Estimated HIV Incidence in California, 2006-2009.

Estimated HIV Incidence in California, 2006-2009.
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DOI:
10.1371/journal.pone.0055002
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发表时间:
2013
期刊:
影响因子:
3.7
通讯作者:
Mark KE
Mark KE
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Scheer S;Nakelsky S;Bingham T;Damesyn M;Sun D;Chin CS;Buckman A;Mark KE

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准确估计艾滋病毒发病率对于确定艾滋病毒预防工作的优先次序、确定目标和评估工作至关重要。使用疾病预防控制中心用于估计全国艾滋病发病率的方法,我们估计了洛杉矶县(LAC)、弗朗西斯科(SF)和加州其余县的艾滋病发病率。我们使用近期血清转换的血清学检测算法(STARHS)估计了2006-2009年LAC、SF和其他加州县成人和青少年中的新发HIV感染。STARHS方法使用BED HIV-1捕获酶免疫测定法,通过检测新诊断为HIV感染者的残留血清来确定近期HIV感染。基于人口的发病率估计值是使用新诊断病例的艾滋病毒检测数据并对不知道自己感染艾滋病毒的人进行插补来计算的。2007-2009年,我们估计拉丁美洲和加勒比地区的新感染病例分别为2426例(95% CI 1871-2982),1669(CI 1309-2029)和1898(CI 1452-2344)(p<0.01); SF中2006-2009年分别为492(CI 327-657)、490(CI 335-646)、458(CI 342-574)和367(CI 261-473)(p  =  0.14);其余加州县2008-2009年分别为2526(CI 1688-3364)和2993(CI 2141-3846)。LAC中男男性行为者(MSM)的艾滋病毒感染率比其他风险人群高100倍; SF MSM的感染率比其他人口群体高3至18倍。在拉丁美洲和加勒比,非裔美国人的发病率是白人和拉丁美洲人的两倍; 40岁或40岁以上的人感染率低于年轻人。我们报告了加州的第一个艾滋病毒发病率估计,强调了艾滋病毒发病率的地理差异,并证实了全国的调查结果,即男男性接触者和非洲裔美国人不成比例地受到艾滋病毒的影响。艾滋病毒发病率估计数可以而且应该用于针对新感染艾滋病毒风险最高的人群开展预防工作,重点关注地理、种族和风险群体的差异。
Accurate estimates of HIV incidence are crucial for prioritizing, targeting, and evaluating HIV prevention efforts. Using the methodology the CDC used to estimate national HIV incidence, we estimated HIV incidence in Los Angeles County (LAC), San Francisco (SF), and California’s remaining counties. We estimated new HIV infections in 2006–2009 among adults and adolescents in LAC, SF and the remaining California counties using the Serologic Testing Algorithm for Recent Seroconversion (STARHS). STARHS methodology uses the BED HIV-1 capture enzyme immunoassay to determine recent HIV infections by testing remnant serum from persons newly diagnosed with HIV. A population-based incidence estimate is calculated using HIV testing data from newly diagnosed cases and imputing for persons unaware of their HIV infection. For years 2007–2009, respectively, we estimated new infections in LAC to be 2426 (95% CI 1871–2982), 1669 (CI 1309–2029) and 1898 (CI 1452–2344) (p<0.01); in SF for 2006–2009, 492 (CI 327–657), 490 (CI 335–646), 458 (CI 342–574) and 367 (CI 261–473) (p = 0.14); and in the remaining California counties in 2008–2009, 2526 (CI 1688–3364) and 2993 (CI 2141–3846) respectively. HIV infection rates among men who have sex with men (MSM) in LAC were 100 times higher than other risk populations; the SF MSM rate was 3 to 18 times higher than other demographic groups. In LAC, incidence rates among African-Americans were twice those of whites and Latinos; persons 40 years or older had lower rates of infection than younger persons. We report the first HIV incidence estimates for California, highlighting geographic disparities in HIV incidence and confirming national findings that MSM and African-Americans are disproportionately impacted by HIV. HIV incidence estimates can and should be used to target prevention efforts towards populations at highest risk of acquiring new HIV infections, focusing on geographic, racial and risk group disparities.
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期刊: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
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作者:
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