Excess mortality and influencing factors among HIV-positive men who have sex with men in China,2004-2021
Objective This study aims to evaluate the excess mortality rates and their influencing factors among newly reported HIV-positive men who have sex with men(MSM)in China from 2004 to 2021.Methods Data of MSM aged ≥ 18 years,diagnosed as HIV positive,infected through male-to-male sexual behavior,and newly reported between 2004 and 2020 were obtained from the China Information System for Disease Control and Prevention.The excess mortality rates for HIV-positive MSM were calculated using the mortality rates of the general male population as a reference.The factors influencing the excess mortality rates among HIV-positive MSM were analyzed using a multivariable Poisson regression model based on the relative survival estimation method.Results From 2004 to 2021,the crude mortality rate for HIV-positive MSM was 1.33/100 person-years and the excess mortality rate was 1.10/100 person-years.The excess mortality rate was 0.65/100 person-years for diagnosed MSM who initiated combination antiretroviral therapy(cART)within 30 days,and 13.85/100 person-years for the untreated population.Subsequently,there was a decreasing trend in the excess mortality rates among HIV-positive MSM with the increasing follow-up period.Multivariable Poisson regression indicated that higher excess mortality risk among HIV-positive MSM was associated with older age,lower educational level,and lower initial CD4+cell count.In addition,HIV-positive MSM residing in central or western provinces,with marital status of unmarried/divorced/widowed,detected by medical institutions,with time from diagnosis to cART initiation＞30 days or untreated had a higher risk of excess mortality.Conclusions The mortality risk of HIV-positive MSM is higher than that of the general male population.Initiation of cART may help to narrow the mortality gap.It is of the utmost importance to continuously expand the scope of HIV testing,detect infections earlier,and initiate antiretroviral treatment without delay.Furthermore,it is essential to improve the quality of follow-up services for older individuals.
HIV/AIDSmen who have sex with men(MSM)excess mortality rate
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NSTL
万方数据
