2010－2013年中国男男性行为人群艾滋病/梅毒感染状况、性行为特征及艾滋病知识知晓情况的Meta分析

目的 通过2010－2013年针对MSM人群的调查进行Meta分析,了解近年来中国MSM人群的性行为特征、艾滋病知识知晓率情况、HIV/梅毒的感染状况及其随时间和地区的分布。方法 检索中国期刊全文数据库(CNKI)、万方数据库、PubMed数据库上已发表的2010－2013年针对中国MSM人群HIV、梅毒感染状况的文献,采用Stata 12.0软件对入选文献进行Meta分析。结果 共有66篇文献纳入,2010－2013年中国MSM人群中HIV合并感染率为7.7%(95%CI:7.2%～8.3%),呈逐年上升趋势,其中西南地区合并HIV感染率最高(12.0%);合并梅毒感染率为10.9%(95%CI:9.8%～12.1%),华南地区合并梅毒感染率最高(14.4%);性行为特征呈现近6个月肛交发生率偏高(84.2%),肛交坚持使用安全套率较低(44.8%)的特点,但该人群有较高的艾滋病知识知晓率(88.4%)。结论 2010－2013年中国MSM人群HIV、梅毒感染疫情呈高流行态势,面对该人群“高艾滋病知识知晓率,高无保护性性行为”这一普遍现象,探求有效促进MSM人群安全套使用的综合干预策略,减少“知行分离”的发生尤为重要。     

HIV/AIDS among men who have sex with men and inject drugs--United States, 1985-1998

Men who have sex with men and inject drugs (MSM/IDU) pose unique challenges for human immunodeficiency virus (HIV) risk reduction efforts because they have multiple risks for HIV acquisition and transmission. This report presents 1) the demographic characteristics of MSM/IDU diagnosed with acquired immunodeficiency syndrome (AIDS) in 1998 and MSM/IDU living with AIDS as of December 31, 1998; 2) trends in AIDS incidence among MSM/IDU from 1985 to 1998; and 3) information on selected behaviors from interviews of MSM/IDU who had AIDS diagnosed from 1996 to 1998 in 12 states. The findings indicate that 1) over half of MSM/IDU with AIDS were non-Hispanic blacks and Hispanics, and most MSM/IDU with AIDS were reported from large metropolitan statistical areas (MSAs); 2) AIDS incidence has declined since 1996; and 3) a high prevalence of drug-related and sexual risk behaviors occurred among MSM/IDU with AIDS.     

乌鲁木齐市男男性行为者HIV新发感染及危险因素研究

目的 获得乌鲁木齐市男男性行为者(MSM)HIV新发感染率,了解MSM人群新发感染的相关危险因素,为估计艾滋病流行趋势,判断疫情形势以及高危行为干预提供科学依据。 方法 对2015年乌鲁木齐市艾滋病哨点监测MSM人群866例样本纳入研究,用ELISA方法对所有研究对象血清样本进行HIV抗体初筛,对于HIV抗体初筛阳性者,使用免疫印迹法进行确证,符合条件的HIV抗体阳性血清再用HIV-1 BED捕获酶联法(BED方法)检测,从而估算该人群2015年的新发感染率;通过问卷调查,了解MSM人群与HIV感染相关的危险因素。 结果 共调查866例MSM人群,平均年龄(31.03±7.44)岁,其中汉族734(84.76%)例,维吾尔族54(6.24%)例,回族54(6.24%)例,其它少数民族24(2.76%)例;文化程度以大专及以上为主(83.60%);艾滋病防治知识知晓率为97.92%;最近6个月,95.84%(830例)发生过肛交行为,每次都使用安全套的占52.04%(432例);HIV抗体检出率为5.31%(46例),其中既往感染7例;进一步采用BED检测,结果表明其中14例为长期感染,25例为新发感染,利用McDougal法计算出新发感染率为5.95%(95%CI:4.37%~7.52%);多因素logistic回归显示年龄≥45岁(OR=3.105)、近6个月同性性行为安全套使用情况为每次都用(OR=0.205)、艾滋病防治知识知晓情况为知晓(OR=0.151)是乌鲁木齐MSM人群HIV新发感染的独立影响因素。 结论 乌鲁木齐市MSM人群HIV新发感染率较高,应继续加强干预力度,给予该人群中年龄较大者重点关注。     

重庆市男男性接触者艾滋病病毒感染率及其影响因素

目的 了解重庆市男男性接触人群(MSM)艾滋病病毒(HIV)感染率及其影响因素.方法 2007年7-9月在重庆市渝中区、九龙坡区和沙坪坝区通过滚雪球方式招募1044名MSM进行面对面的问卷调查,以HIV感染状况为应变量,人口学特征、艾滋病防治知识知晓水平、性行为状况、接受干预服务、梅毒感染状况等为自变量进行逐步向前法的logistic回归分析与HIV感染相关的因素.结果 调查的1044名MSM中,艾滋病防治知识知晓率高(89.5%),近6个月与男性发生无保护性的肛交比例为63.8%;梅毒感染率为8.5%(89/1044),HIV感染率为12.5%(131/1044).多因素回归分析发现,年龄较大(OR=1.69,95%CI:1.13～2.52)、文化程度在初中以下(OR=1.89,95%CI:1.17～3.05)、首次性行为年龄在18岁以下(OR=3.11,95%CI:1.20～8.02)、近6个月男性性伴数在10个以上(OR=2.24,95%CI:1.24～4.02)、近6个月与女性有性行为史(OR=2.40,95%CI:1.64～3.51)和梅毒感染(OR=4.52,95%CI:2.77～7.38)是HIV感染的独立危险因素.结论 MSM人群无保护性性行为发生率、梅毒和HIV感染率均高.     

2015年绵阳市男男性行为人群艾滋病哨点监测结果分析

摘要:目的 了解男男性行为人群（MSM）艾滋病疫情及知识知晓和性行为现状,分析艾滋病病毒（HIV）感染影响因素。方法 2015年2 - 6月,以绵阳城区MSM为对象,用滚雪球抽样法,在固定场所和知情同意下,进行调查对象招募和自填式行为学调查及血清学检测。结果 共监测436例,艾滋病知识知晓率98.4%（429/436）,近1年做过艾滋病病毒（HIV）检测并知晓结果75.0%（327/436）,近1年干预服务覆盖率92.0%（401/436）。HIV确证阳性率8.3%（36/436）,梅毒现症感染率7.6%（33/436）。多因素分析结果:高中及以上文化程度（OR=0.366,95%CI:0.146～0.918）、接受干预服务覆盖（OR=0.154,95%CI:0.056～0.427）是HIV感染保护因素,近6月无保护性男性肛交是危险因素（OR=2.924, 95%CI:1.211～7.092）（P值均＜0.05）。结论 该市MSM艾滋病知识知晓、干预服务覆盖及安全套使用率较高,HIV疫情相对低水平,但有所回升。应及时分析、解决存在不足,促进防治工作持续深入开展。     

中国2006--2010年男男性行为者艾滋病疫情分析

目的 分析2006-2010年中国男男性行为者(MSM)的艾滋病疫情特征.方法 分析2006-2010年中国艾滋病病例报告系统中男男性传播病例的三间分布(时间、人群、地区)及哨点监测系统中MSM的HIV抗体检出率及安全套使用率.结果 艾滋病病例报告系统显示,2006-2010年男男性传播病例构成比从1.5％增长到10.8％,是增长最快的传播途径.与其他传播途径相比,男男性传播HIV/AIDS病例具有以下明显的特征:15～29岁为主(54.6％)、文化程度较高(具有高中及以上学历者占69.8％)、未婚为主(64.8％)、干部/教师/医生离退休人员(14.3％)及学生(7.9％)等职业占相当高的比例、流动性强(流动人口占36.2％)、城市为主(城市人口占72.6％)、专题调查(26.7％)及无偿献血(6.4％)检出比例较高.地区分布差异大,主要分布在北京、四川、广东、重庆、江苏、辽宁、上海和浙江等经济发达地区的大中城市.哨点监测系统显示,2006-2010年中国MSM的HIV抗体阳性检出率(中位数)为3.4％,最近一次安全套使用率(中位数)为73.2％.结论2006-2010年中国男男性传播艾滋病报告病例构成比增长快速,哨点监测发现MSM感染率较高,安全套使用率较低,表明MSM艾滋病流行严重且呈明显上升趋势,其中以15～29岁青年学生及无偿献血人员感染为主.     

黑龙江省男男性行为者中艾滋病相关知识、行为及HIV感染检出率调查

目的探讨黑龙江省男男性行为者艾滋病相关知识、行为及艾滋病病毒感染检出状况,为在该人群中开展有效的艾滋病干预措施提供科学依据。方法由经过专业培训的调查者对男男性行为者进行一对一的问卷调查,同时收集研究对象的血液样本。结果在1353名被调查的男男性行为者中,艾滋病病毒感染率为2.3%。来自佳木斯、收入2000～元、在互联网寻找性伴和有过检测史的男男性行为者有较高的知识评分。在过去6个月,48.7%男男性行为者与多个男性发生过肛交性行为以及44.5%的男男性行为者每次都使用安全套。结论在男男性行为者中艾滋病病毒感染率已经升高,并且广泛存在着艾滋病相关危险行为,必须及时采取措施加以控制,防止艾滋病在该人群中广泛传播。     

Sexual diversity among black men who have sex with men in an inner-city community

Dramatic increases in HIV-incidence rates have been documented for Black men who have sex with men (MSM). Moreover, MSM has become a more visible HIV-transmission route in the Black community, in part due to public interest in the “down low” (i.e., “straight” men who also have sex with men). Interviews were conducted with 21 Black MSM in central Brooklyn, New York City, in efforts to understand the diversity of MSM experience in a low income, high HIV-prevalence community. Two thirds of the men identified as either heterosexual (43%) or bisexual (24%) and 15 (71%) MSM reported recent sex with women. Conformity to masculine social role expectations made it difficult to identify sex partners in the community; therefore, men relied on private sex clubs and the Internet. The findings suggest that stigma surrounding both HIV and homosexuality may effectively insure that nonheterosexual preferences and practices remain hidden in the Black community. A focus on sexual orientation and bisexuality has obscured the issue of race in the HIV/AIDS epidemic among Black MSM. In the long term, public health promotion and HIV prevention will require greater tolerance and acceptance of sexual diversity in the Black community.     

江苏省男男性行为人群HIV和梅毒感染状况及影响因素研究

目的 了解江苏省男男性行为人群（men who have sex with men,MSM）人类免疫缺陷病毒（human immunodeficiency virus,HIV）和梅毒感染状况及影响因素。方法 2015年在江苏省8个地级市招募MSM,并进行问卷调查及实验室检测,采用多因素Logistic回归模型分析HIV和梅毒感染的影响因素。结果 2 451名MSM的HIV感染率为10.3%,梅毒现症感染率为8.3%。多因素分析结果显示:40岁及以上、网络招募、最近6个月发生无保护性肛交（unprotected anal intercourse,UAI）、最近一年未接受过HIV检测及正在感染梅毒是MSM人群感染HIV的主要危险因素（均有P<0.05）;25岁及以上、初中及以下文化程度、场所招募及最近6个月发生UAI是MSM人群感染梅毒的主要危险因素（均有P<0.05）。结论 江苏省MSM人群HIV感染持续呈高水平状况,梅毒现症感染得到控制。促进安全套使用和HIV/梅毒检测应持续成为MSM人群性病艾滋病防治的重要工作。     

中国内地大、中学生中男男性行为者HIV感染率的Meta分析

目的运用Meta分析综合评价2005-2010年中国内地大、中学生中男男性行为者HIV感染率,并分析其在样本量、抽样方法及不同研究时间等因素间的差别。方法检索万方数据库、维普信息资源系统、中国期刊全文数据库、中国生物医学文献数据库及PubMed数据库,收集所有关于中国内地大中学生中HIV感染状况的调查研究,再从中筛选出有关男男性行为者群体的研究报告。对各项研究进行异质性检验,以确定采用固定模型或随机模型进行合并分析,绘制漏斗图进行发表偏倚的评估。结果共入选相关研究10项,累计大、中学生MSM人数为2014人,HIV感染人数为106人,总的HIV感染率为4.6%(95%CI 2.9%～6.3%)。将HIV感染率按照样本量、抽样方法及研究时间等进行分层分析,样本量大于200时合并的HIV感染率为4.7%(95%CI 2.5%～7.0%),样本量小于等于200时合并的HIV感染率为4.7%(95%CI 1.9%～7.4%);抽样方法为滚雪球时,合并HIV感染率为6.1%(95%CI 3.0%～9.1%),高于非滚雪球抽样的方法 2.9%(95%CI 1.7%～4.1%);2007年及以前研究合并的HIV感染率为3.0%(95%CI 1.7%～4.2%),低于2008年及以后的研究6.0%(95%CI 3.1%～9.0%)。结论中国内地大、中学生中男男性行为者HIV感染率远高于一般人群。     

柳州市男男性行为队列人群HIV感染影响因素分析

目的 利用队列人群数据探讨影响柳州市男男性行为人群（men who have sex with men,MSM）感染艾滋病的影响因素,为制定柳州市艾滋病预防控制策略和措施提供依据。方法 2014年6月在柳州市区采用雪球抽样方法招募MSM并建立队列,每半年随访一次,每次随访时进行问卷调查、采集静脉血进行艾滋病病毒（human immune deficiency virus,HIV）抗体检测。结果 基线和三次随访共招募MSM 1 369人次,成功完成一次、二次、三次随访的人数分别为158例、126例、74例。随着随访次数增加,MSM队列人群对艾滋病相关知识的知晓率升高（χ_趋势2=7.698,P=0.006）;最近一次肛交性行为（χ_趋势2=7.510,P=0.006）和商业同性肛交性行为（χ_趋势2=5.005,P=0.025）中安全套使用情况均有上升的趋势。多因素Cox回归分析显示:艾滋病相关知识得分较高（OR=0.119,95%CI:0.021~0.686,P=0.017）及最近6个月未使用过毒品（OR=0.036,95%CI:0.006~0.212,P<0.001）者,其感染艾滋病的风险低。结论 应进一步加强MSM人群艾滋病知识宣传,提高艾滋病相关知识知晓率和安全套使用频率,降低毒品使用,以遏制艾滋病在该人群的蔓延。     

HIV incidence among young men who have sex with men--seven U.S. cities, 1994-2000

Twenty years after the first report on human immunodeficiency virus (HIV) infection in the United States, studies of sexually transmitted diseases (STDs) and sexual behaviors suggest a resurgent HIV epidemic among men who have sex with men (MSM). However, few recent studies have measured HIV incidence in this population. To determine HIV incidence among young MSM, CDC analyzed data from the Young Men's Survey (YMS), a study that found a high prevalence of HIV and associated risks among MSM aged 15-22 years sampled in seven U.S. cities. This report confirms high HIV incidence among these young men.     

HIV and syphilis epidemic among MSM and non-MSM aged 50 and above in Shanghai,China: A yearly cross-sectional study, 2008–2014

The magnitude of the HIV and syphilis epidemic among Chinese men ages 50 and older is unclear. In this study, we aimed to characterise and compare the prevalence of HIV and syphilis infections; linkage to care among those infected with HIV; and the geographic distribution of the two epidemics among elderly men who have sex with men (MSM) and non-MSM in Shanghai, China. This cross-sectional study involved 12,910 men ages 50 and above who participated in the HIV voluntary and counselling testing programme each year from 2008 to 2014. HIV prevalence among MSM in our sample ranged between 4.9% and 15.4%, while syphilis frequency among non-MSM decreased from 26.0% to 18.7%. Further, in 2014, MSM participants had a higher HIV prevalence than non-MSM (4.9% vs 1.8%), whereas syphilis was higher in older non-MSM compared to MSM (18.7% vs 12.4%). Among those infected with HIV, 121/211 (53.75%) of participants were linked to HIV treatment, where the linkage rate was comparable to that in Kunming [Zhao, S., Zhao, G., Zhang, W., liao, B., Chu C., Wang J., & Li, L. (2015). Compare the difference of efficiency between voluntary counseling testing and provider-initiated testing counseling for identifying HIV/AIDS in Kunming. Chinese Journal of AIDS & STD, 21(7), 623-625]. The high burden of HIV and syphilis among men ages 50 and older in Shanghai, China highlights the need to target older Chinese men, both MSM and non-MSM, with prevention efforts.     

新疆乌鲁木齐市男男性行为人群HIV传播动力学的预测和分析

目的建立人类免疫缺陷病毒(HIV)感染传播动力学模型,评估男男性行为(MSM)人群HIV感染状况,并预测未来十年新疆乌鲁木齐市MSM人群HIV的流行趋势,为制定合适的防控措施提供定量依据。方法利用新疆乌鲁木齐市2009—2017年MSM人群HIV的监测数据,建立HIV传播的动力学模型。通过模型分析得到决定疾病传播与否的基本再生数R0,并用收集和估计的参数对模型进行数值模拟,分析乌鲁木齐市MSM人群HIV的流行状况。结果建立的MSM人群HIV的传播动力学模型拟合效果合理[平均绝对百分比误差(MAPE)=10.89%,均方根百分比误差(RMSPE)=25.74%],基本再生数R0≈0.2616(95%CI:0.2394～0.9299),该模型预测2027年乌鲁木齐市MSM人群HIV的阳性率下降至2%。参数敏感性分析发现,由低危易感者发展成为高危易感者的比例、由HIV感染者发展成为艾滋病患者的比例和高危易感者发展成为低危易感者的比例是影响MSM人群HIV流行的主要因素。结论乌鲁木齐市MSM人群HIV感染呈现持续流行,相关部门应加强对MSM人群的防控,推广安全套的使用,加强宣传教育等综合性干预措施,控制MSM人群HIV的流行。     

山东省部分男男性接触者艾滋病防治相关知识、态度和行为调查

目的了解山东省男男性接触者艾滋病防治相关知识、态度和行为状况,为制定艾滋病防治政策提供科学依据。方法采用滚雪球法或方便样本法,在全省8个城市使用统一设计的调查问卷对男男性接触者进行面对面调查,并采集静脉血标本。结果共调查1617名男男性接触者,平均年龄为26岁,已婚占71.9%,大学以上文化程度占58.6%,青年学生占25.3%。艾滋病防治相关知识全部回答正确率较低,为28.2%;发生高危性行为的比例较高,安全套使用率低于50%;检出HIV抗体阳性18例,感染率1.3%。结论山东省男男性接触者人群中存在着艾滋病流行,并有向一般人群蔓延的潜在危险。因此,应进一步加强该类人群艾滋病防治相关知识的宣传教育和安全套推广使用工作,以提高他们的艾滋病防治知识知晓率和自我防护意识。     

HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men--five U.S. cities, June 2004-April 2005

Well into the third decade of the human immunodeficiency virus (HIV) epidemic, rates of HIV infection remain high, especially among minority populations. Of newly diagnosed HIV infections in the United States during 2003, CDC estimated that approximately 63% were among men who were infected through sexual contact with other men, 50% were among blacks, 32% were among whites, and 16% were among Hispanics. Studies of HIV infection among young men who have sex with men (MSM) in the mid to late 1990s revealed high rates of HIV prevalence, incidence, and unrecognized infection, particularly among young black MSM. To reassess those findings and previous HIV testing behaviors among MSM, CDC analyzed data from five of 17 cities participating in the National HIV Behavioral Surveillance (NHBS) system. This report summarizes preliminary findings from the HIV-testing component of NHBS, which indicated that, of MSM surveyed, 25% were infected with HIV, and 48% of those infected were unaware of their infection. To decrease HIV transmission, MSM should be encouraged to receive an HIV test at least annually, and prevention programs should improve means of reaching persons unaware of their HIV status, especially those in populations disproportionately at risk.     

HIV prevalence among female sex workers,drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis

Background  

The Brazilian response towards AIDS epidemic is well known, but the absence of a systematic review of vulnerable populations ─ men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) remains a main gap in the available literature. Our goal was to conduct a systematic review and meta-analysis of studies assessing HIV prevalence among MSM, FSW and DU, calculating a combined pooled prevalence and summarizing factors associated the pooled prevalence for each group.     

重庆市男男性行为人群艾滋病干预效果初步研究

目的 评估重庆市男男性行为者(MSM)的艾滋病综合干预项目实施效果.方法 2006年与2007年对MSM人群采用"滚雪球"法进行二次面对面的问卷调查,比较干预前后MSM人群知识、行为和HIV及梅毒患病率的变化隋况,采用SPSS 12.0软件进行统计分析.结果 干预后,MSM人群艾滋病防治知识知晓率明显提高,由干预前的74.3%上升到干预后的82.4%(P=0.01);最近一次与男性发生肛交性行为时安全套使用率由56.4%上升到65.5%(P=0.00);最近6个月与男性发生肛交时每次都使用安全套率也由2006年干预前的31.8%上升至41.9%(P=0.00).干预前后HIV感染率分别为10.4%和10.8%,梅毒患病率分别为9.3%和7.3%,干预前后HIV和梅毒的患病率差异均无统计学意义.结论 MSM人群干预后艾滋病防治知识明显提高,安全套使用率也有所提高,干预工作产生明显效果.     

中国1995-2009年艾滋病哨点监测主要人群艾滋病病毒感染流行趋势分析

目的 分析中国吸毒者、暗娼、性病门诊就诊者、男男性行为者、孕产妇5类人群的艾滋病病毒(HIV)感染流行趋势,为艾滋病综合防治和科学干预提供信息和依据.方法 1995-2009年,在哨点监测期内以重复横断面调查的方法对吸毒者、暗娼、性病门诊就诊者、男男性行为者、孕产妇5类人群进行监测(采血及问卷调查).结果 吸毒人群HIV抗体阳性检出率(中位数)在疫情较重省份从1996年开始呈快速上升,1999-2000年达到高点(19.2%),2001-2003年逐步下降,2004年后趋于平稳状态;在疫情居中省份从2001年开始呈小幅上升,2004年达到相对高点(2.9%)后趋于平稳,近两年又呈小幅下降趋势;在疫情较轻省份一直处于低水平.暗娼人群HIV抗体阳性检出率(中位数)在疫情较重省份从1999年开始小幅上升并达到高点(1.5%),之后下降并维持在较低水平;在疫情居中省份和较轻省份一直处于低水平.性病门诊就诊人群HIV抗体阳性检出率(中位数)一直维持在较低水平,低于0.7%.男男性行为人群HIV抗体阳性检出率近两年均大于1%,部分哨点大于10%,且呈快速上升趋势,成为近年来推动艾滋病疫情发展的重要原因之一.孕产妇人群HIV抗体阳性检出率(中位数)在疫情较重省份从1997年开始呈缓慢上升,之后趋于平稳状态(0.3%);在疫情居中省份和较轻省份一直处于低水平.结论 男男性行为人群HIV抗体阳性检出率呈上升趋势;吸毒者、暗娼、性病门诊就诊者、孕产妇人群的HIV抗体阳性检出率都趋于相对平稳状态.吸毒人群疫情仍集中在疫情较重的6个省份.暗娼和性病门诊就诊人群疫情总体仍处于较低水平,但流行范围在不断扩大.

Abstract：

Objective To effectively monitor the time trend of HIV prevalence and epidemic among injecting drug users ( IDUs ), female sex workers (FSWs), sexually transmitted disease (STD)clinic attendants, men who have sex with men (MSM) and pregnant women etc., to provide information for evaluation on strategies regarding comprehensive HIV prevention and effectiveness of intervention, in China. Methods Cross-sectional studies had been repeatedly conducted on sentinel surveillance program with uniformed questionnaire and collection of venous blood specimen among IDUs, FSWs, STD clinic attendants, MSM and pregnant women, from 1995 to 2009. Results HIV prevalence (median) among IDUs had been increasing rapidly since 1996, reaching the plateau (19.2%) in 1999-2000, then gradually decreasing in 2001-2003, and leveling off since 2004 in those relatively hard-hit epidemic provinces. HIV prevalence among drug users had increased a bit since 2001, achieving high level (2.9%) in 2004 before leveling off, showing a slight downward trend in the past two years among the medially-hit epidemic provinces, while it maintained at a low level in those low epidemic provinces. HIV prevalence (median) among FSWs had been slightly increasing,reaching a high level ( 1.5% ) in 1999, then decreased and maintained at a low level in relatively hard-hit provinces. HIV prevalence among FSWs maintained at a low level in medially-hit and low epidemic provinces. HIV prevalence(median) among STD clinic attendants had been maintained at a lower level, lower than 0.7%. HIV prevalence among MSM had been consistently greater than 1%, and was increasing year by year, becoming one of the most important drivers of the HIV/AIDS epidemic over the past years. HIV prevalence (median) among pregnant women had slightly been increasing since 1997, then leveling off over the past years in those relatively hard-hit provinces (0.3%). HIV prevalence among pregnant women had maintained at a low level in the medial and low epidemic provinces. Conclusion Data from sentinel surveillance programs showed a leveling-off situation on HIV prevalence rates among IDUs, FSWs, sexually transmitted infections clinic patients and pregnant women. However, HIV prevalence among MSM had increased significantly since 2005, indicating the high speed of transmission among this population. Epidemic among IDUs had still been concentrated in those relatively hard-hit epidemic provinces. As for FSWs and STD patients, the overall epidemic remained at low level, but the areas of epidemic kept expanding.     

Trends in HIV seroprevalence, AIDS and prevention policy among intravenous drug users and men who have sex with men, before and after 1990 in Austria

This study reports for the first time on secular trends in human immunodeficiency virus (HIV) infection and AIDS, and possible associations with prevention policy in Austria. We analysed HIV seroprevalence and AIDS cases among intravenous drug users (IDU) and men who have sex with men (MSM). In this study we found a diminished rate of increase in new cases of AIDS and a decline in HIV seroprevalence among IDU but not among MSM. Among clients visiting HIV counselling and testing centres in Austria between 1987 and 1990, seroprevalence among IDU was estimated at 27.9% as compared to 19.6% between 1990 and 1992 (odds ratio: 0.62; 95% confidence interval (CI): 0.45–0.85). Among MSM corresponding prevalence for these two periods was 12.1% and 10.9%, respectively, which was not a significant decline. In the period 1990 to 1994, the increase in AIDS cases per half-year levelled off for IDU (incidence rate ratio (IRR): 1.00; 95% CI: 0.99–1.01) but to a lesser extent among MSM (IRR: 1.01; 95% CI: 1.01–1.02). The most effective prevention policy intervention was considered to be the national methadone maintenance program (MMTP), started in 1987, and the provision of sterile injection equipment. We observed that in the recent period there was a decline in the frequency of attendance among young (less than 28 years of age) MSM at counselling centres (odds ratio (OR): 1.27; 95% CI: 1.08–1.49), accompanied by the observation that the rate of seroprevalence among this group did not decline. This is in contrast to young IDU where attendance did not decline but seroprevalence did. Although inference is limited from cross sectional studies, we argue for a reoriented and effectively monitored HIV prevention policy focused on young MSM.