摘要
目的探讨SDET及Menza两种危险评分对男男性行为者(MSM)艾滋病暴露前预防用药艾滋病病毒(HIV)阳转风险评价的适用性。方法通过乌鲁木齐非政府组织招募HIV阴性MSM,依其意愿分为时间驱动组、事件驱动组及空白对照组,进行口服替诺福韦24个月的干预;问卷调查获得MSM性行为特征,计算每位MSM的SDET及Menza危险评分,通过两种危险评分的受试者工作特征曲线(ROC曲线)下面积评价其对MSM HIV阳转的预测效果;结合多因素Logistic回归分析筛选出对HIV阳转有影响的变量,将变量加入原危险评分后再次评价并进行比较。结果共纳入527名MSM的HIV抗体阴性受试者,2年随访过程中30名MSM血清HIV阳转;SDET和Menza危险评分评价MSM HIV血清阳转风险的ROC曲线下面积为0.623和0.663;经多因素Logistic回归分析发现,MSM依从性与通过互联网寻找性伴是MSM的HIV阳转的影响因素(P <0.05);对两种危险评分加入依从性及通过互联网寻找性伴两个变量后重新评分,其评价MSM HIV血清阳转风险的ROC曲线下面积变化不大(P> 0.05),分别为0.691和0.701。结论 SDET及Menza危险评分对暴露前预防用药的这一特殊MSM队列阳转风险评价效果良好,因其简单易行,今后可考虑在这一特殊人群中推广使用。
Objective To explore the applicability of SDET and Menza risk scores for risk evaluation of HIV/AIDS positive transmission among men who have sex with men(MSM) cohort of pre-exposure prophylaxis. Methods We recruited HIV negative subjects by NGO and divided them into daily group, event-driven group and control group according to their willingness to take tenofovir disoproxil fumarate for 24 months. A questionnaire survey was conducted to know their characteristics of sexual behaviors. Then SDET and Menza risk scores were calculated, to evaluate the prediction effect of HIV positive transformation of MSM based on the area evaluation of ROC curve. The multivariate logistic regression analysis was used to know the influential variables. Results A total of 527 HIV-negative MSM were included in the study by the end of 2-year follow-up, with 30 cases of positive serum conversion. The area under the ROC curve of SDET and Menza risk scores to evaluate the risk of serum positive conversion in HIV negative MSM was 0.623 and 0.663 respectively. The multivariate analysis showed that the influence factors of HIV positive conversion included drug taking compliance and seeking sexual partners through Internet,with the differences statistically significant(P < 0.05). Considering the two variables of compliance and sexual behavior, we calculated again the score, and found its area under the ROC curve was 0.691 and 0.701( P> 0.05). Compared with the original risk score, SDET and Menza scores with the two variables did not significantly improve the effect of the risk evaluation of HIV/AIDS positive conversion. Conclusion The SDET and Menza risk scores have a good effect on the hazard evaluation of HIV positive conversion among the special group of MSM who uptake HIV/AIDS pre-exposure prophylaxis. It is simple and practical, which can be used in MSM group in the future.
作者
陈珍
妥小青
古丽斯亚·海力力
叶勒丹·马汉
田恬
裴华莲
符文慧
罗涛
迪力拜尔·阿里木
戴江红
CHEN Zhen;TUO Xiaoqing;GULISIYA·Hailili;YELEDAN·Mahan;TIAN Tian;PEI Hualian;FU Wenhui;LUO Tao;DILIBAIER·Alimu;DAI Jianghong(Department of Epidemiology and Health Statistics,College of Public Health,Xinjiang Medical University,Urumqi 830011,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2020年第4期368-372,共5页
Chinese Journal of Aids & STD
基金
国家“十二五”科技重大专项(2012ZX10001-007)。
