Does the recent increase in HIV diagnoses among men who have sex with men in the UK reflect a rise in HIV incidence or increased uptake of HIV testing?
Does the recent increase in HIV diagnoses among men who have sex with men in the UK reflect a rise in HIV incidence or increased uptake of HIV testing?
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DOI：
10.1136/sti.2006.021428
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发表时间：
2007-04-01
影响因子：
3.6
通讯作者：
Gill, O. Noel
中科院分区：
文献类型：
--
作者：
Dougan, Sarah;Elford, Jonathan;Gill, O. Noel
目的：要确定是否增加艾滋病毒的诊断，自1997年以来，在男性与男性发生性关系（男男性行为者）在英国反映了艾滋病毒的发病率上升或增加HIV testing.Methods：估计艾滋病毒的发病率来自英国艾滋病毒监测系统（艾滋病毒诊断，CD 4监测，无关联的匿名调查）的数据为1997-2004年。艾滋病毒检测的数据提供了KC 60法定回报，自愿检测和无关联的匿名调查在哨兵泌尿生殖医学（GUM）clinics.Results：艾滋病毒诊断在英国男男性接触者之间上升了54%，1997年至2004年（从1382年至2124年），年龄和地理位置的变化。伦敦35岁以下的男男性行为者中艾滋病毒诊断人数没有增加，但在所有其他群体中都有所增加。在整个英国，1997年至2004年期间，在GUM诊所就诊的MSM中，包括“高危”MSM，接受艾滋病毒检测的人数显著增加（p < 0.001）。直接发病率估计值（最近HIV血清转换检测的血清学检测算法）未提供HIV发病率统计学显著增加或减少的证据。间接估计表明，可能有一个上升的艾滋病毒的发病率，但这些估计的影响，增加了艾滋病毒testing.Conclusions的摄取：1997年和2004年之间，在英国的男男性接触者中，艾滋病毒诊断的数量增加，除了在年轻的男男性接触者在伦敦，其中没有变化。自1997年以来，英国男男性行为者中艾滋病毒诊断的增加似乎反映了艾滋病毒检测的增加，而不是艾滋病毒发病率的上升。
Objectives: To determine whether the increase in HIV diagnoses since 1997 among men who have sex with men ( MSM) in the UK reflects a rise in HIV incidence or an increase in HIV testing.Methods: Estimates of HIV incidence were derived using data from UK HIV surveillance systems ( HIV diagnoses; CD4 surveillance; unlinked anonymous surveys) for 1997-2004. Data on HIV testing were provided by KC60 statutory returns, voluntary testing and unlinked anonymous surveys in sentinel genitourinary medicine ( GUM) clinics.Results: HIV diagnoses among MSM in the UK rose by 54% between 1997 and 2004 ( from 1382 to 2124), with variation by age and geographical location. The number of HIV diagnoses among MSM < 35 years of age in London showed no increase, but in all other groups it increased. Throughout the UK, uptake of HIV testing increased significantly among MSM attending GUM clinics between 1997 and 2004, including "at-risk'' MSM ( p < 0.001). Direct incidence estimates ( serological testing algorithm for recent HIV seroconversion assay) provided no evidence of a statistically significant increase or decrease in HIV incidence. Indirect estimates suggested that there may have been a rise in HIV incidence, but these estimates were influenced by the increased uptake of HIV testing.Conclusions: The number of HIV diagnoses increased among MSM in the UK between 1997 and 2004, except among younger MSM in London, in whom there was no change. The increase in HIV diagnoses among MSM in the UK since 1997 seems to reflect an increase in HIV testing rather than a rise in HIV incidence.