四川地区血站分离血浆HIV/HBV/HCV残余风险研究

目的评估四川地区血站分离血浆中HIV、HBV、HCV的残余风险。方法收集2013年1-12月四川9家血站HBs Ag、抗-HCV、抗-HIV筛查阳性样本,对筛查HBs Ag阳性标本采用中和试验确证,对筛查抗-HCV及抗-HIV阳性标本采用免疫印迹法确证。采用改良的发病率-窗口期模型计算HBV,HCV,HIV残余风险。结果四川地区血站分离血浆中HBV,HCV和HIV的残余风险分别为1/1 355,1/35 587和1/92 593。结论血站分离血浆仍存在一定残余风险,增加核酸检测等新型检测技术可进一步降低其残余风险。     

The significance of repeat testing in Turkish blood donors screened with HBV,HCV and HIV immunoassays and the importance of S/CO ratios in the interpretation of HCV/HIV screening test results and as a determinant for further confirmatory testing

The purpose of this study was to investigate the intra‐assay correlations amongst initial reactive and repeat screening results used in enzyme immunoassays (EIAs) for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV in blood donors. This study evaluated the value of using the power of the signal to cut‐off (S/CO) ratio index for confirming anti‐HCV/HIV reactive screening results, thereby touching upon the utility of S/CO indices in determining whether further confirmatory testing was necessary. Screening test results of the 72 695 blood donors were evaluated over a 1‐year period. Correlation analysis among each initial test and retests was done by Pearson r test. Appropriate S/CO values to determine the need of the confirmation testing was investigated by ROC analyses. EIA intra‐assay correlations were of statistical significance and were determined as follows: 0·948 for anti‐HCV, 0·827 for anti‐HIV and 0·948 for HBsAg. The threshold S/CO ratio values which predicted more than 95% of the confirmation test result were 3·8 for HCV and 5·6 for HIV. We were able to demonstrate a strong level of intra‐assay correlation amongst EIAs, thereby eliminating the need for repetition of the screening test. Hence, we suggest that repeat screening should only be limited to HBV and HIV tests with low EIA S/CO ratios. Thus, using the power of the S/CO ratio in determining the need for HCV confirmation testing can be a cost‐effective measure, especially if the S/CO value is ≥3·8.     

深圳市龙华区男男性行为人群HIV感染分布特征及影响因素

目的探讨深圳市龙华区男男性行为人群(MSM)人类免疫缺陷病毒(HIV)感染的分布特征,探究其影响因素。方法整理2014年1月—2019年12月深圳市龙华区MSM人群HIV感染资料,并进行统计学分析。结果本研究共搜集2316例男男性行为人群,HIV感染率为5.91%。经过单因素及多因素分析结果显示,年龄偏大、无性行为保护措施、吸毒、合并梅毒感染为MSM人群HIV感染的影响因素(P<0.05)。结论深圳市龙华区MSM人群HIV感染情况不容乐观,年龄大、无性行为保护措施、吸毒、合并梅毒感染为MSM人群HIV感染的高危因素。     

男男同性性行为人群4种性传播疾病感染状况及相关危险因素分析

目的 了解浙江省温州市鹿城区男男同性性行为人群(men who have sex with men,MSM)人类免疫缺陷病毒(human immunodeficiency virus,HIV,艾滋病病毒)、梅毒螺旋体(Treponema pallidum,TP)、丙型病毒性肝炎(丙肝)病毒 (Hepatitis C virus,HCV)、乙型病毒性肝炎(乙肝)病毒 (Hepatitis B virus,HBV)感染状况及其影响因素,为实施有效干预,预防控制相关疾病在该类人群中流行提供依据。方法 在知情同意的前提下,由经过培训的调查员和志愿者对MSM人群进行匿名问卷调查及抽血检测。结果 401名调查对象艾滋病相关知识知晓率为72.32%;最近６个月与男性发生肛交性行为时坚持使用安全套者占48.66%,与女性发生性行为时坚持使用安全套者占33.96%;最近6个月有32.55%的调查对象曾提供过商业性同性性服务;HIV、TP、HCV、 乙肝病毒表面抗原阳性率分别为9.23%、10.47%、0.25%和3.24%。结论 MSM人群HIV、梅毒感染率较高,危险行为较普遍,应及时采取有效的预防和干预措施。     

浙江省台州地区男男性行为人群艾滋病病毒感染及艾滋病相关危险行为横断面调查

目的 了解浙江省台州地区男男性行为人群中艾滋病相关危险行为状况及艾滋病病毒(HIV)感染状况。 方法 于2012年1月至2012年8月31日对台州地区到浴室、浴池、酒吧或通过网络招募的男男性行为者(MSM),以面对面访问的方式开展艾滋病相关行为横断面调查。 结果 共312名MSM人群参与此次调查,其中已婚143人,占45.8%,本省户籍205人,占65.7%,312名MSM中艾滋病相关知识知晓率为89.1%。312名MSM者中,最近6个月与同性发生过肛交性行为的253人,占81.1%;最近一次性行为使用安全套的155人,占61.3%;每次都用的7人,仅占2.77%。最近6个月与女性发生过性行为的106人,占33.97%,最近一次性行为使用安全套的38人,占35.9%。发生商业性行为时每次使用18.9%(20/106)。312名MSM接受了血清学检测,其中HIV阳性50例,阳性检出率为16.0%,梅毒阳性42例,阳性检出率为13.5%,丙肝阳性1例,阳性检出率为0.3%。 结论 尽管MSM人群艾滋病防治知识知晓率较高,但艾滋病相关危险行为普遍存在,并存在通过与女性的性接触而传递到女性及相关人群的危险。     

Syphilis incidence in men who have sex with men with human immunodeficiency virus comorbidity and the importance of integrating sexually transmitted infection prevention into HIV care

Introduction: Syphilis continues to be a growing epidemic among men who have sex with men (MSM), particularly for those living with the human immunodeficiency virus (HIV). In 2016, MSM accounted for 80% of primary and secondary syphilis diagnoses in men in the United States; almost half of who were also HIV-infected. The synergistic relationship between HIV and syphilis has significant implications not only for HIV patient management, but also for sexually transmitted infection (STI) control among MSM.

Areas covered: We review the literature on STI screening and treatment barriers at the patient-, provider-, and health system-levels, and present strategies to incorporate STI prevention into HIV care settings.

Expert commentary: Integration of STI prevention into HIV care is paramount to stop the epidemic of not only syphilis, but also other curable STIs like gonorrhea and chlamydia. Although guidelines have been established for STI testing in HIV-infected MSM, screening rates continue to be lower than desired. Gonorrhea and chlamydia screening is below 50% in HIV-infected MSM; interventions that improve testing of those two infections must be implemented. For syphilis control, other additional strategies such as chemoprophylaxis should be considered given syphilis screening is above 50% in HIV-infected MSM.     

Relative risk of reducing the lifetime blood donation deferral for men who have had sex with men versus currently tolerated transfusion risks

The risks of known and emerging transfusion-transmitted infections (TTIs) from reducing the current lifetime blood donation deferral for men who have had sex with men (MSM) to 1 or 5 years were compared to the risk from continuing to transfuse in the United States 12.5% of platelet doses as pooled whole-blood-derived (rather than single-donor) platelets. Assumptions made in mathematical models and blood donor/transfusion studies of the risks of TTIs since 2000 were evaluated. The number of HIV, hepatitis B virus, or hepatitis C virus TTIs from reducing the MSM deferral to 1 year is, respectively, 0.88, 2.94, or 66.9, many more than 10 times smaller than the risk from pooled platelets. If erroneous release of HIV-positive units (a risk independent of a donor's source of infection) is not considered, the MSM risk is 1 HIV-infectious donation per 17 to 56 million MSM donations. Any purportedly increased risk of human herpesvirus-8 transmission from MSM donors is far smaller than the risk of transfusion-associated sepsis from pooled platelets. Single-donor platelets from MSM after 5 years' abstinence are as safe or 5 times safer than our current pooled platelets--if the next TTI to emerge were transmitted, respectively, sexually or by another route. Thus, acceptance of MSM as blood donors after 1 or 5 years' abstinence may result in a postulated increase in risk that is so much smaller than the currently tolerated transfusion risk and so small in absolute terms that the ethical question of fairness to the MSM group justifies the change in policy.     

Quantitative estimate of the risks and benefits of possible alternative blood donor deferral strategies for men who have had sex with men

BACKGROUND: Implementation of sensitive screening methods for human immunodeficiency virus (HIV) and hepatitis viruses prompts the question of what quantitative risks may result from altered deferral strategies for donation of blood by men who have had sex with men (MSM).
STUDY DESIGN AND METHODS: Quantitative probabilistic models were developed to assess changes in the residual risk of transfusion-transmitted HIV and hepatitis B virus (HBV) associated with blood testing and quarantine release errors (QREs) in the initial year of two hypothetical policy scenarios that would allow donations from donors who have abstained from MSM behavior for at least 5 years (MSM5) or at least 1 year (MSM1).
RESULTS: The MSM5 and MSM1 models, respectively, predicted annual increases in units of HIV-infected blood of 0.5% (0.03 mean additional units; 95% confidence interval [CI], 0-1) and 3.0% (0.18 mean additional units; 95% CI, 0-1) over current estimated HIV residual risk using recent, nationwide biologic product deviation reports to estimate QRE rates. These estimates are approximately 10-fold lower than estimates based on New York State QRE data from the previous decade. The models predicted smaller increases in infectious HBV donations.
CONCLUSIONS: QREs remain the most significant preventable source of risk. More accurate inputs, including the percentage of MSM in the population, the percentage of MSM who have abstained from MSM activity for 1 or 5 years, the prevalence of HIV and HBV in MSM who have abstained from MSM activity for 1 or 5 years, the rate of self-deferral, and QRE rates, are required before making more precise predictions.     

济南市男男性行为者艾滋病感染状况及其危险因素调查

目的了解济南市男男性行为人群艾滋病感染状况和影响因素,为济南市艾滋病防治政策和策略的制定提供参考依据。方法采用连续采样的方法在取得研究对象人群知情同意的前提下,对2012年11月至2013年3月到济南市疾病预防控制中心(CDC)艾滋病自愿咨询检测门诊的男男性行为者(MSM)共300人进行了问卷调查及采血检测艾滋病、梅毒抗体。利用EpiData软件录入数据,用SPSS 17.0软件做logistic回归分析。结果本次调查共有31例艾滋病抗体阳性,感染率为10.33%。在多因素分析中,首次性行为年龄20岁和最近6个月与男性发生肛交性行为时不能每次都使用安全套是艾滋病感染的危险因素。结论男男同性传播艾滋病所占比例逐年提高,已成为济南市报告HIV感染最主要的传播途径。在男男性行为人群中提倡减少性伴和发生性行为时每次都使用安全套应是今后干预工作中的重点。     

Intervening to identify and reduce drug use and sexual HIV risk patterns among men who have sex with men in three provinces in South Africa

Formative work to inform interventions aimed at addressing drug and sexual risk behaviours among men who have sex with men (MSM) in South Africa highlighted the need to target drug-using MSM with prevention interventions addressing both sexual and drug-related HIV risk. From 2007, in collaboration with two local NGOs, intervention activities were rolled out to vulnerable drug-using MSM. Over the first two years, 3475 drug-using MSM were reached through community outreach that promotes HIV/AIDS prevention and addresses drug risk behaviours and 745 among them were tested for HIV and received their results and 239 of them were referred from HCT to other services. Additionally, 66 individuals were trained to promote HIV/AIDS prevention services and 15 were trained in HCT. Twelve new targeted condom and lubrication services and 7 new HCT outlets were established. MSM reported a variety of high-risk activities including not using condoms for anal sex, having sex while under the influence of alcohol or drugs and sharing needles (among injection drug users). However, MSM were willing to develop risk reduction strategies. Year one and two of the intervention has demonstrated the willingness of the NGOs to broaden their service delivery, improved integration of drug treatment, HIV intervention and other services, and has shown positive results across a number of risk behaviours among MSM.     

Your blues ain't like mine: considering integrative antiracism in HIV prevention research with black men who have sex with men in Canada and the United States

Evidence‐based interventions have been developed and used to prevent HIV infections among black men who have sex with men (MSM) in Canada and the United States; however, the degree to which interventions address racism and other interlocking oppressions that influence HIV vulnerability is not well known. We utilize integrative antiracism to guide a review of HIV prevention intervention studies with black MSM and to determine how racism and religious oppression are addressed in the current intervention evidence base. We searched CINAHL, PsychInfo, MEDLINE and the CDC compendium of evidence‐based HIV prevention interventions and identified seventeen interventions. Three interventions targeted black MSM, yet only one intervention addressed racism, religious oppression, cultural assets and religious assets. Most interventions' samples included low numbers of black MSM. More research is needed on interventions that address racism and religious oppression on HIV vulnerability among black MSM. Future research should focus on explicating mechanisms by which multiple oppressions impact HIV vulnerability. We recommend the development and integration of social justice tools for nursing practice that aid in addressing the impacts of racism and other oppressions on HIV vulnerability of black MSM.