【摘要】 目的采用连续横断面调查和BED-捕获酶免疫试验(BED-capture enzyme immunoassay,BED-CEIA)估算重庆市男男性行为人群(MSM)2009年艾滋病病毒Ⅰ型(HIV-1)的发病率,分析流行趋势,讨论该方法应用于MSM人群的效率。方法利用"滚雪球"和同伴推动抽样方法(RDS),采用标准化问卷收集行为信息并采集血样,对HIV抗体确认阳性者采用BED-CEIA方法检测HIV-1新近感染,根据标准公式和2种校正公式,对该人群2009的发病率按不同年龄、寻找性伴方式、学历、收入状况等进行分层计算,与历年结果进行比较分析。结果共招募MSM志愿者942名,平均年龄为(26.32±7.11)岁,大专及以上学历者598人(63.48%);共发现HIV感染者142人,BED检测为新近感染者62人。重庆市MSM人群2009年HIV-1年发病率为15.43%(95%CI:11.59～19.28),较2008年增长了64.49%,与过去3年有显著性差异。21～30岁年龄组年发病率为15.03%(95%CI:10.42～19.42),通过网络寻找性伴组的年发病率为14.69%(95%CI:10.14～19.24),大专及以上学历组年发病率为13.74%(95%CI:9.25～18.23)。结论重庆市MSM人群HIV-1发病率呈快速上升趋势,2009年发病率校正之后的绝对值与前三年比较,结果有显著性差异;不同的校正公式得到的结果没有显著性差异,但与估计感染率之间存在令人深思的矛盾现象。更多还原

【Abstract】 Objective To estimate HIV-1 incidence among MSM in Chongqing in 2009,and to provide scientific evidence for application of BED-incidence estimation approach.Methods By using "snowballing" and RDS methods,942 MSM were recruited during April and July,2009.BED was applied to the leftover blood samples of HIV positive cases to estimate the crude and adjusted HIV-1 incidence rates.Incidence was stratified by age,venues,and education background.Results The incidence among MSM in Chongqing was 15.43%(95%CI 11.59-19.28),an increase by 64.49%(95%CI 5.22-10.38)in comparison with that in 2008(7.80 %).The incidences in group of 21-30 years of age,group looking for sex-partner via internet,and group with education above college were estimated as 15.03%(95%CI 10.42-19.42),14.69%(95%CI 10.14-19.24),and 13.74%(95%CI9.2518.23)respectively.Conclusion There is a statistically significant difference in HIV incidence between 2009 and the past three years,suggesting a trend of rapid increase of HIV incidence.There is an apparent disparity between prevalence and incidence,which merits further in-depth analysis of existing data and explanations.更多还原