Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013.
Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013.
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DOI：
10.2196/publichealth.5684
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发表时间：
2016-05-17
影响因子：
8.5
通讯作者：
Sullivan PS
中科院分区：
文献类型：
--
作者：
Rosenberg ES;Grey JA;Sanchez TH;Sullivan PS
在美国，男男性行为者（MSM）越来越多地代表了大多数感染和获得人类免疫缺陷病毒（HIV）的人。地方和联邦监测项目估计艾滋病毒诊断患者、艾滋病毒感染者和新诊断患者的人数。由于缺乏对美国各州、大都市统计区（MSA）或县MSM人数的基于人口的估计，因此不可能使用这些指标准确估计这些级别的比率，从而抑制了理解艾滋病毒负担和指导预防工作的能力。综合最近公布的估计MSM人口规模与公开的艾滋病毒监测数据，以估计艾滋病毒诊断和感染的流行率和新诊断率，在国家，州，MSA和县一级。2012年感染艾滋病毒的MSM人数（患病率），2012年诊断为艾滋病毒的MSM人数（确诊患病率），以及2013年新诊断为艾滋病毒感染的MSM人数（新诊断），在州，MSA和县一级，从AIDSVu.org和美国疾病控制和预防中心的公开数据中获得。生活在美国每个县的MSM估计人数是使用最近公布的方法计算的，该方法利用了国家健康和营养调查和美国社区调查的数据。估计县级MSM计数汇总形成MSA和州一级的总数。由此，我们估计了艾滋病毒的流行率，诊断流行率和新诊断率。2012年美国男男性行为者中估计的艾滋病毒感染率为15.0%（666，900/4，452，772），2012年确诊的艾滋病毒感染率为11.1%（493，453/4，452，772），2013年的新诊断率为每100名男男性行为者中0.7人。对于州一级的诊断患病率，6个州的病例数<15，000例，诊断患病率≥ 15%，均在南方。五个人口稠密的州有≥ 15，000例病例，发病率在10%至15%之间。格鲁吉亚州是唯一一个病例数≥ 15，000例且确诊患病率≥15%的州。在美国诊断患病率最高的25个MSA中，21个在南方，6个诊断患病率≥ 25%。县一级的数据显示，南方城市和农村县的确诊流行率都很高。在美国的许多地区，尤其是在南方，艾滋病毒感染在男男性行为者中是高流行病。我们的数据强调了美国国家艾滋病毒/艾滋病战略（NHAS）中规定的艾滋病毒预防和护理的优先事项，并提供了NHAS指标的可更新的地方估计。司法管辖区可以使用这些结果来指导资源，计划和政策，以最佳方式使MSM的健康受益。
In the United States, men who have sex with men (MSM) increasingly represent the majority of people living with and acquiring human immunodeficiency virus (HIV) infection. Local and federal surveillance programs estimate the number of persons living with an HIV diagnosis, persons living with HIV infection, and new diagnoses. Given the absence of population-based estimates of the number of MSM for US states, metropolitan statistical areas (MSAs), or counties, it is not possible to accurately estimate rates using these indicators at these levels, inhibiting the ability to understand HIV burden and to direct prevention efforts. To synthesize recently published estimates of MSM population size with publicly available HIV surveillance data, in order to estimate the prevalence of HIV diagnosis and infection and the rate of new diagnoses, at the national, state, MSA, and county levels. The number of MSM living with HIV infection in 2012 (prevalence), living with an HIV diagnosis in 2012 (diagnosed prevalence), and newly diagnosed with HIV infection in 2013 (new diagnosis), at state, MSA, and county levels, were obtained from publicly available data from AIDSVu.org and the US Centers for Disease Control and Prevention. The estimated number of MSM living in every US county was calculated using recently published methodology that utilized data from the National Health and Nutrition Examination Survey and American Community Survey. Estimated county-level MSM counts were aggregated to form MSA- and state-level totals. From this, we estimated HIV prevalence, diagnosed prevalence, and new diagnosis rates. The estimated HIV prevalence among MSM in the United States in 2012 was 15.0% (666,900/4,452,772), the diagnosed HIV prevalence in 2012 was 11.1% (493,453/4,452,772), and the new diagnosis rate for 2013 was 0.7 per 100 MSM. For diagnosed prevalence at the state level, 6 states had both <15,000 cases and diagnosed prevalence rates of ≥15%, all in the South. Five highly populated states had ≥15,000 cases and rates between 10% and 15%. Georgia was the only state with ≥15,000 cases and ≥15% diagnosed prevalence rate. Of the 25 MSAs with the highest diagnosed prevalence rates in the United States, 21 were in the South and 6 had diagnosed prevalence of ≥25%. County-level data showed high diagnosed prevalence rates in both urban and rural counties of the South. HIV infection is hyperendemic among MSM in many areas of the United States, particularly in the South. Our data emphasize the priorities for HIV prevention and care set forth in the United States National HIV/AIDS Strategy (NHAS) and provide updatable local estimates of NHAS indicators. Jurisdictions can use these results to direct resources, programs, and policies to optimally benefit the health of MSM.