Test of HIV incidence shows continuing HIV transmission in homosexual/bisexual men in England and Wales

It has been suggested that HIV incidence will decrease with the increased use of antiretroviral Therapy (ART) in HIV infected homosexual/bisexual men. HIV incidence was measured using a sensitive/less sensitive assay technique, at a time when combination ART was widespread. The Serological Testing Algorithm for Recent HIV Seroconversion (STARHS)13 technique was applied to syphilis test specimens collected from homosexual/bisexual men attending 15 sexually transmitted infections (STI) clinics which participated in an unlinked anonymous serosurvey of HIV infection during 1998. The HIV incidence rate was adjusted to compensate for patients who had a repeat syphilis test within the same year. Leftover syphilis test sera from 6202 men had been unlinked and anonymised, of which 415 were HIV positive. Sera from 412 (99.3%) patients were available. The STARHS assay showed 62 to have been recently infected with HIV (approximately in the last four months), giving an incidence of 3.33% per annum (95% CI: 2.06%-5.27%). The highest incidence was seen in those aged 35-44 years. About 46% of all HIV-infected homosexual/bisexual men were probably receiving combination ART at this time. If 10% of those on treatment were misclassified as recent infections the incidence would have been 2.58% per annum (95% CI: 1.53%-4.24%). In homosexual/bisexual men having syphilis tests at STI clinics in the UK during 1998 the incidence of HIV infection was between two and three per hundred per year. Treatment with combination ART of almost a half of homosexual/bisexual men who are HIV infected in the population is compatible with appreciable continuing HIV transmission among those at high behavioural risk. Public health surveillance systems for those at high risk for HIV infection should, as soon as possible, incorporate the STARHS methodology for monitoring recent HIV incidence.     

HIV and hepatitis B infection and risk behavior in young gay and bisexual men.

OBJECTIVES: To estimate the prevalence of and identify risk factors for human immunodeficiency virus type 1 (HIV-1) and hepatitis B virus (HBV) infections and unprotected anal intercourse among young homosexual and bisexual men. METHODS: The authors performed a cross-sectional analysis of data from a prospective cohort of 508 young gay and bisexual men ages 18-29. RESULTS: HIV-1 seroprevalence was 2.4%, with five (1.3%) of 390 college students and seven (6.0%) of 117 non-students infected. After adjusting for confounders, HIV-1 infection was associated with having a history of a sexually transmitted disease other than HIV-1 or hepatitis B. The prevalence of hepatitis B markers in unvaccinated men was 12.9%. The presence of hepatitis B markers in unvaccinated men was significantly associated with Asian ethnicity, off-campus residence, and history of a sexually transmitted disease other than HIV-1 or hepatitis B and inversely associated with recent non-intravenous drug use. Eighteen percent of the participants reported having had sex with women during the previous 12 months, and 26.4% reported a history of unprotected anal intercourse during the previous six months. Men who reported unprotected anal intercourse were more likely to have at least one steady partner, to have met their partners in anonymous settings, and to be identified as probably alcohol dependent. CONCLUSIONS: Although the prevalence of HIV-1 infection among young homosexual and bisexual men in Boston was relatively low, the high rates of unprotected anal intercourse suggest a potential for future HIV-1 and hepatitis B transmission. Interventions should focus on young men with histories of sexually transmitted diseases, alcohol abuse, and depression.     

Monitoring for HIV-1, HIV-2, HTLV-I sero-progression and sero-conversion in a population at risk in east Africa.

Thirty-three individuals from East Africa, at risk for acquiring sexually transmitted infections, were selected to be monitored over a five month period for evidence of sero-progression and/or sero-conversion for human immunodeficiency virus type-1 and type-2 (HIV-1, HIV-2), and human T cell leukemia virus type-1 (HTLV-I). Initially, all sera were reactive by at least one retroviral screening assay, but most produced negative or indeterminate results by western blot assays. Five months after the initial screening, western blot assays indicated that one individual exhibited full sero-conversion for HIV-1; one HIV-1 positive individual also became positive for HIV-2; and two subjects showed sero-progression to become HTLV-I confirmed positive. Sera from fourteen individuals produced indeterminate results by western blot for HIV-1, ten of which were previously negative; the remaining four sera exhibited reactivity to at least one additional viral specific antigen after the five months. Circulating HIV-1 antigen was not demonstrated in any of the sera but DNA isolated from one of the individuals with indeterminate results produced a positive reaction for HIV-1 by the polymerase chain reaction.     

Human T-cell leukemia virus type II infection among high risk groups and its influence on HIV-1 disease progression

The prevalence and the risk factors of the human T-cell leukemia virus type I/II (HTLV-I/II) infection were evaluated among 552 individuals at high risk for HIV-1. HTLV infections showed a low (1.6%) prevalence, were restricted to intravenous drug addicts and were due to HTLV-II alone. Moreover, in order to weigh the influence of HTLV-II on the natural history of HIV-1 infection, the clinical outcome of HIV-1 disease was compared between subjects with and without HTLV-II coinfection. Our findings showed that HTLV-II does not adversely affect the outcome of HIV-1 infection. Infact, a slower disease progression has been recorded in some HTLV-II coinfected subjects.     

Concomitant infection of HTLV-I and HIV-l: Prevalence of IgG and IgM antibodies in Washington,D.C. area

Serum samples collected from four groups of individuals in the Washington, D.C. area were examined for the presence of IgG and IgM classes of antibody reacting against HTLV-1 and HIV-1. These four groups were: (1) healthy adults with negative premarital VDRL test for syphilis (n=113), (2) miscellaneous common disease patients (n=155), (3) drug abusers (n=130), and (4) homosexual men (n=187). The former two groups are considered to be low-risk groups, and the latter two, high-risk groups. The prevalence of IgG antibody on ELISA/Western blot tests for these groups were respectively: (1) 5.3%/1.8%, (2) 5.2%/1.9%, (3) 13.9%/4.6%, and (4) 4.3%/1.6% for HTLV-1, and (1) 2.7%/0.9%, (2) 4.5%/0%, (3) 12.3%/5.4%, and (4) 8.0%/5.9% for HIV-1. Instances of possible concomitant infection as shown by the presence of antibodies against both HTLV-I and HIV-1 were found only in the latter two high-risk groups, i.e. two (1.5%) in group (3), and three (1.6%) in group (4) as confirmed by both Western blot and immunofluorescence tests. Out of 97 sera collected from drug abusers in 1985-86 which had IgG antibody by Western blot test against HIV-1, 23 (23.7%) were HTLV-I antibody positive by ELISA test (Group 5), and 8 of these were confirmed by Western blot test. Among these 8 persons, IgM antibody against HTLV-I was found in 2, while that against HIV-1 was positive in 7 persons. This fact suggests that the exposure to HIV-1 occurred more recently than that with HTLV-I in most of those persons who were dually infected. By cross-absorption studies, it was shown that the dual antibody reactivities were not due to cross-reactivity between HTLV-I and HIV-1.     

Seroprevalence of HIV-1 and HIV-2 infection among children diagnosed with protein-calorie malnutrition in Nigeria.

Excessive weight loss due to protein calorie malnutrition (PCM) is a significant problem in Nigerian children. This syndrome may be difficult to differentiate from the wasting disease caused by human immunodeficiency virus type 1 (HIV-1) infection. We studied 70 children admitted to the Baptist Medical Center in Ogbomosho, Nigeria in 1990 with PCM for prevalence of antibodies to HIV-1 and HIV-2. The cohort was from low-risk mothers and had a median age of 25 months (range, 4 months-9 years) with a weight deficit of at least 20% of the theoretical weight for age. Two sera were positive for anti-HIV-1 by both ELISA and Western blot (WB). A high prevalence of samples negative for HIV-1 antibody by ELISA were repeatedly reactive (11%, 8/70) or indeterminate (46%, 32/70) by WB. None of the sera was positive for antibody to HIV-2. There was no correlation of ELISA positivity or extent of WB banding with successful recovery from malnutrition. These results indicate a relatively low but significant prevalence of HIV-1 infection in Nigerian children with PCM. The high prevalence of indeterminate reactions in WB assays for HIV-1 suggests that other procedures may be necessary for confirmatory diagnosis of HIV-1 infection in this African population.     

福建东部沿海地区人类嗜T淋巴细胞白血病病毒Ⅰ/Ⅱ感染的血清流行病学研究

目的 调查福建东部沿海地区人群人类嗜T淋巴细胞白血病病毒Ⅰ/Ⅱ(HTLV-Ⅰ/Ⅱ)的感染状况。方法 用酶联免疫吸附试验方法筛查1999～2002年福州、宁德两地的吸毒人群、性病就诊者、暗娼及健康献血者、健康体检人群血清标本3259份。阳性者用免疫印迹进行确认。使用EpiInfo6.0软件进行X~2和Fisher’s exact test分析。结果 健康人群HTLV-Ⅰ抗体阳性率为0.06％,吸毒人群为0.32％,性病就诊者及暗娼为0.58％,未检出HTLV-Ⅱ抗体。性病就诊者及暗娼HTLV-Ⅰ抗体阳性率显著高于健康人群(P<0.05),吸毒者HTLV-Ⅰ抗体阳性率与健康人群比较差异无显著性(P>0.05)。HTLV-Ⅰ抗体阳性率在各年龄组间差异均未见有显著性(P>0.05)。HTLV-Ⅰ抗体阳性率在福州、宁德两地差异也未见有显著性(P>0.05)。结论 提示福建东部沿海地区人群以HTLV-Ⅰ的流行为主,且HTLV-Ⅰ的流行水平很低,未发现HTLV-Ⅱ的流行。年龄、性别因素在闽东沿海地区不是HTLV-Ⅰ流行的危险因子,性暴露次数的增加可能是影响HTLV-Ⅰ流行水平的因素。     

Temporal trends in human immunodeficiency virus type 1 seroconversion 1984-1989. A report from the Multicenter AIDS Cohort Study (MACS)

The 5-year temporal trends in human immunodeficiency virus type 1 (HIV-1) seroconversion between 1984 and 1989 among homosexual/bisexual men participating in the Multicenter AIDS Cohort Study (MACS) are reported. Of 3,262 initially seronegative men, 368 (11.3%) had seroconverted by December 31, 1989. Although the incidence of seroconversion declined precipitously during the first 3 years of follow-up (from 4.1% to 0.9% per 6 months), no evidence for a further substantial reduction was noted after mid-1987, since 6-month incidence rates ranged between 0.5% and 1.2%. The Chicago cohort experienced an increase in HIV-1 seroconversion during both semesters of 1989; 2.1% and 1.6% per 6 months, respectively, became newly infected. Other MACS centers did not report such an increase. Center-specific differences were observed by race; black men were at higher seroconversion risk than white men in Baltimore/Washington (relative risk (RR) = 3.4) and Chicago (RR = 2.4), while Hispanic men were at higher risk than white men in Chicago (RR = 3.3). Younger age (less than 35 years) was also associated with HIV-1 seroconversion (RR = 1.5). It is disturbing to report an overall annual seroconversion rate of 1.2% for the 2 years prior to December 31, 1989, as well as evidence for a sustained recent increase in Chicago during 1989. Long-term maintenance of safe-sex behaviors should be the cornerstone of acquired immunodeficiency syndrome prevention among homosexual/bisexual men.     

HIV-1 counseling and testing sites, Minnesota: analysis of trends in client characteristics.

We report here a summary of the data obtained from two HIV-1 antibody counseling and testing sites in Minneapolis-St. Paul for the first 48 months of operation (24,911 persons tested). The HIV-1 antibody seroprevalence rate for all persons tested was 5 percent. The highest seroprevalence rates were in male homosexual/bisexual intravenous drug users (23 percent) and homosexual/bisexual men (13 percent). There was a significant decrease in the HIV-1 antibody seroprevalence rate among clients during the 48-month period from 14 percent in the first six months to 3 percent in the last six months. This decrease coincided with an increase in the number of low-risk female clients and low-risk heterosexual male clients, and a decrease in the number of homosexual/bisexual males participating in the programs. These findings suggest the need for development and implementation of other strategies to identify and reach persons at highest risk for HIV-1 infection.     

Letter to the Editor: Prevalence of HIV, HTLV-I and HTLV-II among female sex workers in Spain, 2000–2001

Using an unlinked anonymous survey the seroprevalence of HIV, HTLV-I and HTLV-II was analysed among female sex workers. They were surveyed when they attended sexually transmitted disease clinics in six Spanish cities during the period 2000-2001. Fifty-eight percent of the 3149 women analysed came from Latin America or sub-Saharan Africa. The total prevalence of HIV was 0.7%, rising to 15.9% amongst injecting drug users (IDUs). When this group was not included, the prevalence amongst the Latin-Americans or sub-Saharan Africans was 0.8% and amongst the women from other origins 0.3% (p = 0.148). 33.3% of the women infected with HIV already knew about their infection. The prevalences of HTLV-I and HTLV-II were 0.3% and 0.2%, respectively. The prevalences of these three infections in this collective were low if evaluated without the IDUs.     

Assessment of the prevalence and risk factors for human immunodeficiency virus type 1 (HIV-1) infection among college students using three survey methods

To evaluate the seroprevalence and risk factors for human immunodeficiency virus type 1 (HIV-1) infection among undergraduate college students, the authors simultaneously conducted three types of surveillance on a large university campus (27,902 undergraduates) in the Baltimore-Washington metropolitan area: a voluntary HIV-1 serosurvey with a linked risk assessment questionnaire (n = 3,394), a blinded serosurvey using blood specimens collected for routine purposes in the Student Health Center (n = 1,829), and a random sample risk assessment and case identification mail survey (n = 1,017 respondents of 3,000 solicited). The proportion of students belonging to a known risk group (a homosexual or bisexual man, intravenous drug user, or a sexual partner of a bisexual man, an HIV-1-infected person, a female prostitute, or an intravenous drug user) was 5.9% in the mail survey and 8.8% in the voluntary serosurvey. Whereas no infections were detected in the blinded serosurvey, two infected persons were identified in the mail survey (0.2%) and two in the voluntary serosurvey (0.06%), all among high-risk persons. Although derived from independent samples and subject to different biases, these three survey methods yielded a consistent pattern of HIV-1 epidemiology on this campus, whereby the overall prevalence of infection was low and confined to members of high-risk groups, despite the common occurrence of behaviors that might facilitate sexual transmission of HIV-1 among many other students.     

Intravenous drug addicts: a high risk group for infection with human immunodeficiency virus, hepatitis viruses, cytomegalo virus and bacterial infections in Alexandria Egypt

In this work the seroprevalence of HIV, HBV, HCV and CMV were studied among two groups of population; IVDA (intravenous drug addicts) (100) and control group (40). Syphilis and other bacterial infections which may be encountered among IVDA were also investigated. It was found that all serum samples (of both groups) were negative for anti-HIV. Regarding HBV markers, the prevalence of HBc antibodies was significantly higher among IVDA (62%) than the control group (27.5%). Also HBsAg was detected in 16% of IVDA while it was 75% among the control group. Prevalence of anti-HCV was significantly higher among IVDA (63%) than the control group (27.5%). The prevalence of co-infection with HBV and HCV was significantly higher in IVDA (40%) than the control group (15%). Sharing of needles and duration of drug use were positively associated with the presence of both HBV markers and anti-HCV. CMV seroprevalence was high in both groups. Antibodies to Syphilis were found in sera of 3 IVDA and one control using MHA-TP test. Although HIV infection has not yet been sufficiently introduced among IVDA in Alexandria but potentials for its spread among addicts are high as supported by observation that other infections with similar mode of transmission are common among addicts.     

Respiratory and urinary tract infections, arthritis, and asthma associated with HTLV-I and HTLV-II infection

Human T-lymphotropic virus types I and II (HTLV-I and -II) cause myelopathy; HTLV-I, but not HTLV-II, causes adult T-cell leukemia. Whether HTLV-II is associated with other diseases is unknown. Using survival analysis, we studied medical history data from a prospective cohort of HTLV-I- and HTLV-II-infected and -uninfected blood donors, all HIV seronegative. A total of 152 HTLV-I, 387 HTLV-II, and 799 uninfected donors were enrolled and followed for a median of 4.4, 4.3, and 4.4 years, respectively. HTLV-II participants had significantly increased incidences of acute bronchitis (incidence ratio [IR] = 1.68), bladder or kidney infection (IR = 1.55), arthritis (IR = 2.66), and asthma (IR = 3.28), and a borderline increase in pneumonia (IR = 1.82, 95% confidence interval [CI] 0.98 to 3.38). HTLV-I participants had significantly increased incidences of bladder or kidney infection (IR = 1.82), and arthritis (IR = 2.84). We conclude that HTLV-II infection may inhibit immunologic responses to respiratory infections and that both HTLV-I and -II may induce inflammatory or autoimmune reactions.     

我国人类免疫缺陷病毒2型感染的初步回顾性血清学调查

[目的]初步了解我国人类免疫缺陷病毒2型（HIV-2）的感染状况。[方法]用多种HIV抗体确认方法检测来自全国各地的HIV-2可疑血浆/血清样品,用Genelabs HIV Blot2.2WB检测5份已知HIV-2血浆样品。[结果]用Genelabs HIV Blot2.2WB检测54份HIV-2可疑样品,全部呈HIV-1抗体阳性反应且有HIV-2指示带;用HIV-2WB试剂检测,44.4%（24/54）呈HIV-2抗体阳性反应、55.6%（30/54）呈不确定反应;用2种线性免疫试验检测,分别只有3.7%（2/54）和1.9%（1/54）判定为HIV-1/2混合感染,绝大部分仅为HIV-1抗体阳性。对于5份已知HIV-2样品,使用Genelabs HIV Blot2.2WB检测时与HIV-1抗原发生不同程度的交叉反应,但带型明显不同于HIV-1样品。[结论]结果提示我国的HIV-2感染很少见,现有的HIV-2WB不宜用于检测HIV-1抗体呈阳性反应的样品。     

江苏省男男性行为者HIV新发感染状况及影响因素研究

目的了解江苏省男男性行为者（menwhohavesexwithmen,MSM）HIV新发感染状况及影响因素。方法2011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,应用BEDHIV一1IgG捕获酶免疫（BED-CEIA）法检出其中的新发感染者,以HIV阴性MSM为对照,采用多因素Logistic回归模型分析HIV新发感染的影响因素。结果共招募2432名MSM,HIV新发感染率为4．67％（95％CI：3．44％～5．89％）,HIV阴性和新发感染者之间在户籍省、文化程度、最近6个月是否与同性发生肛交、最近1次同性肛交是否使用安全套、最近6个月同性肛交安全套使用率及是否正在感染梅毒等变量上差异有统计学意义（均有P〈0．05）,多因素分析外省籍、文化程度低、最近1次同性肛交未使用安全套及正在感染梅毒是MSM人群HIV新发感染的主要危险因素。结论江苏省MSM人群中HIV新发感染率较高,提示HIV在该人群中正快速传播,必须加大防控力度;影响新发感染的主要因素仍为无保护性肛交及正在感染梅毒等。     

天津市男男性途径感染HIV者新近感染因素分析

目的 了解天津市经男男性途径感染人类免疫缺陷病毒（human immunodeficiency virus,HIV）者中新近感染状况及相关影响因素。方法 收集2013-2015年天津市经男男性途径感染HIV者人口学资料,采用BED捕获酶联免疫法（BED capture enzyme immunoassay,BED-CEIA）进行新近感染判定,计算HIV-1新近感染比例。采用单因素和多因素非条件Logistic回归方法分析新近感染影响因素。结果 2013-2015年天津市累积报告发现经男男性途径感染HIV者1 474例,495例被判定为新近感染,HIV-1新近感染率为45.7%。3年间HIV-1新近感染者人口学构成基本保持稳定（均有P>0.05）。多因素分析显示,25岁以下年龄组（OR=1.639,95%CI:1.089~2.466）、高中（OR=1.460,95%CI:1.059~2.013）和大学（OR=1.392,95%CI:1.003~1.931）文化程度、学生（OR=1.984,95%CI:1.144~3.442）感染者是HIV-1新近感染的可能性更高;通过自愿检测咨询（OR=3.658,95%CI:2.393~5.590）、性病门诊（OR=3.784,95%CI:2.262~6.329）、男男性行为者（men who have sex with men,MSM）专题调查（OR=4.021,95%CI:2.700~5.987）和无偿献血者筛查（OR=5.192,95%CI:2.775~9.712）发现的感染者为新近感染的可能性较高。结论 天津市经男男性途径感染HIV者中新近感染比例较大,应重点加强对25岁以下、高中及以上文化程度和学生中MSM主动监测,并采取更具针对性的宣传干预措施,以减少二代传播。     

Seropositivity for human T-lymphotropic virus types I and II among donors at the Municipal Blood Bank of Caracas and associated risk factors]

OBJECTIVE: To conduct research at the Municipal Blood Bank of Caracas (MBBC) and find out the proportion of blood units discarded for being seropositive for human T-lymphotropic virus (HTLV) types I and II, the prevalence of that infection among their donors, and the probable risk factors for that infection among those HTLV-positive donors. METHODS: ELISA serological testing was done with 23 413 donors seen at the MBBC between July 2000 and April 2001. Samples that were repeat reactive (RR) with the ELISA underwent supplementary Western blot (WB) testing. Donors who had a positive or indeterminate WB result were scheduled for counseling in order to carry out confirmatory testing using nucleic acid amplification (NAA), to collect data on their risk background, and to advise them concerning their HTLV status. RESULTS: Of the 23 413 MBBC donors, 48 of them (0.2%) had a donation that was RR. Of those 48, 25 of them (52.1%) were positive on the WB (23 for HTLV-I and 2 for HTLV-II), 2 of them (4.1%) were indeterminate on the WB, 14 of them (29.2%) were negative, and 7 (14.6%) could not be evaluated. Of the 27 donors scheduled for counseling, 16 of them actually attended (14 WB-positive for HTLV-I, 1 WB-positive for HTLV-II, and 1 indeterminate). All 16 of them were positive with the confirmatory NAA testing. When these 16 seropositive donors were compared with a control group of seronegative donors, no significant differences were found with regard to age, sex, type of donation, number of previous donations, history of transfusions, and sexual behavior. However, significant differences were found in two areas: the seropositive donors were more likely to have used non-intravenous drugs (P < 0.05), and the seropositive donors were much more likely to have had an extended breast-feeding period (more than 2 years) as a child (P < 0.001). To assess the probability of mother-to-child transmission, six of the mothers of seropositive donors who had had an extended breast-feeding period were tested, and all six of those mothers were also found to be seropositive. With the 16 seropositive donors who were counseled, the spouse or partner of 13 of them was also tested; only 1 of those 13 was positive, but the oldest son of that couple was also HTLV-positive. CONCLUSIONS: Of the donated blood, 0.2% of the units were discarded for being positive for HTLV-I or HTLV-II, and the prevalence found among the donors was 0.11%. Sexual transmission between an HTLV-positive donor and a partner or spouse was less frequent than was mother-to-child transmission. At present in Venezuela, blood banks are not required to screen donations for HTLV. Given our results at the MBBC, we believe serious consideration should be given to implementing serological screening for HTLV I/II among blood donors throughout Venezuela.     

Estimation of time since infection using longitudinal disease-marker data

We propose a method to estimate the usually unknown time since infection for individuals infected with human immunodeficiency virus type 1 (HIV-1). If we assume the time since infection has an exponential prior distribution, then under the model the conditional distribution of time since infection, given the CD4 level at the time of the first positive HIV-1 antibody test, is a truncated normal density. We applied the method to prevalent cohort data both from intravenous drug users and from homosexual/bisexual men. For the intravenous drug users the estimated mean time since infection was 15.0 months from infection at a presumed mean CD4 level of 1060 cells/ml to first positive antibody test at a CD4 level of 597 cells/ml, which was the average CD4 at enrolment for infected subjects. For the homosexual/bisexual men the estimated mean time since infection was 16.7 months from infection at a presumed mean CD4 level of 699 cells/ml to first positive antibody test at an average CD4 level of 577 cells/ml. We performed a validation study using initially seronegative subjects in these cohorts who seroconverted to HIV-1-positive antibody status during the follow-up period. For the intravenous drug users, data were too few to provide definitive verification of the method. In the cohort of homosexual/bisexual men, however, there was a total of 70 seroconverters with relevant data. Among them, the median absolute difference between the midpoint of the known seroconversion interval and the estimated mean infection date was 4.6 months, conditional on CD4-lymphocyte measurements taken approximately 18 months subsequent to infection. Conditional on CD4 approximately 30 months after infection, this median difference increased modestly to 8.2 months. Our analysis suggested that the underlying mathematical model tends to overestimate short times since infection and underestimate long times since infection. We consider potential corrective modifications to the model.     

限制性抗原亲和力酶联免疫法和集合核酸法检测用于云南省哨点监测男男性行为人群HIV-1新发感染的研究

目的:比较限制性抗原亲和力酶联免疫法（LAg-Avidity EIA）和集合核酸法评估MSM的HIV-1新发感染率的可行性 。方法:对2016-2017年云南省13个州（市）MSM哨点监测采用滚雪球方法采集样本进行HIV-1抗体检测,确证阳性样本进行LAg-Avidity EIA检测,HIV-1抗体阴性样本...     

青年男同性恋者/男双性恋者购买性商业同性性行为的社会文化因素

  目的   调查青年男同性恋者/男双性恋者购买性商业同性性行为, 分析影响购买性商业同性性行为的社会文化因素。   方法   于2016年在贵州省贵阳市、遵义市、安顺市和铜仁市釆取分类滚雪球抽样(classification snowball sampling, CSS)调查和艾滋病(acquired immunodeficiency syndrome, AIDS, 又称获得性免疫缺陷综合征)自愿咨询检测门诊调查相结合的方法, 对824例青年男同性恋者/男双性恋者进行AIDS危险性行为一对一面访匿名问卷调查。   结果   2016年购买性商业同性性行为总报告率为7.8%(95% CI:5.9%~9.6%), 其中, 青年男双性恋者报告率为13.0%, 高于男同性恋者的5.7%(P < 0.001)。对购买性商业同性性行为有影响的因素为月均收入(OR=6.54, P=0.005), 年龄(OR=3.59, P=0.011), 喜欢同性年龄(OR=2.85, P=0.004), 婚姻状况(OR=2.62, P=0.005), 户籍(OR=2.38, P=0.011), 口交增加危险性(OR=0.42, P=0.019), 感染AIDS可能性(P < 0.005), 公开性取向(OR=0.17, P=0.001)。   结论   青年男同性恋者/男双性恋者, 尤其是男双性恋者购买性商业同性性行为报告率较高。社会文化影响因素为喜欢同性年龄、口交增加危险性、感染AIDS可能性和公开性取向。