High and persistent HIV seroincidence in men who have sex with men across 47 U.S. cities.
High and persistent HIV seroincidence in men who have sex with men across 47 U.S. cities.
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DOI：
10.1371/journal.pone.0034972
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Gurwith M
中科院分区：
文献类型：
--
作者：
Ackers ML;Greenberg AE;Lin CY;Bartholow BN;Goodman AH;Longhi M;Gurwith M
提供美国男男性行为者（MSM）的HIV血清发生率数据，并确定血清转换的预测因素。从1998年到2002年，4684名年龄在18-60岁之间的高危MSM参与了在美国56个临床试验地点进行的随机、安慰剂对照的HIV疫苗有效性试验。在基线和6个月的时间间隔评估人口统计学、行为数据和HIV状态。由于未检测到总体疫苗有效性，因此将两个试验组的数据合并，以根据随访人年（py）计算HIV发病率。血清转换的预测因素，调整的风险比（aHR），采用考克斯比例风险模型与随时间变化的协变量进行评价。总体而言，HIV发病率为2.7/100 py，在各研究中心和研究年份之间相对一致。青年男子和报告有无保护性行为、娱乐性吸毒和性传播感染史的男子的艾滋病毒感染率最高。HIV血清转换的独立预测因素包括：年龄18-30岁（aHR = 2.4; 95%CI 1.4，4.0），有>10个伴侣（aHR = 2.4; 95%CI 1.7，3.3），有已知的HIV阳性男性性伴侣（aHR = 1.6; 95%CI 1.2，2.0），与HIV阳性/未知男性伴侣无保护肛交（aHR = 1.7; 95%CI 1.3，2.3），安非他明（aHR = 1.6; 95%CI 1.1，2.1）和波普尔（aHR = 1.7; 95%CI 1.3，2.2）使用。 尽管反复进行艾滋病咨询，MSM人群中的艾滋病病毒感染率仍然很高，而且据报道危险性行为有所下降。必须继续制定新的艾滋病毒预防战略并加强现有努力，以降低新的艾滋病毒感染率，特别是年轻男子的感染率。
To provide HIV seroincidence data among men who have sex with men (MSM) in the United States and to identify predictive factors for seroconversion. From 1998–2002, 4684 high-risk MSM, age 18–60 years, participated in a randomized, placebo-controlled HIV vaccine efficacy trial at 56 U.S. clinical trial sites. Demographics, behavioral data, and HIV status were assessed at baseline and 6 month intervals. Since no overall vaccine efficacy was detected, data were combined from both trial arms to calculate HIV incidence based on person-years (py) of follow-up. Predictors of seroconversion, adjusted hazards ratio (aHR), were evaluated using a Cox proportional hazard model with time-varying covariates. Overall, HIV incidence was 2.7/100 py and was relatively uniform across study sites and study years. HIV incidence was highest among young men and men reporting unprotected sex, recreational drug use, and a history of a sexually transmitted infection. Independent predictors of HIV seroconversion included: age 18–30 years (aHR = 2.4; 95% CI 1.4,4.0), having >10 partners (aHR = 2.4; 95% CI 1.7,3.3), having a known HIV-positive male sex partner (aHR = 1.6; 95% CI 1.2, 2.0), unprotected anal intercourse with HIV positive/unknown male partners (aHR = 1.7; 95% CI 1.3, 2.3), and amphetamine (aHR = 1.6; 95% CI 1.1, 2.1) and popper (aHR = 1.7; 95% CI 1.3, 2.2) use. HIV seroincidence was high among MSM despite repeated HIV counseling and reported declines in sexual risk behaviors. Continuing development of new HIV prevention strategies and intensification of existing efforts will be necessary to reduce the rate of new HIV infections, especially among young men.
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DOI：
10.1093/jurban/jti019
发表时间：
2005-03-01
影响因子：
6.6
作者：
Clatts, MC;Goldsamt, LA;Yi, H
通讯作者：
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DOI：
10.1093/jurban/jti027
发表时间：
2005-03-01
影响因子：
6.6
作者：
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影响因子：
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通讯作者：
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DOI：
10.1097/01.qai.0000143600.41363.78
发表时间：
2005-05-01
影响因子：
3.6
作者：
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影响因子：
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作者：
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