Estimates of adults with indications for HIV pre-exposure prophylaxis by jurisdiction, transmission risk group, and race/ethnicity, United States, 2015
Estimates of adults with indications for HIV pre-exposure prophylaxis by jurisdiction, transmission risk group, and race/ethnicity, United States, 2015
复制标题
DOI：
10.1016/j.annepidem.2018.05.003
复制
发表时间：
2018-12-01
影响因子：
5.6
通讯作者：
Grey, Jeremy
中科院分区：
文献类型：
--
作者：
Smith, Dawn K.;Van Handel, Michelle;Grey, Jeremy
目的：有效衡量提供艾滋病毒暴露前预防（PrEP）方面的进展，需要对具有使用该药物适应症的成人人数进行次国家估计，并考虑到按传播风险（风险）群体和种族/族裔分列的艾滋病毒感染率差异。方法：我们采用乘数法，结合2015年美国疾病控制与预防中心按种族/民族和风险群体划分的艾滋病毒诊断比例监测数据，以及基于人群的风险群体规模估计，得出每个辖区按种族/民族划分的风险群体（男男性行为者[MSM]、异性恋活跃成年人[HET]和注射吸毒者[PWID]）有适应症的成年人估计人数。结果：2015年估计有110万成年人有PrEP使用指征：813,970名男同性恋者，258,080名HET， 72,510名注射吸毒者，500,340名黑人，282,260名拉丁裔和303,230名白人。在HET中，176670名女性和81410名男性有指征。在每个风险和种族/族裔群体中有适应症的成年人比例因司法管辖区而异。结论：黑人成年人人数最多，有迹象表明，在这一人群中增加PrEP的使用必须是最优先考虑的。男同性恋者仍然是一个优先考虑的问题，因为有迹象的人数很多。这些估计值可用作分母，在次国家一级评估预防措施的覆盖率及其对艾滋病毒发病率的影响。Elsevier Inc.出版。
Purpose: Effectively measuring progress in delivering HIV pre-exposure prophylaxis (PrEP) requires subnational estimates of the number of adults with indications for its use that account for differences in HIV infection rates by transmission risk (risk) group and race/ethnicity.Methods: We applied a multiplier method with 2015 Centers for Disease Control and Prevention surveillance data on proportions of HIV diagnoses by race/ethnicity and risk group and population-based estimates of risk group sizes to derive estimated numbers of adults with indications by risk group (men who have sex with men [MSM], heterosexually active adults [HET], and persons who inject drugs [PWID]) by race/ethnicity in each jurisdiction.Results: An estimated 1.1 million adults had indications for PrEP use in 2015: 813,970 MSM, 258,080 HET, and 72,510 persons who inject drugs, and 500,340 blacks, 282,260 Latinos, and 303,230 whites. Among HET, 176,670 females and 81,410 males had indications. The proportions of adults with indications in each risk and race/ethnicity group varied by jurisdiction.Conclusions: Blacks comprised the highest number of adults with indications showing that increasing PrEP use in this population must be the highest priority. MSM remain a priority because of the high number with indications. These estimates can be used as denominators to assess PrEP coverage and impact on HIV incidence at subnational levels. Published by Elsevier Inc.