Age biases in a large HIV and sexual behaviour-related internet survey among MSM
Age biases in a large HIV and sexual behaviour-related internet survey among MSM
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DOI：
10.1186/1471-2458-13-826
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发表时间：
2013-09-10
影响因子：
4.5
通讯作者：
Schmidt, Axel J.
中科院分区：
文献类型：
--
作者：
Marcus, Ulrich;Hickson, Ford;Schmidt, Axel J.
背景：来自MSM的行为数据通常收集在非代表性的便利样本中，越来越多地在互联网上。从这些样本中获得的流行病学数据可能有助于国家之间的比较，但可能存在未知的参与偏差。来自生活在捷克共和国、德国、荷兰、葡萄牙、瑞典和联合王国的欧洲男男性行为者互联网调查（EMIS）参与者的自我报告的艾滋病毒诊断与监测数据进行了比较，包括总体诊断流行率和2009年的新诊断。国家一级的患病率和每100名男男性接触者的新诊断率是根据假设男男性接触者占成年男性人口的3%的人口规模计算的。调查监测差异（SSD）的调查参与，诊断的艾滋病毒感染率和新的艾滋病毒诊断的比例确定。结果按15- 64岁男男性行为者的5岁年龄组计算和呈现。结果：监测得出的15-64岁男男性行为者确诊艾滋病毒感染率估计值范围从捷克共和国的0.63%到荷兰的4.93%。新的艾滋病毒诊断率在捷克共和国每100名男男性行为者中有0.10人，在荷兰每100名男男性行为者中有0.48人。EMIS的自我报告率一直较高，流行率从捷克共和国的2.68%到荷兰的12.72%不等，新的艾滋病毒诊断率从瑞典的0.36/100到荷兰的1.44/100。在各年龄组中，调查监测差异（SSD）为新的艾滋病毒诊断在英国和5.95之间，在捷克共和国，和确诊的患病率之间的1.80在德国和4.26在捷克共和国。互联网样本的男男性行为者向年轻的年龄组倾斜时，一般成年男性人口的年龄分布。EMIS参与的调查监督差异（SSD）在整个年龄范围内呈倒U形。两个HIV相关的SSD呈U形或J形，非常年轻和老年MSM的值较高。最高的调查和监测数据之间的差异，观察到在最古老的年龄组在瑞典和最年轻的年龄组在Portuguel.Conclusion：互联网样本偏向于一个较低的中位数年龄，因为年轻的男性在男男性接触者约会网站的代表性过大，因此可能更有可能被招募到调查。在互联网调查中，被诊断为艾滋病毒感染者的男性比例过高，而且在年龄较大的群体中越来越多。在25岁以下的年龄组中也观察到类似的效果。与监测数据相比，互联网样本中自我报告的高峰流行率和艾滋病毒诊断率往往转移到较高的年龄组。在将互联网调查数据与监测数据联系起来时，应考虑对在线可访问性的年龄效应进行调整。
Background: Behavioural data from MSM are usually collected in non-representative convenience samples, increasingly on the internet. Epidemiological data from such samples might be useful for comparisons between countries, but are subject to unknown participation biases.Methods: Self-reported HIV diagnoses from participants of the European MSM Internet Survey (EMIS) living in the Czech Republic, Germany, the Netherlands, Portugal, Sweden and the United Kingdom were compared with surveillance data, for both the overall diagnosed prevalence and for new diagnoses made in 2009. Country level prevalence and new diagnoses rates per 100 MSM were calculated based on an assumed MSM population size of 3% of the adult male population. Survey-surveillance discrepancies (SSD) for survey participation, diagnosed HIV prevalence and new HIV diagnoses were determined as ratios of proportions. Results are calculated and presented by 5-year age groups for MSM aged 15-64.Results: Surveillance derived estimates of diagnosed HIV prevalence among MSM aged 15-64 ranged from 0.63% in the Czech Republic to 4.93% in the Netherlands. New HIV diagnoses rates ranged between 0.10 per 100 MSM in the Czech Republic and 0.48 per 100 in the Netherlands. Self-reported rates from EMIS were consistently higher, with prevalence ranging from 2.68% in the Czech Republic to 12.72% in the Netherlands, and new HIV diagnoses rates from 0.36 per 100 in Sweden to 1.44 per 100 in the Netherlands. Across age groups, the survey surveillance discrepancies (SSD) for new HIV diagnoses were between 1.93 in UK and 5.95 in the Czech Republic, and for diagnosed prevalence between 1.80 in Germany and 4.26 in the Czech Republic.Internet samples of MSM were skewed towards younger age groups when compared to an age distribution of the general adult male population. Survey-surveillance discrepancies (SSD) for EMIS participation were inverse u-shaped across the age range. The two HIV-related SSD were u- or j-shaped with higher values for the very young and for older MSM. The highest discrepancies between survey and surveillance data regarding HIV-prevalence were observed in the oldest age group in Sweden and the youngest age group in Portugal.Conclusion: Internet samples are biased towards a lower median age because younger men are over-represented on MSM dating websites and therefore may be more likely to be recruited into surveys. Men diagnosed with HIV were over-represented in the internet survey, and increasingly so in the older age groups. A similar effect was observed in the age groups younger than 25 years. Self-reported peak prevalence and peak HIV diagnoses rates are often shifted to higher age groups in internet samples compared to surveillance data. Adjustment for age-effects on online accessibility should be considered when linking data from internet surveys with surveillance data.