摘要
目的建立并验证大学生男男性行为者(men who have sex with men,MSM)的HIV感染风险预测模型。方法利用我国7大城市(上海、南京、长沙、郑州、济南、沈阳和昆明)MSM横断面调查数据库中在校大学生MSM相关信息,通过单因素和多因素logistic回归建立模型并采用Stepwise逐步回归法筛选模型变量;采用C-statistics检验、Hosmer-Lemeshow检验(H-L检验)对模型进行判别能力和拟合效果的内部验证和评价;采用Bootstrap重抽样技术进行模型内部验证。结果共纳入742名大学生MSM参加研究,其HIV感染率为5.9%(44/742)。经logistic回归模型拟合并通过stepwise法筛选,以下变量进入最终模型:有性传播疾病感染史(OR=5.4,95%CI:2.5~11.4,P<0.01)(5分);近半年使用过新型毒品(OR=2.2,95%CI:1.2~4.2,P=0.016)(2分);最近一次男男性行为方式为被插入方或同时为插入方和被插入方(OR=2.3,95%CI:1.0~5.0,P=0.044)(2分)。模型的C-statistic检验的统计量AUC为0.71,H-L检验的卡方值为1.35(P=0.717);各变量在1 000个Bootstrap样本中出现的频率均>50%。结论大学生MSM人群HIV感染风险预测模型具有较好的判别能力和拟合效果,有助于大学生MSM人群比较客观地评估其自身HIV感染风险,以及促进其参与后续HIV检测等防控活动。
Objective To develop and validate a predictive model for HIV infection risk in college student MSM.Methods The information related to college student MSM was collected from the database of MSM cross-sectional survey in 7 cities(including Shanghai,Nanjing,Changsha,Zhengzhou,Jinan,Shenyang and Kunming).Univariate and multivariate logistic regression was used to develop the model,and a stepwise procedure was used to select variables.C-statistics test was employed to assess the model discrimination,and Hosmer–Lemeshow test was used to estimate the model calibration.Bootstrap resampling technology was used for model validation.Results A total of 742 college student MSM were enrolled in this study,and the prevalence rate of HIV was 5.9%(44/742).According to logistic regression and stepwise procedure,the variables and their scores in the predictive model for HIV infection risk among college student MSM were having a history of infection with sexual transmitted diseases(OR=5.4,95%CI:2.5-11.4,P<0.01)(5 points),new-type drug abuse in the past six months(OR=2.2,95%CI:1.2-4.2,P=0.016)(2 points),and practicing receptive or both insertive and receptive anal intercourse in the most recent homosexual behavior(OR=2.3,95%CI:1.0-5.0,P=0.044)(2 points).The area under the curve(AUC)of C-statistics was 0.71,and the Chi-square value of Hosmer-Lemeshow test was 1.35(P=0.717).The frequency of each variable in the final model appeared in1,000 Bootstrap samples were all greater than 50%.Conclusions The said predictive model for HIV infection risk among college student MSM has better judgment ability and fitting effect.It is conducive to objectively self-evaluating the risk for HIV infection among college student MSM and promoting them to participate in HIV detection and other prevention and control activities.
作者
黄掣驰
呼志丽
胡清海
楚振兴
张晶
徐俊杰
HUANG Che-chi;HU Zhi-li;HU Qing-hai;CHU Zhen-xing;ZHANG Jing;XU Jun-jie(NHC Key Laboratory of AIDS Immunology(China Medical University),Department of Laboratory Medicine,the First Affiliated Hospital of China Medical University,Shenyang,Liaoning 110001,China;Key Laboratory of AIDS Immunology of Liaoning Province,the First Affiliated Hospital of China Medical University,Shenyang,Liaoning,110001,China;Key Laboratory of AIDS Immunology,Chinese Academy of Medical Sciences,Shenyang,Liaoning 110001,China;Information Center of Liaoning Province,Shenyang,Liaoning 110001,China)
出处
《实用预防医学》
CAS
2020年第2期156-160,共5页
Practical Preventive Medicine
基金
中国科技部十三五重大专项课题(2017ZX10201-101-002-007)
中国科技部“一带一路”传染病防控保障关键技术研发(2018ZX10101-001-001-003)
国家自然科学基金面上项目(81872674)
国家自然科学基金青年科学基金项目(81703277)
