒流行率估计显示出与德国西部和东部的城市化水平、男男性行为者集中程度和艾滋病毒流行起点有关的差异。
Measuring prevalence and incidence of sexually transmitted infections in hard to reach populations like men who have sex with men (MSM) is hampered by unknown size and regional distribution of this population. Community sample – and study-based measurements are often fraught with participation biases and do not allow generalization of the results for other regions or the whole population group of MSM. We used the proportional regional distribution of participants of large internet-based surveys among MSM from Germany together with a general population survey-derived estimate of the MSM population to estimate regional population sizes. Based on transmission group category from surveillance data and regional MSM population size we calculated regional population-specific incidence rates of newly diagnosed HIV infection and syphilis. For HIV prevalence we compared estimates of prevalent HIV infections in MSM from a surveillance data-based model with a mixed model in which we used the proportional regional distribution of HIV positive participants from surveys and the estimated total number of prevalent HIV infections from the surveillance based model. Assuming a similar regional distribution of survey participants and the MSM population as a whole, the regional proportion of MSM in the general population can be estimated. Regional incidence calculated with the estimated MSM population as denominator and national surveillance data as numerator results in regional peak incidence rates of 7–8 per 1,000 MSM for newly diagnosed HIV infection and syphilis. The gradient between metropolitan and rural areas narrows considerably compared with calculations which use the total (male) population as denominator. Regional HIV prevalence estimates are comparable in the two models. Considering the difficulties to obtain regionally representative data by other sampling methods for MSM, in Western post-industrialized countries internet-based surveys may provide an easy and low cost tool to estimate regional population distributions. With national surveillance data, which categorize transmission groups, regional population-specific incidence rates for reportable sexually transmitted infections can be estimated. HIV prevalence estimates for regional MSM populations show differences related to the level of urbanization, MSM concentration, and starting points of the HIV epidemic in western and eastern Germany.
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影响因子：
2
作者：
HEISTERKAMP, SH;JAGER, JC;DOWNS, AM
通讯作者：
DOWNS, AM
DOI：
10.2807/esm.09.12.00494-en
发表时间：
2004-12-01
期刊：
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
影响因子：
--
作者：
Marcus, U;Bremer, V;Hamouda, O
通讯作者：
Hamouda, O
DOI：
10.1590/s0102-311x2006000700002
发表时间：
2006-07-01
期刊：
Cadernos de Saúde Pública
影响因子：
--
作者：
Michaels, Stuart;Lhomond, Brigitte
通讯作者：
Lhomond, Brigitte
影响因子：
4.5
作者：
Marcus U;Schmidt AJ;Hamouda O;Bochow M
通讯作者：
Bochow M
影响因子：
3.8
作者：
Mercer, CH;Fenton, KA;Johnson, AM
通讯作者：
Johnson, AM