HIV incidence and associated risk factors in men who have sex with men in Mainland China: an updated systematic review and meta-analysis

Sexual Health ◽  
2016 ◽  
Vol 13 (4) ◽  
pp. 373 ◽  
Author(s):  
Wei Zhang ◽  
Jun-Jie Xu ◽  
Huachun Zou ◽  
Jing Zhang ◽  
Ning Wang ◽  
...  
Keyword(s):  
Meta Analysis ◽  
College Education ◽  
Junior College ◽  
People Living With Hiv ◽  
Hiv Incidence ◽  
Syphilis Infection ◽  
Hiv Intervention ◽  
Hiv Prevention Strategies ◽  
Hiv Seroconversion ◽  
Sex With Men

Background: The national annually reported proportion of men who have sex with men (MSM) among people living with HIV (PLWH) is growing in China. To better inform the public health sector how to improve HIV prevention strategies, it is necessary to understand the current level of HIV incidence and its correlates. Methods: Google Scholar, PubMed, Web of Science and three major Chinese electronic publication databases (http://qikan.cqvip.com/, http://g.wanfangdata.com.cn/, http://www.cnki.net/, respectively) were searched for studies reporting HIV incidence. Comprehensive Meta-Analysis (CMA) 2.0 statistical software (Biostat, Inc. Englewood, NJ, USA) was used to calculate the pooled HIV incidence and perform subgroup-analysis to find correlates for HIV seroconversion in Chinese MSM. Random effects modelling was then conducted. Results: Twenty-five eligible studies were included in this meta-analysis. The calculated pooled HIV incidence was 5.61/100 person years (PY), with an increasing trend over time (3.24/100PY, 5.29/100PY, 5.50/100PY in 2005–2008, 2009–2011, 2012–2014 respectively, χ2 test for trend P = 0.04). Subgroup analyses indicated that age <25 years (rate ratio (RR) = 1.85), junior college education and below (RR = 1.87), having ≥ 2 male sexual partners in past 6 months (RR = 2.50), baseline syphilis infection (RR = 2.99), homosexual orientation (RR = 1.91), preferred bottom/versatile roles in anal sexual intercourse (RR = 2.33), and having unprotected anal intercourse in the past 6 months (RR = 2.16) significantly increased the risk for HIV seroconversion (each P < 0.05). Uncircumcised MSM had a marginal statistically significant higher HIV incidence (RR = 3.35, P = 0.051). Conclusion: HIV incidence is still alarmingly high among Chinese MSM. Stronger HIV intervention strategies should be implemented, in particular targeting young, less educated and syphilis-infected MSM.

scholarly journals Incidence of Herpes Zoster in HIV-Infected Patients Undergoing Antiretroviral Therapy: A Systematic Review and Meta-analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2300
Author(s):  
Han-Chang Ku ◽  
Yi-Tseng Tsai ◽  
Sriyani-Padmalatha Konara-Mudiyanselage ◽  
Yi-Lin Wu ◽  
Tsung Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Herpes Zoster ◽  
Antiretroviral Therapy ◽  
Random Effects ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Funnel Plots ◽  
Sex With Men ◽  
Treat All ◽  
Living With Hiv

The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I2 statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56–3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054–2.41)), men who have sex with men (AOR: 1.21 (95% CI: −0.76–1.13)), CD4 count < 200 cells/μL (AOR: 11.59 (95% CI: 0.53–4.38)) and not receiving ART (AOR: 2.89 (95% CI: −0.44–2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.

scholarly journals Effect of syphilis infection on HIV acquisition: a systematic review and meta-analysis

2020 ◽  
pp. sextrans-2020-054706
Author(s):  
Meng Yin Wu ◽  
Hui Zi Gong ◽  
Kui Ru Hu ◽  
He-yi Zheng ◽  
Xia Wan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
High Risk ◽  
Meta Analysis ◽  
Risk Groups ◽  
Hiv Incidence ◽  
Syphilis Infection ◽  
High Risk Populations ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

ObjectivesCo-infection of syphilis and HIV remains hard to manage and its morbidity shows a rising tendency. Syphilis has been associated with increased risk of HIV acquisition in high-risk groups, especially in men who have sex with men (MSM). This systematic review and meta-analysis estimates the effect of syphilis infection on subsequent HIV acquisition, and assesses its difference between MSM and other high-risk populations.MethodsFive electronic databases were searched for literature published to 21 September 2019 without language restrictions. Longitudinal studies that enrolled key populations to compare the incidence of HIV with and without syphilis exposure were included. We used a random-effects model to estimate the effect of syphilis infection on HIV acquisition among high-risk populations, which include MSM, sex workers, serodiscordant couples, people who inject drugs and attendees of STD clinics.ResultsA total of 17 cohorts and 5 case-control studies involving 65 232 participants were included. HIV incidence showed a two-time increase after syphilis exposure, compared with a control group (relative risk (RR) 2.67 (95% CI 2.05 to 3.47); p<0.05 for prevalence; RR 3.21 (95% CI 2.26 to 4.57); p=0.419 for incidence). No significant differences were observed between MSM and other high-risk groups in syphilis infection prevalence (RR 2.60 (95% CI 1.78 to 3.80); p<0.05 vs RR, 2.98 (95% CI 2.15 to 4.14); p<0.05; ratio of relative risk 0.76 (95% CI 0.49 to 1.17)).ConclusionsSyphilis infection increases the risk of HIV acquisition in high-risk populations. There is no evidence to suggest MSM are at greater risk than other high-risk populations. Prompt diagnosis, timely treatment, preventive interventions against syphilis infection would be a worthwhile investment for reducing HIV incidence. Strategies to combat stigma and discrimination targeted at MSM are pragmatically needed.

A multi-state Markov model using notification data to estimate HIV incidence, number of undiagnosed individuals living with HIV, and delay between infection and diagnosis: Illustration in France, 2008–2018

2021 ◽  
pp. 096228022110326
Author(s):  
Charlotte Castel ◽  
Cecile Sommen ◽  
Yann Le Strat ◽  
Ahmadou Alioum
Keyword(s):  
Markov Model ◽  
Hiv Transmission ◽  
Hiv Incidence ◽  
Infected People ◽  
Hiv Surveillance ◽  
Hiv Prevention Strategies ◽  
Penalized Likelihood Approach ◽  
Sex With Men ◽  
Living With Hiv ◽  
Notification Data

Thirty-five years since the discovery of the human immunodeficiency virus (HIV), the epidemic is still ongoing in France. To guide HIV prevention strategies and monitor their impact, it is essential to understand the dynamics of the HIV epidemic. The indicator for reporting the progress of new infections is the HIV incidence. Given that HIV is mainly transmitted by undiagnosed individuals and that earlier treatment leads to less HIV transmission, it is essential to know the number of infected people unaware of their HIV-positive status as well as the time between infection and diagnosis. Our approach is based on a non-homogeneous multi-state Markov model describing the progression of the HIV disease. We propose a penalized likelihood approach to estimate the HIV incidence curve as well as the diagnosis rates. The HIV incidence curve was approximated using cubic M-splines, while an approximation of the cross-validation criterion was used to estimate the smoothing parameter. In a simulation study, we evaluate the performance of the model for reconstructing the HIV incidence curve and diagnosis rates. The method is illustrated in the population of men who have sex with men using HIV surveillance data collected by the French Institute for Public Health Surveillance since 2004.

scholarly journals HIV/STI prevention interventions: A systematic review and meta-analysis

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 450-467 ◽  
Author(s):  
Jason Globerman ◽  
Sanjana Mitra ◽  
David Gogolishvili ◽  
Sergio Rueda ◽  
Laura Schoffel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behavioral Interventions ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Sti Prevention ◽  
Quality Of Evidence ◽  
Quality Reporting ◽  
Hiv Intervention ◽  
Prevention Interventions

AbstractBehavioral interventions can prevent the transmission of HIV and sexually transmitted infections. This systematic review and meta-analysis assesses the effectiveness and quality of available evidence of HIV prevention interventions for people living with HIV in high-income settings. Searches were conducted in MEDLINE, EMBASE, PsycINFO, and CDC Compendium of Effective Interventions. Interventions published between January, 1998 and September, 2015 were included. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Forty-six articles and 63 datasets involving 14,096 individuals met inclusion criteria. Included articles were grouped by intervention type, comparison group and outcome. Few of these had high or moderate quality of evidence and statistically significant effects. One intervention type, group-level health education interventions, were effective in reducing HIV/STI incidence when compared to attention controls. A second intervention type, comprehensive risk counseling and services, was effective in reducing sexual risk behaviors when compared to both active and attention controls. All other intervention types showed no statistically significant effect or had low or very low quality of evidence. Given that the majority of interventions produced low or very low quality of evidence, researchers should commit to rigorous evaluation and high quality reporting of HIV intervention studies.

scholarly journals HIV Incidence among Men Who Have Sex with Men in China: A Meta-Analysis of Published Studies

PLoS ONE ◽  
2011 ◽  
Vol 6 (8) ◽  
pp. e23431 ◽  
Author(s):  
Hong-Min Li ◽  
Rui-Rui Peng ◽  
Jing Li ◽  
Yue-Ping Yin ◽  
Baoxi Wang ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Hiv Incidence ◽  
Sex With Men

scholarly journals HIV incidence among men who have sex with men using geosocial networking smartphone application in Beijing, China: an open cohort study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Guo-Dong Mi ◽  
Bin-Bin Zhang ◽  
Fei Yu ◽  
Xian-Long Ren ◽  
Jason J. Ong ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Sexual Behaviors ◽  
Smartphone Application ◽  
Consistent Condom ◽  
Hiv Incidence ◽  
Anal Sex ◽  
Hiv Test ◽  
Hiv Seroconversion ◽  
Geosocial Networking ◽  
Sex With Men

Abstract Background Sexual transmission among men who have sex with men (MSM) is the dominant route of HIV transmission in China. Extensive use of geosocial networking (GSN) smartphone application (app) has dramatically changed the pattern of sexual behaviors and HIV risk among MSM, but data on HIV incidence and the changing risk behaviors of GSN app-using MSM are limited. We aims to assess the HIV incidence and its correlates among gay GSN app-using MSM in China. Methods We constructed an open cohort which was initiated and maintained using a GSN app to assess the HIV incidence among app-using MSM, recruited from June 2017 to December 2018. MSM completed an online questionnaire on their sociodemographic characteristics, sexual behaviors, recreational drug use and sexually transmitted infections status. Then each man had an HIV test, and those tested negatives were enrolled into the cohort. Participants completed follow-ups with additional HIV tests though the app during the study period, and were censored at HIV seroconversion or study end date. HIV incidence was calculated by dividing the sum of observed HIV seroconversions by the observed person-time. Univariate (Chi-square test and Fisher’s exact test) and multivariate (proportional hazards regression) analyses were used to examine correlates of HIV incidence. Results A total of 6957 HIV negative MSM were enrolled in the open cohort, 37 seroconversions occurred among 1937 men contributing 1065 observed person-years: HIV incidence was 3.47 per 100 person-years [95% confidence interval (CI): 2.37–4.57]. More than five sexual partners [hazard ratio (HR) = 2.65, 95% CI: 1.04–6.67], and sex with HIV positive partners (HR = 3.82, 95% CI: 1.16–12.64) in the preceding six months were positively associated with HIV seroconversion. Consistent condom use for anal sex (HR = 0.27, 95% CI: 0.07–0.96), and reporting insertive anal sex only (HR = 0.23, 95% CI: 0.08–0.62) in the preceding six months were protective factors for HIV seroconversion. Conclusions Tailored interventions targeting app-using MSM are urgently needed given their high risk of HIV. As a new tool for accessing MSM at higher HIV risk, GSN smartphone app could play an important role in HIV research among MSM.

scholarly journals HIV incidence among men who have sex with men in mainland China: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Wenting Huang ◽  
Liming Wang ◽  
Mi Guodong ◽  
Ryan J. Zahn ◽  
Jennifer Taussig ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Temporal Trends ◽  
Mainland China ◽  
Hiv Infections ◽  
Future Research ◽  
Hiv Incidence ◽  
Geographic Variations ◽  
Sex With Men

Abstract Background Men who have sex with men (MSM) are disproportionately affected by HIV in China. Globally, younger MSM are at higher risk for incident HIV infections, but there has been substantial variation in the estimates of age-stratified HIV incidence among MSM in mainland China, potentially due to regional differences in the nature of the epidemic. Given the need for quality epidemiological data to meet the global goal of ending new HIV infections by 2030, this systematic review and meta-analysis aims to determine age-stratified HIV incidence in mainland China, including consideration by geographic region and time. Methods This review will include longitudinal studies, cross-sectional surveys, and surveillance reports among MSM in mainland China that have reported HIV incidence. We will search studies and reports published from January 1, 2003, to April 30, 2020, in both English and Chinese language literature databases. For each study considered, two reviewers will independently screen, determine eligibility, and extract relevant data, with discrepancies resolved by consensus of a third reviewer. The methodological quality of included studies will be assessed by the Quality Assessment Tool for Systematic Reviews of Observational Studies Score (QATSO). We will develop age-stratified estimates of HIV incidence with geographic variations and temporal trends. Heterogeneity will be examined using statistical techniques appropriate to the dataset. For subgroup analyses, we will conduct mixed-effects meta-analysis models. Discussion This review will contribute to a better understanding of the HIV epidemic among MSM in mainland China by providing age-stratified estimates of HIV incidence with a portrayal of geographic and temporal variations. Findings will reflect epidemic dynamics, informing local and national intervention programs and policies for HIV prevention, and providing estimation data to inform future research among MSM in China. Systematic review registration PROSPERO ID 154834

scholarly journals HIV Risk Among Men Who Have Sex With Men, Women Who Have Sex With Women, Lesbian, Gay, Bisexual and Transgender Populations in South Africa: A Mini-Review

2016 ◽  
Vol 10 (1) ◽  
pp. 49-64 ◽  
Author(s):  
Meredith G. B. Evans ◽  
Allanise Cloete ◽  
Nompumelelo Zungu ◽  
Leickness C. Simbayi
Keyword(s):  
South Africa ◽  
Hiv Risk ◽  
People Living With Hiv ◽  
Lgb Youth ◽  
Marginalized Groups ◽  
Current State ◽  
Hiv Prevention Strategies ◽  
Bisexual And Transgender ◽  
Sex With Men ◽  
Lgbt Populations

Background: The HIV epidemic in South Africa is characterized mainly by heterosexual transmission. Recently, the importance of targeting key populations and marginalized groups, including men who have sex with men (MSM) and transgender people, has been added to the national agenda. Objectives: This mini-review explores the current state of empirical research on HIV risk and MSM, women who have sex with women (WSW), lesbian, gay, bisexual and transgender (LGBT) populations in South Africa in order to assess the current state of research and identify gaps in the literature. Method: Peer-reviewed empirical social and behavioral articles on HIV prevalence and risk focusing on MSM, WSW, and LGBT populations published since 2006 were included in this mini-review. Results: In total 35 articles were included: 30 on MSM, gay, and/or bisexual male-identified populations, three on WSW, lesbian, and/or bisexual female-identified populations, two on LGB youth, and none on transgender populations. Conclusion: Despite South Africa being the country with the largest number of people living with HIV in the world, there is a limited amount of research in South Africa on HIV and non-normative gender identities and sexualities, especially WSW, lesbian, and/or bisexual female-identified populations, transgender populations, and LGB youth. Research with MSM, WSW, and LGBT populations should be prioritized in South Africa in order to appropriately inform HIV prevention strategies that meet the specific needs of these marginalized groups.

scholarly journals Association between rectal gonorrhoea and HIV incidence in men who have sex with men: a meta-analysis

2021 ◽  
pp. sextrans-2021-055254
Author(s):  
Deborah Donnell ◽  
Kidist Zewdie ◽  
Natasha Ratna ◽  
Veronica Miller ◽  
John Michael Saunders ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Population Level ◽  
Incidence Rates ◽  
Hiv Incidence ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Hiv Exposure ◽  
Sex With Men ◽  
Sexual Health Clinics ◽  
Hiv Negative

BackgroundIncidence of rectal gonorrhoea (GC) has been hypothesised as a correlate of HIV exposure in prevention trials of men who have sex with men (MSM). High rectal GC incidence in MSM trials of new biomedical prevention drugs may provide supportive evidence for ongoing HIV risk. Empirical evidence of correlation between rectal GC and HIV incidence is needed to assess whether high rectal GC rates reliably correlate with high risk of HIV.MethodsRectal GC and HIV are routinely tested in sexual health clinics (SHCs) throughout England. Through routine surveillance data collected at visits to SHCs, we assessed HIV incidence and new rectal GC diagnoses in repeat visits by HIV-negative MSM between 2011 and 2018, predating widespread roll-out of pre-exposure prophylaxis. Meta-analysis regression assessed population-level association between HIV and rectal GC incidence over time.FindingsBetween 2011 and 2018, HIV and rectal GC incidence was assessed in 541 056 HIV-negative MSM attending SHCs in England. HIV incidence among MSM attending SHCs fell from 1.26/100 person-years (PYs) in 2011 to 0.28/100 PYs in 2018. Rectal GC rates increased from 3.5/100 PYs to 11.1/100 PYs over the same period. The rate of HIV incidence decreased by 22.3% for each percent increase in rectal GC (95% CI –30.8 to –14.7, p<0.001).InterpretationAmong the population of MSM attending SHCs in England, rectal GC rates increased substantially while HIV incidence rates decreased between 2011 and 2018. HIV incidence likely decreased through expanded HIV testing, prompt antiretroviral treatment (ART) initiation and increased viral suppression in persons living with HIV, interventions that did not decrease rectal GC. Rectal GC may not be an ideal proxy for HIV incidence in trials, as HIV exposure risk is complex and context dependent, given effective HIV prevention interventions in MSM.Introduction

The electronic identification protects privacy and has consistent HIV incidence with the traditional real-name follow-up among Chinese MSM: A 24-month prospective cohort study (Preprint)

2021 ◽  
Author(s):  
Jie Wei ◽  
Xiangjun Zhang ◽  
Jing Zhang ◽  
Zhenxing Chu ◽  
Wenqing Geng ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cox Regression ◽  
Retention Rates ◽  
Kappa Statistics ◽  
Hiv Incidence ◽  
Predictive Values ◽  
The Real ◽  
Hiv Seroconversion ◽  
Sex With Men

BACKGROUND Men who have sex with men (MSM) usually face stigma and discrimination in relation to their sexual orientation and have the fear of identification disclosure, which may prevent them from taking HIV tests and participating in research studies. The traditionally used real-name identification methods might lead to biased estimates in HIV incidence. OBJECTIVE This study evaluated an electronic identification (eID) method in estimating HIV incidence among MSM using a social media application that allowed good protection of privacy than the real-name identification. METHODS From January 2018 to January 2020, a WeChat OpenID identifier was used to generate and assign eID for MSM who attended the First Affiliated Hospital of China Medical University for voluntary counselling and testing (VCT) services. The inclusion criteria were men aged 18 years and older who had consensual anal or oral sex with men in the previous 12 months and agreed to WeChat authorization. The eID group was compared with the real-name identification group (PID) that we acquired through HIV testing information regarding participants’ demographic and behavioral characteristics and HIV incidence. Sensitivity, specificity, positive and negative predictive values, and Kappa statistics were used to compare the consistency of the two groups. Cox regression was used to assess factors that were associated with HIV infection during the follow-up period. RESULTS Of 1499 WeChat OpenID users, 1133 participants were identified and linked to their traditional PID and some participants used multiple OpenIDs. The Kappa consistency between eID and traditional PID method were 0.753. At baseline, 4.2% participants in eID group received an HIV positive testing result, which was comparable to PID group (5.4%, Kappa=0.992). Thirty-five participants infected HIV during the follow-up period. The incidence of HIV infection was 7.3/100 person-years for eID group (95% CI, 5.4-10.1) and 5.8/100 person-years for PID group (95% CI, 4.2-8.0), and the consistency was high (Kappa=0.712, P>.05). The retention rates between eID and PID group were also accordant (Kappa=0.722). Number of sexual partners, recent unprotected anal sex, and recent party drug use were associated with HIV seroconversion. CONCLUSIONS The eID method that allowed anonymous tests and multiple visits had consistent results compared to the traditional real-name PID method. This method can be scaled up in future prevention and testing programs in HIV high risk populations with high privacy and confidentiality demands.

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