Diagnosis And Treatment Status Of HIV/AIDS In MSM Population And Prediction Of Biological-behavioral Intervention Effect In Shandong Province

Background:The prevention and treatment of Acquired immunodeficiency syndrome(AIDS)is an important public health problem for Human beings.It is caused by Human immunodeficiency virus(HIV),which is of great harm to human society.Antiretroviral therapy(ART)has been implemented since 2003 in Shandong Province,and great progress has been made in antiviral therapy,but the progress of the"95-95-95" target remains to be analyzed.Men who have sex with men(MSM)are high risk groups of HIV infection due to the characteristics of multiple sex partners,temporary partners and high frequency of unprotected sex.Since 2011,the number of HIV infections through homosexual transmission has exceeded that through heterosexual transmission in Shandong Province,which has become the main way of HIV transmission in Shandong Province.Scaling up testing to find as many people with HIV/AIDS as possible and to get them into follow-up treatment services is a key step towards achieving the "95-95-95"goal.Condom use promotion interventions are essential to prevent HIV and other Sexually transmitted diseases(STDS).Proper condom use can significantly cut HIV transmission routes,reduce the risk of infection,and protect vulnerable populations.Pre-exposure prophylaxis,or PrEP,is a new biomedical intervention that can partly reduce the risk of HIV infection.Based on the above analysis,this study intends to analyze the status quo of HIV/AIDS diagnosis and treatment in Shandong Province,and then analyze the factors for HIV/AIDS timely receiving ART in high-risk groups of HIV infection.namely MSM population,to improve the accessibility of ART services in MSM population.And by constructing risk estimation equations for biological interventions such as Treatment as prevention(TasP),PrEP and testing counseling in high-risk groups,and condom use promotion behavioral interventions and new HIV infections in MSM,To comprehensively evaluate the effect of biological behavioral comprehensive intervention measures on reducing new HIV infection in MSM population in the real world,and predict the impact of in-depth implementation of comprehensive prevention and control intervention measures on reducing new HIV infection,so as to provide theoretical basis and data support for optimizing prevention and control strategies and curbing AIDS transmission in Shandong Province.Methods:1.Taking the cumulative existing live HIV/AIDS in Shandong Province from 2018 to 2021 as the research object,the diagnosis and treatment data within one year after diagnosis were collected to describe the status quo of infection diagnosis,ART acceptance and virus suppression of existing live HIV/AIDS in 2018-2021.2.The situation of newly diagnosed same-sex HIV/AIDS receiving ART in Shandong Province in 2018 was described,and the influence of age,STD,occupation and other epidemiological characteristics on timely ART was analyzed by Logistic regression.3.Based on the diagnosis and discovery rate,ART rate and virus inhibition rate of existing live HIV/AIDS through homosexual transmission in Shandong Province in 2020,the new HIV infection risk estimation equation model of MSM population was constructed.The effects of biological interventions such as TasP,PrEP,testing and counseling in high-risk groups,and condom use promotion behavioral interventions on reducing new HIV infections in MSM were evaluated.Results:1.By the end of 2021,it is estimated that there were 28150 living HIV/AIDS cases in Shandong Province,22,188 cases were diagnosed,21,271 cases received antiviral treatment,and 19138 cases obtained virus suppression;"95-95-95" AIDS prevention and treatment progress for diagnosis and discovery rate of 78.82%,antiviral treatment rate of 95.87%,virus inhibition rate of 91.68%.2.In 2018,there were 1,926 cases of HIV/AIDS transmitted by homosexual means in Shandong Province.The proportion of HIV/AIDS registered outside the province receiving ART in time was lower than that of HIV/AIDS in the province.The proportion of HIV/AIDS in detention receiving ART in time was lower than that in key population.The proportion of HIV/AIDS with higher levels of CD4 cells at baseline receiving ART in a timely manner was lower than HIV/AIDS with lower levels of CD4 cells at baseline.3.By 2030,when the diagnosis and treatment level of HIV/AIDS reaches"95-95-95",new HIV infections in MSM population will decrease by 35%compared with 2012;When the diagnosis and treatment level of HIV/AIDS reached "95-95-95"and the coverage rate of PrEP in high-risk populations reached 70%within 5 years,the new HIV infection in MSM population decreased by 65%compared to 2012.When the diagnosis and treatment level of HIV/AIDS reached "95-95-95" and the coverage rate of condom use promotion reached 50%(baseline coverage rate was 12%),the new HIV infection in MSM population decreased by 55%compared with 2012.When the diagnosis and treatment level of HIV/AIDS among MSM population reaches "95-95-95",the coverage rate of PrEP among high-risk MSM population reaches 30%,and the coverage rate of condom use increases to 50%within 5 years,the new HIV infections among MSM population in 2030 will decrease by 64%compared to 2012.It is predicted that by 2030,when HIV/AIDS diagnosis and treatment level reaches "95-95-95",condom use promotion coverage reaches 80%,and PrEP coverage reaches 70%among high-risk MSM population,new HIV infections in MSM population will decrease by 90%compared to 2012.Conclusions:1.By 2021,the diagnosis and discovery rate of live HIV/AIDS,antiviral treatment rate and virus inhibition rate in Shandong Province have been increasing year by year.The virus inhibition rate has nearly achieved the third 95%target,and the antiviral treatment rate has achieved the second 95%target,but the diagnosis and discovery rate is still a certain gap from the first 95%target.2.Timely ART rate of newly diagnosed homosexual HIV/AIDS in Shandong Province needs to be further improved.In particular,follow-up and antiviral therapy should be strengthened for those who are registered outside the province,those in detention and those with high CD4 cell level at diagnosis baseline,so as to further improve the proportion of timely treatment.3.In Shandong Province,single interventions such as "treatment as prevention"cannot achieve the goal of ending HIV transmission by 2030,while combined biological-behavioral interventions can achieve the goal of reducing new HIV infections by 90%.However,it is still difficult to achieve this goal in the real world,and comprehensive application of other effective interventions should be explored.To better control the spread of the HIV epidemic.