珠海市不同活动场所MSM规模估计的研究

目的了解珠海市实体活动场所和虚拟活动场所男男性行为者(MSM)的人群规模,为制定艾滋病干预措施提供依据。方法利用单样本人群规模估计法(LMS法)和捕获-再捕获法估计珠海市实体场所和虚拟场所的MSM人群规模。结果利用LMS法估计珠海市实体场所MSM的人群规模为5 767人(3 718~8 053人),虚拟场所为18 734人(16 925~20 541人),校正结果为14 753人(13 328~16 176人)。利用捕获-再捕获法估计MSM的人群规模为17 089人(10 742~23 436人)。结论珠海市MSM规模较大,虚拟场所的MSM人数远高于实体场所。应重视在互联网等虚拟场所实施有针对性的艾滋病防制策略。     

基于捕获—再捕获法线上估计福州市高校学生MSM人群规模

目的 摸清福州市高校学生男男性行为者（MSM）人群规模以及特征,为开展针对性艾滋病宣传和干预提供依据。方法 利用捕获—再捕获法在线上分别通过网络简单随机抽样和滚雪球抽样进行问卷调查并估算被调查人群规模。结果 通过估算得出福州市高校学生MSM人群约8 506(4 865～12 146)人,约占在校男学生的4.33%(2.48%～6.18%);第一次捕获与第二次捕获MSM学生在学历、性取向、性行为角色、找性伴方式、近6个月性伴人数方面差异均有统计学意义（P<0.05）。结论 福州市高校学生MSM人群规模较大,需加强该人群的艾滋病防治工作。     

利用多种方法联合估计哈尔滨市MSM的规模

目的估计哈尔滨市男男性行为人群(MSM)的规模,为制定和实施有针对性的艾滋病高危人群干预策略提供科学依据。方法利用捕获再捕获法、除数法和乘数法,对哈尔滨市MSM的规模进行估计。结果捕获再捕获法估计哈尔滨市MSM规模为9197人(8520~9874人),MSM在18~77岁男性人口中比例为0.28%;除数法估计哈尔滨市浴池类MSM规模为4311人,酒吧类人群规模为3689人,所有活动场所内MSM规模为7381人;乘数法估计哈尔滨市MSM规模为14 812人。结论同时使用捕获再捕获法、除数法和乘数法进行人群规模估计,可以整合资源、节约时间,各种方法的结果可以相互验证,可信度高。     

应用普查法和捕获再捕获法对难于接触的女性性工作者开展规模估计研究

目的探索在难于接触的女性性工作者中开展规模估计的简便可行的方法,为评价项目效果提供依据。方法固定人群采用普查法,流动人群采用捕获再捕获法。结果用普查法估计固定人群规模为445人(409~480人),用捕获再捕获法估计流动人群规模为586人,95%CI:515~656人;18个调查点目标人群规模995~1 066人。结论根据规模估计的目的、目标人群类别及特征,结合现有资料和工作基础选择规模估计方法,简便可行。调查中,各利益相关群体积极参与和发挥作用至关重要。     

艾滋病高危人群基数估计方法在男性同性恋人群规模估计中的应用

目的探讨艾滋病高危人群基数估计方法在男性同性恋人群规模估计中的应用。方法选择杭州市中心城区3个同性恋聚集场所连续观察10天,运用除数法获得男性同性恋者人数,应用乘数法对男性同性恋者人群规模进行估计。结果调查期间光顾酒吧、公园、浴室3个同性恋活动场所男性同性恋者共2 337人次,可辨识者平均光顾次数为3.79次,采用除数法得到调查期间光顾3个场所总人数为617(571~670)人。采用滚雪球法,经过4轮提名,共调查了342名男性同性恋者,报告调查期间到过酒吧、公园和浴室3个场所的比例为37.72%,获得即乘数为2.65,估计杭州市中心城区艾滋病高危险的男性同性恋人数为1 635(1 513~1 777)人。结论采用乘数法、除数法估计男同性恋人群规模具有推广应用价值。     

应用新媒体技术估计男男性行为者人群规模的初步研究

目的探讨运用新媒体技术,对伊宁市男男性行为者(MSM)的规模进行估计,为艾滋病防治工作提供依据。方法利用同志交友软件获取在伊宁市内的MSM的信息,于2014年4-5月,对登陆伊宁市同志QQ交友群和Blued男同交友软件的MSM展开计数,5天后重复此过程,通过比对登录名和注册信息,确定两次计数均被计入的MSM,采用捕获-再捕获法计算MSM人群规模和MSM活跃人群数。结果伊宁市当地MSM人群规模约为490人[95%可信区间(CI)∶440~540],QQ群内的活跃MSM数约为110人(95%CI∶60~160);平均年龄为25.5岁,其中18~25岁年龄组和26~35岁年龄组人数在所有样本中的比例分别为44.4%和36.8%。性角色为0.5(肛交插入和被插入均可者)的比例为47.2%。结论该技术为应用捕获-再捕获方法估计MSM基数提供了新的手段,同时也提示在网络信息化时代,新媒体技术在艾滋病防治工作中的作用值得更进一步研究。     

淄博市男男性行为人群基数估计

目的掌握男男性行为人群（MSM）的规模,为制定艾滋病防治规划提供依据。方法运用人群调查法和除数法对MSM人群基数进行估计,并比较分析影响因素。结果人群调查法估计淄博市MSM人群基数为19311人,占男性性活跃期人群的1.57%;除数法估计为12 498人,占男性性活跃期人群的1.02%。结论无论人群调查法还是除数法,样本的代表性是MSM人群基数估计的重要条件。与除数法相比,人群调查法更易受外部条件的影响,造成估计误差。     

重庆市男男性行为人群2009年HIV-1 BED发病率调查

目的采用连续横断面调查和BED-捕获酶免疫试验(BED-capture enzyme immunoassay,BED-CEIA)估算重庆市男男性行为人群(MSM)2009年艾滋病病毒Ⅰ型(HIV-1)的发病率,分析流行趋势,讨论该方法应用于MSM人群的效率。方法利用"滚雪球"和同伴推动抽样方法(RDS),采用标准化问卷收集行为信息并采集血样,对HIV抗体确认阳性者采用BED-CEIA方法检测HIV-1新近感染,根据标准公式和2种校正公式,对该人群2009的发病率按不同年龄、寻找性伴方式、学历、收入状况等进行分层计算,与历年结果进行比较分析。结果共招募MSM志愿者942名,平均年龄为(26.32±7.11)岁,大专及以上学历者598人(63.48%);共发现HIV感染者142人,BED检测为新近感染者62人。重庆市MSM人群2009年HIV-1年发病率为15.43%(95%CI:11.59～19.28),较2008年增长了64.49%,与过去3年有显著性差异。21～30岁年龄组年发病率为15.03%(95%CI:10.42～19.42),通过网络寻找性伴组的年发病率为14.69%(95%CI:10.14～19.24),大专及以上学历组年发病率为13.74%(95%CI:9.25～18.23)。结论重庆市MSM人群HIV-1发病率呈快速上升趋势,2009年发病率校正之后的绝对值与前三年比较,结果有显著性差异;不同的校正公式得到的结果没有显著性差异,但与估计感染率之间存在令人深思的矛盾现象。     

利用男同社交软件估计芜湖市3所高校青年学生中男男性行为者规模调查

目的估计芜湖市发生男男性行为青年学生人群规模,为下一步的防治工作提供依据。方法 2019年哨点监测期内利用男同社交软件的距离识别功能估计青年学生使用人数,结合MSM艾滋病哨点监测附属调查获得青年学生MSM使用男同社交软件比例,运用乘数法估算芜湖市3所高校的青年学生中MSM人群规模,同时使用捕获-再捕获法方法予以验证。结果利用乘数法估计A、B和C大学使用Blued的青年学生占该校男生比例分别是4.26%、2.04%和1.64%,平均为2.55%;最近一年发生男男性行为青年学生占在校男生比例分别是2.14%、1.02%和0.82%,平均为1.28%。利用捕获-再捕获法估计出A、B和C大学最近一年发生过男男性行为的青年学生数分别是164(150～179)人、137(122～152)人和46(36～56)人,利用乘数法估计的人数分别是169人、150人和54人。结论利用男同社交软件使用乘数法可以估计高校校园内青年学生MSM规模,使用乘数法和捕获-再捕获法估计的结果基本一致。芜湖市高校青年学生MSM人群规模较大,应加强该人群的艾滋病防控工作。     

广州市1315名男男性行为人群的行为特征及艾滋病流行状况

目的了解广州地区男男性行为人群(MSM)艾滋病及其相关高危行为流行情况,为开展艾滋病防治提供依据。方法对2009年参加艾滋病自愿咨询检测的MSM人群的行为进行调查,并对艾滋病病毒(HIV)和梅毒检测相关资料进行分析。结果共调查1 315名MSM,平均年龄27岁,其中20~30岁的占60.61%;首次与男性发生性行为平均年龄23岁,25岁以下的占65.20%;最近3个月有多个性伴的占41.22%,最近一次与男性发生性行为时使用安全套的只有66.68%;56.20%最近一个月与男性发生性行为时每次都使用安全套。HIV感染率为5.40%,梅毒检出率为6.77%。被动肛交者安全套使用率显著低于主动者,文化程度低者HIV感染率和梅毒感染率更高。结论广州地区MSM中艾滋病流行比较严重,不安全性行为较高,艾滋病有通过MSM向普通人群扩散的危险。     

Osteoporosis in men

Osteoporosis is characterized by a reduction in bone density, associated with skeletal fragility and an increased risk of fracture after minimal trauma. Although osteoporosis is generally considered to be a condition affecting post-menopausal women, it is now clear that substantial bone loss occurs with advancing age in men, such that up to 20% of symptomatic vertebral fractures and 30% of hip fractures occur in men. This chapter highlights the incidence and prevalence of osteoporotic fractures in men and reviews the associated morbidity, excess mortality and health and social service expenditure. The determinants of peak bone mass and bone loss in men are discussed, as is the pathogenesis of osteoporosis and vertebral and hip fractures. The criteria for the diagnosis of osteoporosis in men are reviewed, together with the most appropriate investigations for secondary osteoporosis. The management of osteoporosis in men is also discussed, highlighting the most appropriate treatment options.     

Osteoporosis in men

Osteoporosis is defined as "a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture". Approximately 40-50% of women sustain osteoporotic fractures in their lifetime; as such, it is appropriate that studies initially focused upon females. Despite an increased recognition of osteoporotic fractures in men, there continues to be neglect of this disease in males. This ongoing neglect is inappropriate as 25-33% of men in some populations will sustain osteoporotic fractures in their lifetime. Testosterone plays an important role in male skeletal health. However, recent data suggest that estrogen may in fact be the dominant hormone regulating skeletal status in both men and women. BMD measurement may be utilized for osteoporosis diagnosis and to assist with fracture risk prediction in men prior to their sustaining a fracture. Recognizing this need, the International Society for Clinical Densitometry (ISCD) recommended and recently reaffirmed use of a BMD T-score of -2.5 or below be utilized to diagnose osteoporosis in men. Androgen therapy of hypogonadal men may be considered with the caveat that data do not exist to document that this treatment reduces fracture risk. At this time, the data is inadequate to support use of androgen treatment in eugonadal men with osteoporosis. Parathyroid hormone treatment does increase BMD; existing studies have not been of adequate size or duration to document fracture reduction efficacy. Bisphosphonate therapy increases BMD, reduces vertebral fracture risk and is considered the standard of care for osteoporotic men at this point in time.     

Osteoporosis in men

With the aging of the population, there is a growing recognition that osteoporosis and fractures in men are a significant public health problem, and both hip and vertebral fractures are associated with increased morbidity and mortality in men. Osteoporosis in men is a heterogeneous clinical entity: whereas most men experience bone loss with aging, some men develop osteoporosis at a relatively young age, often for unexplained reasons (idiopathic osteoporosis). Declining sex steroid levels and other hormonal changes likely contribute to age-related bone loss, as do impairments in osteoblast number and/or activity. Secondary causes of osteoporosis also play a significant role in pathogenesis. Although there is ongoing controversy regarding whether osteoporosis in men should be diagnosed based on female- or male-specific reference ranges (because some evidence indicates that the risk of fracture is similar in women and men for a given level of bone mineral density), a diagnosis of osteoporosis in men is generally made based on male-specific reference ranges. Treatment consists both of nonpharmacological (lifestyle factors, calcium and vitamin D supplementation) and pharmacological (most commonly bisphosphonates or PTH) approaches, with efficacy similar to that seen in women. Increasing awareness of osteoporosis in men among physicians and the lay public is critical for the prevention of fractures in our aging male population.     

Osteoporosis in men

Male osteoporosis is an increasingly important public health problem: from age 50 onward, one in three osteoporotic fractures occurs in men and fracture-related morbidity and mortality are even higher than in women. In 50% of osteoporotic men, an underlying cause can be identified (secondary osteoporosis). In the absence of an identifiable etiology, male osteoporosis is referred to as 'idiopathic osteoporosis' in men aged 30-70 years and as 'age-related osteoporosis' in older men. As in women, estrogen, not testosterone, appears the most important sex steroid regulating male skeletal status. Diagnosis and treatment recommendations are still largely based on bone mineral density (BMD), with osteoporosis defined as a T-score of 2.5 standard deviations below young adult values. However, there is ongoing discussion as to whether male or female reference ranges should be used and, like in women, treatment decisions are increasingly based on absolute fracture risk estimations rather than on BMD alone. In men, evidence-based data on the efficacy of pharmacologic interventions in reducing fracture risk are convincing but not conclusive. In particular, bisphosphonates and teriparatide seem to be as effective in men as in women.     

Osteoporosis in men

Although less common than in women, osteoporosis in men is a prevalent worldwide problem with important socioeconomic implications. Our understanding of this condition in men is growing, but there remains a great deal more to be determined. Definitions for osteoporosis in men are needed. Cost-effective guidelines on who should be investigated and treated, and how, are clearly necessary. The role of bone mineral densitometry in diagnosis and treatment decisions needs to be clarified. The efficacy of drug therapies for osteoporosis in men requires greater attention. Currently, a large multicenter study is underway in the United States and should provide much needed insight into the epidemiology of osteoporosis in men.