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预防医学  2022, Vol. 34 Issue (1): 70-77    DOI: 10.19485/j.cnki.issn2096-5087.2022.01.015
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
中国MSM人群HIV新发感染率及其影响因素的Meta分析
何佳晋1, 居豪2, 吴超3
1.浙江大学公共卫生学院,浙江 杭州 310058;
2.中山大学公共卫生学院,广东 广州 510080;
3.浙江大学公共管理学院,浙江 杭州 310058
Incidence of new HIV infection and its influencing factors among men who have sex with men in China: a meta-analysis
HE Jiajin1, JU Hao2, WU Chao3
1. School of Public Health, Zhejiang University, Hangzhou, Zhejiang 310058, China;
2. School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China;
3. School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang 310058, China
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摘要 目的 系统分析中国男男性行为人群(MSM)艾滋病病毒(HIV)新发感染率及其影响因素,为制定艾滋病防控策略提供依据。方法 检索中国知网、万方数据、维普资讯中文期刊服务平台、PubMed、Web of Science、Embase和Cochrane Library等中英文数据库,收集建库至2021年5月发表的中国MSM人群HIV新发感染的队列研究文献,对HIV新发感染率及其影响因素进行Meta分析,采用漏斗图和Egger's检验分析发表偏倚,采用敏感性分析评价结局指标的稳定性。结果 检索文献850篇,最终纳入分析43篇(44项研究),MSM人群HIV合并新发感染率为4.93/100人年(95%CI:4.15/100人年~5.72/100人年)。Egger's检验显示存在发表偏倚(t=2.411,P=0.021)。华东(5.21/100人年)、华北(5.30/100人年)和西南(4.84/100人年)地区合并新发感染率较高,西北地区(2.87/100人年)最低;一线城市(5.12/100人年)合并新发感染率高于非一线城市(3.89/100人年)。梅毒感染(HR=3.41),无保护性肛交(HR=2.52),多性伴(HR=3.51),在酒吧、浴室、公园寻找性伴(HR=3.44),>25岁(HR=0.44),汉族(HR=0.35),知晓艾滋病相关知识(HR=0.20)和有艾滋病预防服务(HR=0.18)是MSM人群HIV新发感染的影响因素。其中涉及梅毒感染(t=4.841,P<0.001)、无保护性肛交(t=4.114,P=0.006)和民族(t=-5.018,P=0.038)的研究存在发表偏倚。结论 中国MSM人群HIV新发感染率仍处于较高水平。应针对可控影响因素制定干预措施,降低MSM人群HIV新发感染率。
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关键词 男男性行为人群艾滋病病毒新发感染率影响因素Meta分析    
AbstractObjective To investigate the incidence of new HIV infection and its influencing factors among men who have sex with men ( MSM ) in China, so as to provide the evidence for formulating the AIDS control strategy. Methods Cohort studies pertaining to new HIV infections among Chinese MSM populations were retrieved in Chinese and English electronic databases, including CNKI, Wanfang Data, VIP, PubMed, Web of Science, Embase and Cochrane Library, and the retrieval time was set to build the database until May 2021. A meta-analysis was performed to investigate the incidence of new HIV infection and its influencing factors among Chinese MSM populations. The publication bias was assessed using funnel plot and Egger's test, and the stability of outcome parameters was evaluated using sensitivity analysis. Results A total of 850 publications were retrieved, and 43 eligible literatures ( 44 studies ) were included in the final analysis. The pooled incidence of new HIV infection was 4.93 ( 95%CI: 4.15 to 5.72) per 100 person-years among Chinese MSM populations. Egger's test showed a publication bias ( t=2.411, P=0.021). Subgroup analysis revealed high incidence of new HIV infection in east ( 5.21 per 100 person-years ), north ( 5.30 per 100 person-years ) and southwest (4.84 per 100 person-years) China, and the lowest incidence in northwest China ( 2.87 per 100 person-years ), and showed higher incidence in first-tier cities ( 5.12 per 100 person-years ) than in nonfirst-tier cities ( 3.89 per 100 person-years ). Syphilis infection ( HR=3.41 ), unprotected anal sex ( HR=2.52 ), multiple sexual partners ( HR=3.51 ), seeking sex partners in bars, public baths and parks ( HR=3.44 ), age of > 25 years ( HR=0.44 ), Han Ethnicity ( HR=0.35 ), awareness of AIDS-related knowledge ( HR=0.20 ) and provision of HIV preventive services ( HR=0.18 ) were associated with new HIV infection in Chinese MSM populations. In addition, publication bias was found in studies reporting syphilis infection ( t=4.841, P<0.001 ), unprotected anal sex ( t=4.114, P=0.006 ) and ethnicity ( t=-5.018, P=0.038 ). Conclusions The incidence of new HIV infection is high among Chinese MSM populations. Interventions targeting the factors affecting new HIV infections are required to reduce in the incidence of new HIV infections among Chinese MSM populations.
Key wordsMSM    HIV    new incidence    influencing factors    meta-analysis
收稿日期: 2021-09-07      修回日期: 2021-12-03     
中图分类号:  R512.91  
作者简介: 何佳晋,硕士在读
通信作者: 吴超,E-mail:chao.wu@zju.edu.cn   
引用本文:   
何佳晋, 居豪, 吴超. 中国MSM人群HIV新发感染率及其影响因素的Meta分析[J]. 预防医学, 2022, 34(1): 70-77.
HE Jiajin, JU Hao, WU Chao. Incidence of new HIV infection and its influencing factors among men who have sex with men in China: a meta-analysis. Preventive Medicine, 2022, 34(1): 70-77.
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