2008~2009年江苏省3城市男男性行为人群HIV-1新发感染率调查

目的:了解江苏省男男性行为人群(men who have sex with men,MSM)HIV的感染状况,估算HIV在该人群中的新发感染率?方法:对2008~2009年南京?扬州?苏州3城市MSM 3轮调查的3 152份样本,进行HIV-1初筛?复检及确证试验,检出的HIV-1阳性样本,再应用BED HIV-1 IgG捕获酶免疫法(BED-CEIA)检出其中的新发感染样本,进而估算该人群的HIV-1新发感染率?结果:3 152份样本共检出HIV-1阳性样本175份,其中92份被判定为新发感染,南京市3轮调查的HIV-1新发感染率分别为7.05%?5.18%?3.71%,扬州市分别为6.99%?2.39%?12.27%,苏州市分别为6.73%?3.31%?9.84%?结论:HIV-1在江苏省MSM人群中的流行仍处于较高水平,且新发感染状况不容乐观,必须加大防控力度?     

2009-2011年青海地区男男性行为者HIV-1新发感染率调查

目的了解青海省男男性行为者(Men have sex with men,MSM)人群HIV新发感染情况。方法此次对青海省2009-2011年连续3年第二季度MSM人群进行横断面调查,采用ELISA和WB对采集的国家哨点MSM人群监测样本进行初筛与确证实验,再对血清学确认为HIV-1阳性的样本进行BED HIV-1捕获酶联法(BED方法)检测,从而估算新发感染情况。结果在1 382份样本中筛出128份HIV-1阳性样本,实际进行BED检测113例,判定为新近感染者59例。3年新发感染率分别为8.14%、9.77%、11.13%。结论青海地区2009-2011年MSM人群HIV新发感染率维持在较高水平,其中2011年超过10%,提示该人群存在HIV感染高水平流行,并可能成为向主流人群蔓延的桥梁人群,应采取有效措施控制艾滋病在MSM人群中的广泛传播,进一步阻断疫情向一般人群蔓延。     

BED发病捕获酶联法检测宁夏男男性行为人群HIV新发感染

目的了解宁夏2011年哨点男男性行为人群(MSM)艾滋病病毒(HIV)新发感染情况,计算新发感染率。方法收集哨点监测人群男男性行为400例,应用BED HIV-1发病捕获酶免疫测定法(BED-CEIA)对HIV-1阳性的样本进行新发感染检测,计算新发感染率。结果 HIV-1感染率为3.75%,感染者中新发感染的比例为33.33%,新发感染率为2.48%(95%CI:0.31%～4.66%)。结论 BED-CEIA方法可应用于哨点男男性行为人群及其他人群,对其新近感染率的计算和估计具有实用性,对艾滋病防治政策的制定和调整具有参考作用。     

Estimation of HIV incidence of MSM with BED incidence capture enzyme immunoassay n Ningxia

目的 了解宁夏2011年哨点男男性行为人群(MSM)艾滋病病毒(HIV)新发感染情况,计算新发感染率.方法 收集哨点监测人群男男性行为400例,应用BED HIV-1发病捕获酶免疫测定法(BED-CEIA)对HIV-1阳性的样本进行新发感染检测,计算新发感染率.结果 HIV-1感染率为3.75%,感染者中新发感染的比例为33.33%,新发感染率为2.48% (95%CI:0.31%～4.66%).结论 BED-CEIA 方法可应用于哨点男男性行为人群及其他人群,对其新近感染率的计算和估计具有实用性,对艾滋病防治政策的制定和调整具有参考作用.     

南宁市男男性行为人群HIV-1新发感染率及感染危险因素分析

目的了解南宁市男男性行为人群(men who have sex with men,MSM)人类免疫缺陷病毒(HIV)新发感染情况及感染危险因素。方法对南宁市2013-2015年连续4轮MSM人群2 524名进行横断面调查,并采集3～5 ml静脉血进行HIV抗体和梅毒检测。应用BED捕获酶联免疫法(BED-CEIA)对HIV抗体确证阳性样本进行HIV-1新发感染检测,估算HIV-1新发感染率,对调查资料进行χ2检验和Logistic回归分析。结果 4轮调查中HIV阳性率分别为6. 98%、11. 65%、11. 98%、11. 40%,新发感染率分别为2. 48%、6. 34%、7. 10%、7. 64%。多因素Logistic回归分析提示本地居住时间(OR=0. 583～0. 897),艾滋病防治知晓率(OR=0. 336～0. 978),性角色(OR=1. 334～1. 710),最近6个月与同性肛交使用安全套频率(OR=0. 501～0. 750),现症梅毒感染(OR=2. 561～4. 091)是HIV感染的危险因素。结论南宁市MSM人群HIV感染率处于较高水平,新发感染率有上升趋势。应该加强主动监测,加大干预力度。     

常德市MSM人群艾滋病、性病感染状况调查

目的 了解常德市男男性行为者(MSM)人群艾滋病、梅毒和丙型肝炎病毒的感染状况,为制定有效的防治措施提供信息和依据.方法 对287例MSM分别进行人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)和梅毒螺旋体(TP)抗体检测.结果 MSM的总感染率为16.4%,其中HIV阳性10份(3.5%),HCV阳性3份(1.0%),TP阳性37份(12.9%).结论 常德市MSM人群的HIV和梅毒感染率较高,是艾滋病防治的重点人群,应立即采取积极有效的预防和干预措施.     

某市2013～2015年男男性行为人群人类免疫缺陷病毒新发感染研究

目的了解淮安市男男性行为（MSM）人群中人类免疫缺陷病毒（HIV）新发感染情况及其影响因素。方法2013～2015 年通过网络招募MSM,进行问卷调查以及实验室检测;检出的HIV 阳性样本再应用BED HIV IgG 捕获酶免疫法（BED-CEIA）检出其中的新发感染样本,计算新发感染率。以HIV 阴性为对照,采用Logistic 回归分析探讨其影响因素。结果2013～2015 年共招募1 202 名调查对象,新发感染率分别为1.81%、1.89%和3.18%,3年间差异无统计学意义（P >0.05）。多因素分析显示在本地居住时间和梅毒感染是HIV感染的主要危险因素。结论淮安市MSM人群HIV 新发感染率较其他地区低,但仍在不断增长,影响新发感染的主要因素为本地居住时间和梅毒感染,应加强MSM 人群的干预力度,同时开展多种疾病联合监测,遏制疾病扩散。     

应用BED-CEIA方法估算河南省2009年多类高危人群HIV-1新近感染率

目的了解河南省2009年三类哨点（男男性行为者、吸毒和性病门诊男性就诊者）和单阳配偶人群的艾滋病病毒（HIV）新近感染情况。方法收集2009年河南省男男性行为者、吸毒和性病门诊男性就诊者及单阳配偶人群各534、1 757、4 767及11 468例,通过酶联免疫和蛋白印迹实验检测出HIV-1感染的样品,再应用BED HIV-1发病捕获酶免疫测定法（BED HIV-1 capture enzyme immunoassay,简称BED-CEIA）检测出其中的新近感染样品,进而估算新近感染率。结果河南省2009年男男性行为者、吸毒和性病门诊男性就诊者哨点的新发感染率分别为4.50%、0.46%和0.13%。单阳配偶人群的新近感染率为0.39%。结论河南省2009年男男性行为人群新发感染率较高,同时不同地区单阳配偶人群的新近感染率有较大差别。     

集合HIV-1 RNA RT-PCR方法在男男性行为人群艾滋病窗口期检测中的应用

目的:检出男男性行为人群中的艾滋病病毒(HIV)窗口期感染者并初步估计发病率?方法:采用20∶1?5∶1?1∶1三级集合HIV-1 RNA RT-PCR方法进行试验?结果:检测948份男男性行为人群HIV抗体阴性血浆,发现HIV-1 RNA阳性4例,追踪随访,HIV-1抗体阳转;初步估计HIV-1年发病率约为5.55%(95%CI,3.50%~7.59%)?结论:集合HIV-1 RNA RT-PCR方法具有良好的实验效果,可以用于HIV高危人群窗口期感染者的检测?     

东莞市男男性行为人群HIV抗体定期检测及其影响因素

目的了解东莞市男男性行为人群(MSM)人类免疫缺陷病毒(HIV)近1年检测情况及其影响因素,为MSM人群定期检测干预提供依据。方法采用互联网招募MSM人群作为研究对象,开展网络问卷调查,获得MSM人群近1年HIV抗体检测情况及影响因素等方面情况。结果共招募1 510人。调查中最近1年HIV检测比例为48.61%(734/1 510);HIV抗体阳性检出率为12.38%(187/1 510),其中1年没有做过HIV检测者中HIV抗体阳性检出率(14.56%)高于1年中做过检测者(10.08%),差异具有统计学意义(χ~2=9.66,P0.05)。多因素logistic回归分析结果显示,既往艾滋病主动咨询行为(OR=3.89,95%CI:1.21~7.82)、接受过专业人员宣传干预(OR=0.10,95%CI:0.03~0.36)以及了解艾滋病抗病毒治疗(OR=0.32,95%CI:0.11~0.74)是MSM定期检测的促进因素;自认为所生活的区域的MSM人群感染艾滋病的比率低(OR=0.69,95%CI:0.48~0.96)、近6个月与男性肛交时安全套的使用频率低(OR=0.67,95%CI:0.47~0.95)是MSM定期检测的阻碍因素。结论东莞市男男性行为人群近1年HIV检测比例较低,而整体HIV感染率较高,且近1年未接受HIV检测的MSM具有更高的HIV感染风险。应继续深入加强以"同志"社区为基础的艾滋病感染风险教育,进一步提高艾滋病高流行地区MSM人群定期主动HIV检测的比例,有效控制艾滋病流行。     

Detection of recent HIV-1 infections among men who have sex with men in Beijing during 2005–2006

Background Men who have sex with men （MSM） have become one of the most risky populations for HIV infection in China. Though several cross-sectional sero-prevalence studies have been conducted, the annual HIV incidence remains unknown in this population.
Methods We applied IgG-capture BED-enzyme immunoassay （BED-CEIA） to define the recent HIV-1 infections among MSM in Beijing in the years 2005 and 2006 and the annual HIV incidence was estimated.
Results Overall, 1067 MSM samples were collected, including 526 samples in the year 2005 and 541 in 2006. In 2005, of 17 HIV seropositive samples, 7 were identified as recent HIV-1 infections and the estimated HIV infection incidence was 2.9% per year （95% CI, 0.8%-5.0%）. In 2006, of 26 HIV seropositive samples, 9 were identified as recent HIV-1 infections and the estimated annual incidence was 3.6% （95% CI, 1.3%-5.9%）, which was 0.7% higher than that in 2005. Individuals engaging in male group sexual intercourse （5.17% vs 0.87%, P=0.019） and having receptive anal sexual intercourse more than five times （2.79% vs 0.33%, P=0.047） in the past 6 months significantly increase the risk of being infected by HIV-1.
Conclusions A high level of annual HIV-1 infection incidence was observed among MSM in Beijing for the consecutive years 2005 and 2006 with a continuous increasing trend. The rising incidence and related high risk behavior among MSM alarmed the health authorities and calls for more effective intervention strategies among this population.     

北京市部分男男同性恋人群中HIV-1分子流行病学研究

目的了解北京市部分男男同性恋(men who have sex with men,MSM)人群HIV-1的分子流行情况,监测该地区人群HIV毒株的最新流行情况。方法提取17例男男同性恋者HIV-1抗体阳性样本全血基因组DNA,直接进行巢式PCR扩增HIVenv基因C2-V5区及gag基因P17-P24区,对PCR产物进行核苷酸序列测定和分析,确定基因亚型。结果17例患者中,共存在CRF01-AE、B亚型和CRF07-BC3种亚型,其中CRF01-AE9例(52.94%),B亚型5例(29.41%),CRF07-BC3例(17.65%)。结论小样本量的流行病学调查显示,北京地区部分男男同性恋人群中主要存在CRF01-AE、B和CRF07-BC3种亚型;CRF01-AE已取代B亚型而成为北京市MSM人群中HIV主要流行亚型,CRF07-BC重组亚型在北京市MSM人群中增长迅速。     

Estimating HIV Incidence Rates among MSM in an Urban Area of Chongqing Using Three Approaches

To evaluate the HIV pandemic in Chongqing, the pooled PCR, Ig G-capture BED enzyme immunoassay (BED-CEIA), and cohort observations were used to estimate the HIV incidences among men who have sex with men (MSM). 617 MSM subjects completed the survey at a voluntary counseling and testing (VCT) site. The observed HIV incidence was 12.5 per 100 P-Ys (95% CI = 9.1-15.7). The annual acute HIV infection (AHI) incidence estimated by pooled PCR was 14.0% (95% CI = 10.9-17.1). The HIV-1 annual incidence estimated based on the BED-CEIA was 12.0% (95% CI = 7.5-16.5). The HIV incidences estimated by these three approaches were consistent and complementary. The HIV incidence rates were alarmingly high with an uptrend among the urban MSM of Chongqing.     

Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type 1 in semen.

OBJECTIVE--To determine the prevalence and temporal expression of infectious human immunodeficiency virus type 1 (HIV-1) in the semen of HIV-1 seropositive men and to determine whether the detection of HIV-1 in semen is associated with disease stage, zidovudine treatment status, or other clinical factors. DESIGN--A microculture technique was used to detect infectious HIV-1 in semen from a cohort of 95 seropositive men. In addition, semen cultures were performed monthly for at least 6 months for 14 of the men. Information was obtained by interview and extracted from medical records to identify clinical variables associated with HIV-1 in semen. PATIENTS--Sixty HIV-1 seropositive homosexual men participating in clinical studies at the Fenway Community Health Center, Boston, Mass, and 35 HIV seropositive bisexual or heterosexual men participating in the California Partner Study of the University of California, San Francisco. MAIN OUTCOME MEASURES--Semen HIV-1 culture results, seminal leukocyte counts, Centers for Disease Control (CDC) disease stage, peripheral CD4+ cell counts, zidovudine therapy, HIV risk category. RESULTS--In the cross-sectional study, HIV-1 was cultured from the semen of nine (9%) of 95 men. Factors associated with detection of HIV-1 in semen were peripheral CD4+ cell counts of 0.20 x 10(9)/L (200/microL) or less (adjusted odds ratio [OR], 23.33; 95% confidence interval [Cl], 2.89 to 175.63); symptomatic (CDC class IV) disease (adjusted OR, 6.56; 95% Cl, 1.02 to 66.76); and seminal leukocytosis (greater than 1 x 10(9) white blood cells per liter of semen) (adjusted OR, 7.02; 95% Cl, 1.28 to 39.29). Zidovudine therapy was associated with decreased detection of HIV-1 in semen (adjusted OR, 0.04; 95% Cl, 0.00 to 0.63). In the longitudinal study of 14 men who had neither peripheral CD4+ cells counts of 0.20 x 10(9)/L or less nor seminal leukocytosis, seminal HIV-1 was detected in at least one sample from six men (43%). CONCLUSION--HIV-1 is more commonly found in semen from men with advanced HIV-1 infection and seminal leukocytosis but can also be cultured from semen of men with neither of these conditions. Zidovudine therapy may decrease the prevalence and/or titer of seminal HIV-1. However, all HIV-1-infected persons should continue to assume that they are potentially infectious through sexual contact.     

Estimating HIV Incidence Rates among MSM in an Urban Area of Chongqing Using Three Approaches

<正>To evaluate the HIV pandemic in Chongqing,the pooled PCR,Ig G‐capture BED enzyme immunoassay(BED‐CEIA),and cohort observations were used to estimate the HIV incidences among men who have sex with men(MSM).617 MSM subjects completed the survey at a voluntary counseling and testing(VCT)site.The observed HIV incidence was 12.5 per 100 P‐Ys(95%CI=9.1‐15.7).The annual acute HIV infection(AHI)incidence estimated by pooled PCR was 14.0%(95%CI=     

某同性恋浴室男男性接触者ＨＩＶ／梅毒感染状况的研究

目的:了解经常在浴室活动的男男性接触人群(MSMs)HIV/梅毒相关知识、态度、行为及其感染状况,为制定有效的防治措施提供信息和依据.方法:在某MSMs聚集的浴室对目标人群进行匿名问卷调查,并采集静脉血进行HIV/梅毒检测.结果:该人群艾滋病知识总知晓率为75.3%.只有21.6%的男男性接触者(MSM)在每次肛交时坚持使用安全套,而从未使用、有时使用安全套者占78.4%.近3个月与异性发生过阴道交行为的MSM有117人,仅19.7%每次使用安全套.HIV阳性率为4.7%,TPPA阳性率为39.9%,RPR阳性率为27.0%.年龄、近3个月性伴数、婚姻状况、文化程度、安全套使用情况、籍贯等因素与HIV/梅毒感染率之间无统计学联系.结论:经常出入浴室的MSMs中高危性行为普遍存在,HIV/梅毒感染率高,应尽快采取针对性的行为干预措施.     

长沙市男男性行为者人群性行为特征分析

目的了解长沙市男男性行为者(men who have sex with men,MSM)的行为状态及艾滋病病毒感染状况。方法在男男性行为者社区中进行匿名问卷调查。结果被调查者年龄为25.9±6.8,绝大部分(89.9%)年龄为20～40岁;55.2%的人只有同性性行为,异性恋的占4.4%;第一次与男性发生性行为的年龄为24.1±6.8岁,最近6个月与男性发生肛交行为时每次都使用安全套的仅为39.4%;同时与女性发生过性行为的占19.8%,HIV确证感染率3.1%,梅毒确证阳性率15.6%。结论男男性行为者中无保护性肛交行为普遍存在,HIV感染率高,是长沙市艾滋病防治的重点人群之一,应加强对这类人群的行为干预,降低其危险行为发生,从而降低HIV感染率。