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。     

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。     

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。     

乘数法与定性访谈相结合估计江苏省某市MSM人群规模的研究

目的估计江苏省某市男男性行为人群(MSM)规模,为指导艾滋病综合防治提供信息。方法乘数法与定性访谈相结合。利用乘数法对规定时间内接触/登陆到指定酒吧、浴室及网站的MSM人群计数(r),通过同伴推动抽样调查获得规定时间内接触/登陆上述场所的比例(p),从而获得相应乘数(1/p),计算出估计数(N=r/p),再结合定性访谈确定估计数。结果乘数法通过酒吧估计数为6618人,浴室估计数为9797人,网络估计数为26683人。定性访谈估计数范围为2万～4.7万人。各种估计值的中位数是2.5万人,第25和75百分位数分别为2万和3.2万人。结论江苏省某市MSM人群规模是2.5万人,可能的范围在2万～3.2万之间。该研究采用多种方法进行规模估计,避免一些可能高估或低估的因素,估计的MSM人群规模及其范围相对接近真实情况。     

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。     

基于男同社交媒体的无锡市市区男男性行为者规模估计研究

目的估计无锡市市区男男性行为者(MSM)规模,为艾滋病疫情估计提供依据。方法利用乘数法结合MSM交友软件估计无锡市市区男男性行为人群规模。通过男同社交媒体Blued后台统计连续一周内每天登录过软件的人数,从而获得目标人群数r;通过RDS方法招募研究对象并开展问卷调查,获得乘数m,由此计算MSM规模估计数N=r×m。结果无锡市市区MSM规模估计数为25 460人[95%可信区间(CI):24 915～26 032]。其中,常住的MSM 21 717人(95%CI=21 310～22 252),流动的MSM有3 743人(95%CI=3 259～4 226);城镇MSM 16 218人(95%CI=14 945～17 618),农村的MSM有9 242人(95%CI=8 529～9 929);自认为同性恋的MSM有14 970人(95%CI=13 774～16 269),自认为双性恋的MSM有8 427人(95%CI=7 587～9 344);为同性提供过商业性服务的MSM 2 521人(95%CI=1 986～3 183)。结论利用乘数法结合MSM社交媒体估计MSM的规模具有一定的可行性和可信性。     

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。     

深圳市2010年男男性行为人群基数估计调查

目的估计深圳市男男性行为人群(MSM)的规模,为调整防治策略和公共卫生资源的投放提供依据。方法使用捕获-再捕获方法对深圳市20个MSM场所进行调查,估计MSM人群的数量。结果两次调查共捕获MSM 2 982人,第一次1 577人,第二次1 405人,共标记312人,估计活跃在MSM场所的约有6 468~7 706人。对1 577知情者、MSM人群及场所业主进行定性访谈,估算深圳市约有MSM人群10万~20万人。结论深圳市MSM人群占男性人口的比例与全国的水平相近。社会歧视减少,使MSM人群更容易被接触。     

普查法与乘数法估计暗娼人群基数方法学的试点研究

目的 通过普查法与乘数法的现场应用，探索不同地区暗娼人群规模估计的有效方法，为疫情估计及预防控制策略制定提供科学依据。方法 普查法是存短时间内对城区所有可能存在暗娼的场所的暗娼人数进行清点计数；乘数法是3个月内到指定性病门诊就诊的暗娼人数，乘以暗娼人群中在3个月内到指定门诊就诊的比例的倒数，得到暗娼人数。结果 兴义市暗娼人数普查法结果为1521人，乘数法结果为2542人。结论 普查法结果直接，原理简单，省时省力，对经费的要求小，适合在小城市或县城开展，但容易造成遗漏。乘数法需要开展流行病学调查，花费较多人力物力，但可利用现有的监测及流行病学调查资源，适合在大中型城市开展，且估计结果相对准确。     

探索应用常规工作数据估计MSM人群HIV新发感染率

目的探索应用常规工作数据建立简便、实用的数学模型,估计男男性行为人群（MSM）艾滋病病毒（HIV）新发感染率。方法假设某小年龄组MSM人群的HIV新发感染率与整体MSM人群相同,以15~49岁年龄组的MSM人群规模、HIV/AIDS病例现存人数、HIV感染率、小年龄组当年新发现HIV感染者人数（CD4淋巴细胞〉200/μL）,横断面调查小年龄组样本在15~49岁年龄组样本中的构成等作为参数建立模型,并进行适用性评估。结果模型估计2006-2012年哈尔滨市MSM人群的HIV新发感染率分别为0.3%、0.8%、0.4%、0.9%、1.3%、1.7%、3.1%,呈线性上升趋势（P=0.000）,相应年度的新发感染率支持年度间的HIV感染率变化。新报告HIV/AIDS病例数量及经同性性传播构成的变化、15~20岁感染者数量及特点的变化、梅毒感染率、无保护肛交比例、≥2个性伴比例水平,另外两种HIV新发感染率估计法的估计结果等均支持此判断。结论研究设计的HIV新发感染率估计模型,应用常规工作数据,估计值有参考价值,值得有需求地区探索使用。     

Pre-exposure prophylaxis sorting among men who have sex with men

Factors such as race, masculinity, and sexually transmitted infections have been documented to influence partner selection in men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has received mixed evaluations as a responsible step in HIV prevention and as an enabler of risker sexual practices. PrEP may consequently serve as an additional factor in partner choice. We examine the role that PrEP use and “promiscuity” play in affiliation and dating decisions by men who have sex with men with different HIV and PrEP stati. We invited 450 MSM across the United States from a smartphone geo-locating sex application to complete a survey of which 339 successfully finished the task. The survey contained vignettes of fictional men who were promiscuous or monogamous and either taking PrEP or not. Participants provided responses on whether to affiliate with these characters in three social domains: as friends, dates, or sex partners. Neither PrEP nor promiscuity influenced friendship choices. There was a preference for dating monogamous characters. Critically, PrEP influenced sexual affiliations for HIV negative individuals who showed a preference for PrEP-using characters. The pattern of results provides quantitative evidence for PrEP-based sexual sorting aimed at reducing risk of HIV transmission.     

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.     

Entamoeba histolytica infection in men who have sex with men

Entamoeba histolytica infection (amoebiasis) is the second leading cause of death from parasitic diseases. Epidemiological studies from developed countries have reported an increasing prevalence of amoebiasis and of invasive infections, such as amoebic colitis, among men who have sex with men (MSM) who engage in oral-anal sex. Although most infections with E histolytica are asymptomatic, clinical manifestations of invasive amoebiasis mainly include amoebic colitis and amoebic liver abscess, which are associated with substantial morbidity and medical cost. Laboratory diagnosis of amoebiasis should be based on detection of E histolytica by use of tests with high sensitivity and specificity, such as specific amoebic-antigen or PCR-based assays. Microscopy used in routine clinical laboratories is not sensitive or specific enough for detection of E histolytica. Metronidazole or tinidazole remains the mainstay of treatment for invasive amoebiasis, followed by treatment with luminal agents to prevent relapse and transmission of E histolytica to sexual partners or close contacts.     

Sexually transmitted diseases in men who have sex with men

Men who have sex with men (MSM) have increased rates of human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs) compared with demographically matched controls. The reasons for the disproportionate infection burden are complex, including biological, behavioral, and sociocultural factors. HIV and syphilis may often be coprevalent among MSM. The use of nucleic acid amplification testing has enhanced the ability to detect frequently asymptomatic gonococcal and chlamydial infections of the rectum and other sites. Lymphogranuloma proctitis outbreaks among MSM were noted in the developed world several years ago but have not been common recently. MSM are at increased risk for viral hepatitis and anal human papillomavirus disease. Preventive interventions include vaccination for the former and anal cytologic screening for the latter. Because of the diverse ways in which MSM may be exposed to STDs, it is essential for clinicians to obtain a thorough sexual history in a culturally competent manner.