北京市MSM人群HIV感染者合并HCV与梅毒感染的状况及相应免疫指标与病毒载量的变化

目的了解北京市男男性接触者(MSM)的艾滋病病毒(HIV)感染及宿主的免疫状态。方法2005年7~12月对招募的MSM进行HIV感染检测,采集阳性感染者的外周血,对分离毒株进行鉴定,并对阳性感染者的免疫状态包括CD4 、CD8 T细胞的数量,以及感染者体内病毒载量进行了分析。结果在招募的526名MSM中,HIV感染的主要流行亚型为欧美B亚型,1例为CRF01-AE重组亚型,后者主要为异性间HIV感染的流行亚型。HIV感染者中合并HCV或者梅毒的感染率分别为17.65%与35.29%,合并感染者的CD4 、CD8 T淋巴细胞数量明显降低,病毒载量明显升高。结论MSM人群中HIV感染者合并STD感染,明显降低宿主免疫系统控制病毒复制的能力,同时存在着MSM人群与其他高危人之间通过性途径相互传播HIV的趋势。     

男男性行为者"HIV感染状况配对"研究进展

MSM是HIV感染的高风险人群,"HIV感染状况配对"(serosorting)是MSM为了减少HIV感染风险,选择与自身感染状况相同的性伴发生无保护性行为的预防措施,国内外对该措施的预防效果和应用状况进行了多年研究.本文回顾了近20年国内外MSM"HIV感染状况配对"的研究文献,对"HIV感染状况配对"在预防HIV感...     

常德市男男性行为者中HIV感染者抗病毒治疗现状及影响因素

在我国,男男性行为者(MSM)的艾滋病病毒(HIV)感染现状不容乐观,新增HIV感染有29.4%发生在MSM^[1]。为控制HIV感染,联合国艾滋病规划署2014年提出"90-90-90"目标^[2]。截至2015年,我国HIV感染者接受抗病毒治疗(ART)的比例为67%,MSM中的治疗覆盖率达到71%^[3]。为实现第二个90目标,了解目前MSM中HIV感染者ART现状,探索MSM选择ART的相关因素,本文对常德市MSM中HIV感染者相关资料进行分析,以期为HIV预防控制提供证据支持。     

2014年扬州市MSM中HIV及梅毒检测结果分析

<正>男男性行为人群(Men who have sex with men,MSM)中的梅毒、艾滋病的感染率和发病率呈上升趋势。MSM中的梅毒和艾滋病病毒(Human immunodeficiency virus,HIV)具有相同的传播途径,近几年关于梅毒在MSM中爆发的报道,以及梅毒可能增加HIV感染率、影响HIV感染者免疫状态的研究,引发了人们对HIV与梅毒合并感染的关注。本文旨在     

1例男男性行为者的HIV急性期感染诊断

正男男性行为者(MSM)由于多性伴和"知行分离"等特点,已成为艾滋病病毒(HIV)感染的重要人群,及早发现感染者并给予干预,是减少二代传播的重要途径。采用同时检测血清中p24抗原和抗体的第四代检测试剂和HIV核酸检测技术有利于发现早期及急性期感染者。在实际工作中遇到一位MSM急性期感染者,现报告对其检测和诊断情况。     

盐城市MSM的HIV感染情况及影响因素分析

<正>盐城市在1999年发现了首例艾滋病病毒(Human immunodeficiency virus,HIV)感染者,随后在2005年发现了首例经男男性行为感染者。之后,新报告的HIV感染者中男男性行为人群(Men who have sex with men,MSM)感染的比例逐年增加,已成为HIV的重要传播途径。为了解盐城市MSM艾滋病知识知晓情况、HIV/梅毒感染状况及相关的影     

北京市疾病预防控制中心VCT门诊点MSM的HIV检测和导医情况

目的评估2012年北京市疾病预防控制中心(CDC)艾滋病病毒(HIV)自愿咨询检测(VCT)门诊点,男男性行为人群(MSM)的HIV检测水平和HIV感染确诊后的导医情况。方法采用回顾性研究。收集2012年1月1日至12月31日北京市CDC VCT门诊点MSM的HIV检测和HIV感染确诊后导医情况等相关数据,并按月份整理。删除重复检测者和既往阳性者后,收集新确诊阳性者的CD+4T淋巴细胞(简称CD4细胞)检测和抗病毒治疗情况。利用Cox比例风险模型评估HIV感染确诊后CD4细胞水平和开始抗病毒治疗(ART)的相关性。结果2012年,北京市CDC VCT门诊总共检测HIV和梅毒1639人次,其中52.9%(867/1639)是MSM,142例为新发现的HIV感染者/AIDS病人。新发现的HIV感染者中,4.9%(7/142)是现患梅毒,12.7%(18/142)是既往梅毒患者。90.1%(128/142)的新发现HIV感染者已进行了阳性告知,85.2%(121/142)检测了CD4细胞计数,48.8%(59/121)的CD4细胞计数350个/μL。在121名接受了CD4细胞检测的MSM中,15名CD4细胞计数200个/μL的MSM开始了治疗;在40名CD4细胞计数为200~350个/μL的MSM中,有30人(75.0%)开始了治疗。结论 2012年,北京市MSM中新发现HIV感染的人数依然在增加,HIV阳性MSM开始抗病毒治疗的比例依然有待提高。     

男男性行为者急慢性HIV感染者口腔菌群结构及多样性分析

目的探讨MSM急、慢性HIV感染者与MSM中HIV未感染者口腔菌群的变化规律和差异。方法 2019年5-11月,收集15例MSM急性HIV感染者、15例MSM慢性HIV感染者以及15例未感染HIV的MSM健康对照者的咽拭子标本。提取咽拭子基因组DNA进行16S rRNA基因PCR扩增,然后对其V4～V5区域进行测序,并对口腔菌群群落结构及多样性进行差异分析。结果在门水平上,以厚壁菌门、变形菌门、拟杆菌门和梭杆菌门为主,这四大菌门占据全部菌群成员的90%以上,其中对照组中四大菌门所占比例为91.92%,急性HIV感染组为97.73%,慢性HIV感染组为98.62%。与MSM对照组相比,MSM急、慢性HIV感染组口腔菌群丰度和多样性均显著下降,并且群落结构组成存在显著差异。在属水平上,MSM急、慢性HIV感染组的丁酸弧菌属、拟杆菌属、劳特罗普菌属、乳杆菌属、罗氏菌属、棒状杆菌属等丰度显著低于MSM对照组;MSM急性HIV感染组金氏菌属、普氏菌属丰度显著高于MSM对照组,而纤毛菌属显著低于MSM对照组;MSM慢性HIV感染组链球菌属丰度显著高于MSM对照组,而放线菌属丰度显著低于MSM对照组;MSM慢性HIV感染组的假单胞菌属、金氏菌属和Oribacterium丰度与MSM急性HIV感染组相比显著降低。结论 MSM急、慢性期HIV感染者口腔菌群丰度和多样性与健康对照组相比存在显著差异;急、慢性HIV感染组之间的口腔菌群组成及丰度也存在差异。     

济南市男男性行为者HIV TP HCV HBV HSV-2检测结果及HIV感染影响因素

目的了解男男性行为者(MSM)艾滋病病毒(HIV)、梅毒螺旋体(TP)、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)、单纯疱疹病毒2型(HSV-2)感染现状,分析HIV感染影响因素。方法 2015-2017年在济南市MSM中通过同伴推荐法抽样,进行行为学及HIV、TP、HCV、HBV、HSV-2血清学调查,用χ2检验、Logistic回归模型进行HIV感染影响因素的单因素及多因素分析。结果 1 300名MSM的HIV抗体阳性率为6.54%(85人),TP抗体阳性率为5.46%(71人);HCV抗体阳性率为0.31%(4人);HBV阳性率为7.31%(95人);HSV-2阳性率为5.62%(73人)。多因素分析结果显示,最近6个月同性肛交坚持使用安全套[比值比(OR)=0.535] HIV感染风险较小,TP感染者(OR=2.555)、HSV-2感染者(OR=5.308)HIV感染风险较大。结论 TP和HSV-2感染是HIV感染的高危因素,应该有针对性地开展行为干预工作。     

山西省首例经MSM感染HIV的报告

山西省自1995年发现艾滋病病毒(HIV)感染者以来,感染人数逐年上升,感染人群逐渐扩大,在供血(浆)员、婴幼儿、吸毒者、暗娼、性病病人、自愿检测者、术前病人、大学生以及僧人中,均发现了HIV感染者。2006年11月,山西省首次在男男性行为(MSM)人群中发现1例HIV感染者,现将有关情况     

性网络与男男性行为人群的HIV传播

性网络是男男性行为人群(MSM)经性途径传播艾滋病病毒(HIV)的直接通道。网络分析方法可揭示性网络构成与个体感染HIV风险及与群体中HIV传播的动力学关系。为深入探讨MSM HIV传播风险,为预防干预定位提供信息,该文对性网络与MSMHIV传播关系的研究现况做一简要概述。     

Gender identity and HIV risk among men who have sex with men in Cape Town,South Africa

Gender identity plays a potentially important role contributing to HIV risk among MSM in South Africa. Where studies have included a focus on gender identity, MSM reporting gender non-conformity have been found to have a higher risk of being HIV positive than other MSM. This article examines HIV risk among gender non-conforming MSM in a sample of 316 MSM in Cape Town, South Africa. Reporting gender non-conformity was associated with higher HIV prevalence and increased HIV risk behaviour. Gender non-conformity was also associated with a higher likelihood of being unemployed and reporting low household incomes. These findings highlight the importance of gender-identity as a factor affecting access to HIV treatment, care, and prevention in South Africa and this is an issue that needs to be addressed in interventions targeting MSM populations.     

Global epidemiology of HIV infection in men who have sex with men

Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world.     

Epidemiologic data on young men of color who have sex with men

Young men of color who have sex with men (YMSM of color) have been disproportionately affected by the HIV/AIDS epidemic in the United States. Between 2001 and 2006, HIV/AIDS diagnoses increased 93.1% among African-American MSM aged 13-24 and 45.8% among Latino MSM aged 13-24. Many multisite studies have yielded valuable information on the behaviors associated with HIV infection in adolescents, MSM, African-Americans, and Latinos. Studies among adolescents found a high prevalence of risky sexual behaviors, including having multiple partners and unprotected intercourse and frequent substance use. Multisite studies of MSM also found frequent reports of alcohol and drug abuse, and one study found that nearly one-half (48%) of HIV-positive MSM were unaware of their infection. Similarly, two multisite studies of YMSM found high rates of unprotected sex, substance use, and HIV-infection among YMSM of color. Recognizing these challenges, the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA) funded the first multisite study to improve engagement, linkage to HIV care, and retention in care for HIV-positive YMSM of color. The objective of this article is to review the epidemiologic data on HIV-positive YMSM of color from surveillance and multisite studies in order to identify the needs of this population and the gaps in the literature.     

HIV-testing behavior among young migrant men who have sex with men (MSM) in Beijing, China

Previous studies suggested a rapid increase of HIV prevalence among men who have sex with men (MSM) in China in recent years, from 0.4% in 2004 to 5.8% in 2006. However, some MSM had never been tested for HIV. In order to expand the accessibility to HIV testing, understanding HIV-testing behavior and barriers among MSM is important. Using data collected from 307 young migrant MSM (aged 18-29 years) in 2009 in Beijing, we aimed to identify psychological and structural barriers to HIV testing. MSM were recruited through peer outreach, informal social networks, Internet outreach, and venue-based outreach. Participants completed a confidential self-administered questionnaire. Results show that about 72% of MSM ever had an HIV test. Logistic regression analysis indicated that the HIV-testing behavior was associated with sexual risk behaviors (e.g., multiple sexual partners and inconsistent condom use for anal sex) and history of sexually transmitted diseases. Eighty four MSM (28%) who never had an HIV test reported that the psychological barriers mainly were perceived low risk of HIV infection and fears of being stigmatized. The structural barriers reported inconvenience of doing test and lack of confidentiality. Future HIV prevention programs should be strengthened among MSM to increase their awareness of HIV risk. Efforts are needed to increase access to quality and confidential HIV testing among MSM and reduce stigma against MSM.     

Successes and challenges of HIV prevention in men who have sex with men

Men who have sex with men (MSM) have been substantially affected by HIV epidemics worldwide. Epidemics in MSM are re-emerging in many high-income countries and gaining greater recognition in many low-income and middle-income countries. Better HIV prevention strategies are urgently needed. Our review of HIV prevention strategies for MSM identified several important themes. At the beginning of the epidemic, stand-alone behavioural interventions mostly aimed to reduce unprotected anal intercourse, which, although somewhat efficacious, did not reduce HIV transmission. Biomedical prevention strategies reduce the incidence of HIV infection. Delivery of barrier and biomedical interventions with coordinated behavioural and structural strategies could optimise the effectiveness of prevention. Modelling suggests that, with sufficient coverage, available interventions are sufficient to avert at least a quarter of new HIV infections in MSM in diverse countries. Scale-up of HIV prevention programmes for MSM is difficult because of homophobia and bias, suboptimum access to HIV testing and care, and financial constraints.     

204例MSM人群HIV／梅毒感染状况及行为学特征分析

目的了解天津市部分男男同性性行为人群（MSM）艾滋病相关危险行为,以及艾滋病病毒（HIV）、梅毒（SP）感染状况,为预防性病、艾滋病传播提供依据。方法采用横断面调查,对进入酒吧的男同性恋者进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测。结果调查的204人中,HIV感染率为5．9％,梅毒感染率为18．7％。艾滋病知识知晓率为81．4％,近6个月每次性行为均使用安全套的比例为47．9％,HIv感染者安全套使用率低,仅为11．1％,71．4％的HIV感染者最近6个月存在多性伴现象。结论天津市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高,应加强对该人群艾滋病性病相关的宣传教育及干预工作,控制HIv的传播。     

HIV risk and prevention among men who have sex with men in rural South Africa

Rural South African men who have sex with men (MSM) are likely to be underserved in terms of access to relevant healthcare and HIV prevention services. While research in urban and peri-urban MSM populations has identified a range of factors affecting HIV risk in South African MSM, very little research is available that examines HIV risk and prevention in rural MSM populations. This exploratory study begins to address this lack by assessing perceptions of HIV risk among MSM in rural Limpopo province. Using thematic analysis of interview and discussion data, two overarching global themes that encapsulated participants’ understandings of HIV risk and the HIV risk environment in their communities were developed. In the first theme, “community experience and the rural social environment”, factors affecting HIV risk within the broad risk environment were discussed. These included perceptions of traditional value systems and communities as homophobic; jealousy and competition between MSM; and the role of social media as a means of meeting other MSM. The second global theme, “HIV/AIDS knowledge, risk and experience”, focused on factors more immediately affecting HIV transmission risk. These included: high levels of knowledge of heterosexual HIV risk, but limited knowledge of MSM-specific risk; inconsistent condom and lubricant use; difficulties in negotiating condom and lubricant use due to uneven power dynamics in relationships; competition for sexual partners; multiple concurrent sexual partnerships; and transactional sex. These exploratory results suggest that rural South African MSM, like their urban and peri-urban counterparts, are at high risk of contracting HIV, and that there is a need for more in-depth research into the interactions between the rural context and the specific HIV risk knowledge and behaviours that affect HIV risk in this population.     

Diagnosing HIV in men who have sex with men: an emergency department's experience

In the United States, men who have sex with men (MSM) constitute the risk group in which the prevalence of new HIV infection is increasing. The percentage of undiagnosed HIV infection and HIV risk behaviors in MSM and non-MSM participating in an emergency department-based rapid HIV screening program were compared. Medical records of all male patients participating in the program from May 2008 to October 2010 were reviewed. MSM were identified as male or male-to-female patients reporting oral and/or anal sex with a male. Males eligible for testing were aged 18 or older, English-speaking, not known to be HIV infected, and able to decline testing. A total of 6672 males were approached for testing; 5610 (84.1%) accepted, 366 (6.5%) were MSM, and 5244 (93.5%) were non-MSM. A total of 90.7% were black. Median age was 41. Fifty-nine MSM (16.1%) were diagnosed with HIV compared to 81 (1.5%) non-MSM. MSM were 10 times more likely than non-MSM to have undiagnosed HIV infection (odds ratio [OR] 10.4, 95% confidence interval [CI] 7.3, 14.0). HIV-infected MSM (median age, 26) were younger than non-MSM (median age, 41). HIV-infected non-MSM were 2 times more likely than MSM to have CD4 counts less than 200 cells per microliter. MSM were more likely to report previous HIV testing (OR 1.9, 95% CI 1.4, 2.5) and risk behaviors, including sex without a condom (OR 2.0, 95% CI 1.5, 2.6), sex with an HIV-infected partner (OR 14.6, 95% CI 8.3, 25.6) and sex with a known injection drug user (OR 4.1, 95% CI 2.0, 8.4). Further investigation of emergency department-based HIV testing and risk reduction programs targeting MSM is warranted.     

沈阳市男男性行为人群HIV感染率及其影响因素分析

目的了解沈阳市男男性行为人群（MSM）艾滋病病毒（HIV）感染率及其影响因素,进一步做好MSM的艾滋病防治工作。方法采用同伴推动法（RDS）招募900名MSM,由经过专业培训的调查员进行面对面的问卷调查,主要内容包括社会人口学特征、艾滋病知识知晓水平、性行为状况、接受干预服务情况和HIV/梅毒感染状况,并抽取静脉血检测HIV及梅毒,对影响HIV感染的相关因素进行χ2检验。结果调查了900名MSM,艾滋病知识知晓率达到91.3%。86.9%的调查对象最近6个月有同性肛交性行为,最近6个月与男性发生肛交性行为时每次都使用安全套的比例为57.5%。HIV感染率为9.3%,梅毒感染率为11.0%。分析显示,年龄较大、文化程度在初中及以下、最近6个月与男性发生肛交性行为时未坚持使用安全套、梅毒感染是感染HIV的危险因素。结论 MSM人群高危性行为发生率、HIV和梅毒感染率均高,可能成为当前HIV流行的重要人群和重要因素,应采取积极有效的宣传教育和行为干预活动。