超越保护:在MSM中导航生物医学HIV预防和风险补偿,2018-2024年
Junfeng Zhang1, Zhan Lin1, Jing Yang1,2
1Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping district, Tianjin, China.
AIDS research and therapy
|March 10, 2026
概括
生物医学预防艾滋病毒 (PrEP/PEP) 减少了与男性发生性关系的男性 (MSM) 的发病率,但可能会增加无保护交的风险. 整合行为支持对于这些关键子组至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 艾滋病毒预防研究 预防研究
背景情况:
- 在全球范围内,与男性发生性关系的男性 (MSM) 经历了不成比例的高艾滋病风险.
- 生物医学干预措施,如暴露前预防 (PrEP) 和暴露后预防 (PEP) 是有效的减少艾滋病毒传播的方法.
- 关于联合生物医学策略对性风险行为,特别是风险补偿的影响存在不确定性.
研究的目的:
- 调查生物医学干预使用与中国天津MSM中HIV发病率之间的关联.
- 分析生物医学干预措施对艾滋病毒检测频率和未受保护的交 (UAI) 风险的影响.
- 确定潜在经历更大的风险补偿效应的子组.
主要方法:
- 在中国天津 (2018-2024) 的8790名MSM的纵向队列研究,通过雪球采样招募.
- 通过Poisson回归和Cox比例危险模型分析HIV检测频率和发病率.
- 通过混合效应和轨迹建模,构建UAI风险评分和评估与生物医学干预使用的关联.
主要成果:
- 生物医学干预使用者 (21.14%) 呈现较低的艾滋病毒发病率 (0.40对0.62每100人年) 和更频繁的艾滋病毒检测.
- 干预用户显示UAI风险得分较高,交频率增加,避孕套使用减少.
- 轨迹分析表明,干预使用者更有可能在高风险群体中,在老年和郊区MSM中观察到更大的风险补偿.
结论:
- 生物医学干预与减少艾滋病毒发病率和增加检测有关,但可能会增加UAI风险,特别是在老年和郊区MSM中.
- 风险补偿是一个潜在的问题,需要在特定的人口群体内进行仔细监测.
- 将行为支持服务与生物医学HIV预防相结合,对于减轻风险补偿和解决预防悖论至关重要.
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