The continuing HIV epidemic among men who have sex with men
The continuing HIV epidemic among men who have sex with men
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DOI：
10.2105/ajph.91.6.907
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发表时间：
2001-06-01
影响因子：
12.7
通讯作者：
Coates, TJ
中科院分区：
文献类型：
--
作者：
Catania, JA;Osmond, D;Coates, TJ
目标.本研究旨在探讨城市男男性接触者（MSM）艾滋病流行特征。1997年从纽约、洛杉矶、芝加哥和旧金山弗朗西斯科获得了MSM的概率样本（n = 2881; 18岁及以上），通过自我报告和生物学测量确定HIV状态。HIV感染率为17%（95%置信区间= 15%，19%），非裔美国人（29%）、使用注射毒品的MSM（40%）、“超重”非注射毒品使用者（32%）和受教育程度较低的男性（<高中，37%）的HIV感染率极高。一旦控制了这些其他因素，城市一级的艾滋病毒差异就不显著了。在比较目前的研究结果与历史数据的基础上，公共记录和建模，艾滋病毒的流行似乎已经下降，由于高死亡率（69%）和稳定，但高，发病率（1%-2%）。虽然研究结果表明，艾滋病毒的流行率已显着下降，从20世纪80年代中期，目前的水平在城市男男性接触者在美国接近撒哈拉以南国家（例如，14%-25%），并且在许多人口细分中非常高。尽管取得了多年的进展，艾滋病的流行在男男性行为者社区的亚群体中仍然有增无减。
Objectives. This study characterized the AIDS epidemic among urban men who have sex with men (MSM).Methods. A probability sample of MSM was obtained in 1997 (n = 2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures.Results. HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with-extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (32%), and less educated men (< high school, 37%). City-level HIV differences were nonsignificant once these other factors were controlled for. In comparing the present findings with historical data based on public records and modeling, HIV prevalence appears to have declined as a result of high mortality (69%) and stable, but high, incidence rates (1% 2%).Conclusions. Although the findings suggest that HIV prevalence has declined significantly from the mid-1980s, current levels among urban MSM in the United States approximate those of sub-Saharan countries (e.g., 14%-25%) and are extremely high in many population subsegments. Despite years of progress, the AIDS epidemic continues unabated among subsegments of the MSM community.