广西男男性行为者不同HIV检测轨迹使用HIV暴露前/后预防药物的影响因素  

Trajectories of HIV testing frequency and its association with pre-/post-exposure prophylaxis use among men who have sex with men,Guangxi,China

作　　者：梁银霞 彭洪滨 罗霞 莫金莉 田韦毅 王敏[1] 张云 岑平[3,4] 宁传艺 LIANG Yin-xia;PENG Hong-bin;LUO Xia;MO Jin-li;TIAN Wei-yi;WANG Min;ZHANG Yun;CEN Ping;NING Chuan-yi(The Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530007,China;不详)

机构地区：[1]广西医科大学第二附属医院,广西南宁530007 [2]广西医科大学护理学院,广西南宁530007 [3]广西医科大学公共卫生学院,广西南宁530007 [4]南宁市疾病预防控制中心,广西南宁530007 [5]广西艾滋病防治研究重点实验室,广西南宁530007

出　　处：《现代预防医学》2024年第14期2634-2641,共8页Modern Preventive Medicine

基　　金：广西自然科学基金项目杰出青年科学项目(2023GXNSFFA026007)。

摘　　要：目的探讨HIV检测频率与HIV暴露前/后预防药物使用的关联。方法基于在广西五个城市(南宁、柳州、桂林、玉林和北海)开展的男男性行为者(MSM)随访队列,运用基于群组轨迹模型(group-based trajectory model,GBTM)识别MSM随访期间每三个月的HIV检测频率发展轨迹中可能存在相似的发展轨迹亚组,使用无序多分类logistic回归分析MSM的HIV检测频率发展轨迹组的相关因素及发展轨迹组与HIV暴露前/后预防药物使用的关联。结果共有327名MSM纳入分析,年龄为27.722±8.137岁。基于最优模型评价指标贝叶斯信息准则等,GBTM识别出3组HIV检测发展轨迹组,分别为低频率HIV检测组、中频率HIV检测组、高频率HIV检测组。相比于低频率HIV检测组,高频率HIV检测组MSM的HIV暴露前预防药物使用率(9.49%vs.55.56%)(χ^(2)=32.02,P<0.001)、HIV暴露后预防药物使用率(17.39%vs.44.44%)较高(χ^(2)=8.19,P<0.017)。控制相关混杂因素发现,相比于高频率HIV检测组,低频率HIV检测组和中频率HIV检测组的MSM使用HIV暴露前预防药物的OR=0.153(95%CI:0.047~0.501,P=0.002)和OR=0.251(95%CI:0.070~0.907,P=0.035)。而在最近一年HIV自我检测频率方面,随着HIV检测频率的降低,HIV自我检测频率增多(低频率HIV检测组OR=5.664,95%CI:1.313~24.428,P=0.020)(中频率HIV检测组OR=5.087.95%CI:1.082~23.926,P=0.039)。结论有更多高风险性行为的MSM表现出定期和频繁的HIV检测模式,并且更积极地利用PrEP/PEP来预防HIV。与定期HIV检测频率较高的MSM相比,HIV检测频率较低的MSM表现出更高的自我检测使用率。Objective To explore the association between HIV testing frequency and pre-/post-exposure prophylaxis(PrEP/PEP)use among individuals at risk of HIV.Methods Utilizing a follow-up cohort of men who have sex with men(MSM)conducted in five cities(Nanning,Liuzhou,Guilin,Yulin,and Beihai)in Guangxi Province,China,we employed a group-based trajectory model(GBTM)to analyze the developmental trajectories of HIV testing frequency among MSM.Furthermore,we conducted logistic regression analysis to examine the factors associated with different trajectory groups of HIV testing frequency and their relationship with the utilization of PrEP/PEP before and after HIV exposure.Results The analysis included a total of 327 MSM participants,with an average age of 27.722±8.137 years.Based on evaluation criteria such as the Bayesian information criterion,GBTM identified three trajectory groups of HIV testing frequency:low-frequency group(73.87%),medium-frequency group(19.75%),and high-frequency group(6.37%).Comparing to the low-frequency group,MSM in the high-frequency group exhibited higher utilization rates of PrEP(9.49%vs.55.56%)(χ^(2)=32.02,P<0.001)and PEP(17.39%vs.44.44%)(χ^(2)=8.19,P<0.017).After controlling for relevant confounding factors,the low-frequency group and medium-frequency group showed of the used PrEP by OR=0.153(95%CI:0.047-0.501,P=0.002)and OR=0.251(95%CI:0.070-0.907,P=0.035),respectively,compared to the high-frequency group.Furthermore,regarding the frequency of HIV self-testing in the past year,as HIV testing frequency decreased,there was an increase in the frequency of HIV self-testing in the past year(low-frequency group OR=5.664,95%CI:1.313-24.428,P=0.020)(medium-frequency group OR=5.087.95%CI:1.082-23.926,P=0.039).Conclusion MSM who engage in higher-risk sexual behaviors are more likely to undergo regular and frequent HIV testing,and they are more proactive in using PrEP/PEP for HIV prevention.Compared with MSM with higher frequency of regular HIV testing,MSM with lower frequency of HIV testing showed higher

关 键 词：HIV检测 男男性行为者 HIV暴露前/后预防药物 基于群组轨迹模型 

分 类 号：R512.91[医药卫生—内科学]