青少年和年轻成年人的艾滋病毒发病率和流行率以及预测因素的下降:观察性队列研究,拉卡伊,乌干达,2005-2020年
medRxiv : the preprint server for health sciences
|January 20, 2025
概括
在乌干达的青少年和年轻成年人 (AYA) 中,艾滋病毒的发病率和流行率显著下降,这与获得VMMC和ART的机会增加以及性行为开始减少有关. 预防策略必须解决多种风险因素.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 预防传染病 预防传染病
背景情况:
- 青少年和年轻人 (AYA) 面临着由个人,社区和政策因素影响的显著艾滋病毒感染风险.
- 了解艾滋病毒发病率和艾滋病毒流行率的时间趋势对于有效的预防策略至关重要.
研究的目的:
- 探索艾滋病毒发病率和流行率与个人,社区和政策因素随时间推移在乌干达Rakai的AYA之间的关联.
- 分析大量基于人口的监测队列中的艾滋病毒感染趋势和相关风险因素.
主要方法:
- 来自Rakai社区队列研究 (RCCS) 的9个调查轮 (2005-2020年) 的分析,涉及35,938人.
- 评估个人/社区因素 (包括社区病毒病) 与艾滋病毒发病率/流行率之间的关联,使用后勤GEE,Poisson GLM和单变量模型.
主要成果:
- 在AYA男性 (66%) 和女性 (60%) 中,艾滋病毒的发病率和流行率分别在2010-2011年和2015-2016年后大幅下降.
- 观察到性经验显著下降,男性中VMMC患病率增加,PLHIV中ART使用增加 (至86%).
- 社区病毒血量和VMMC是HIV发病率和流行率的关键预测指标,分别在年轻女性和男性中.
结论:
- 在AYA中艾滋病毒发病率和流行率的下降与增加对VMMC和ART的获取,以及减少性开始相吻合.
- 对于AYA来说,有效的组合艾滋病毒预防需要在多个层面上解决个人行为和公共政策.
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