中老年男性人群艾滋病传播社会-分子网络分析及感染风险预测研究

HIV/AIDS is an emerging public health problem among the middle and older aged males in China. In this population, the major route of HIV transmission is via extramarital heterosexual transmission, but the transmission mechanisms are unclear. Given that Social Network Analysis and HIV molecular epidemiology approach have their own strengths and weaknesses, this study plans to combine both approaches to investigate HIV transmission mechanisms, based on samples from the area with high HIV prevalence of the middle and older aged men where the population mobility is limited in Chengdu. Firstly, a cross-sectional survey about HIV infection and social networks of high-risk behaviors will be conducted among around 100 newly detected HIV infected middle and older aged males and among around 50 high-risk network members who are reached through contacting tracing, in order to depict the characteristics of high-risk sexual behavior networks among them, and prepare for the following study. Secondly, Social-Molecular Mechanisms for HIV Transmission will be studied in a social-molecular transmission network comprised of around 100 newly detected HIV infected aged males and their high-risk network members, 275 blood samples of HIV infected females, and 100 blood samples of HIV infected Men who have Sex with Men(MSM).HIV-1 pol sequences will be obtained and used to infer the molecular transmission network, and social transmission network information will be combined. Using statistical analyses, social network analysis, social-molecular analyses, and back-propagation artificial neural network model, the social-molecular mechanism for HIV transmission among the aged males will be explored, so as to give pertinent suggestions for HIV prevention and control among the aged males. In this study, we are applying social-molecular analyses to studying HIV transmission mechanisms, which will provide methodological insights for how to combine the social transmission and molecular transmission network information into studies of HIV transmission mechanisms, even for studies of other high-risk groups, thus to provide better scientific evidence for precision prevention.

艾滋病正成为威胁我国中老年男性人群健康的重要公共卫生问题，联合社会网络和分子网络分析是传播机制研究新发展方向，亟待突破的是构建尽可能完整的社会-分子传播网络，通过多种方法揭示传播机制。本项目拟在成都市艾滋病疫情严重区域，首先完成约100名中老年男性新报告HIV感染者及其高危接触者（约50名）的高危性网络调查，获取HIV(+)血样，然后提取区域内所有女性PLHIV（约275例）、MSM PLHIV（约100例）血样，对所有血样进行HIV-1pol基因区扩增测序，结合社会传播网络信息，构建以中老年男性新报告HIV感染者为中心，包含所有传播途径的网络成员在内的艾滋病传播社会-分子整体网络实证模型。通过社会网络分析、社会-分子分析和BP-人工神经网络模型，依据高危性网络特征，开展中老年男性HIV感染风险预测。本研究为社会传播网络信息与分子传播网络信息如何结合，精准预防提供理论和实证支持。

艾滋病正成为威胁我国中老年男性人群健康的重要公共卫生问题，联合社会网络和分子网络分析是传播机制研究新发展方向，亟待突破的是构建尽可能完整的社会-分子传播网络，通过多种方法揭示传播机制。本项目在成都市艾滋病疫情严重区域，首先完成约114名中老年男性新报告HIV感染者及其高危接触者（20名）的亲密关系社会网络和性网络调查；获取113例中老年男性的HIV(+)血样，6例女性高危接触者HIV（+）血样，其他PLHIV417例，合计采集血样536例进行HIV-1 pol基因区扩增测序，结合社会传播网络信息，构建以中老年男性新报告HIV感染者为中心，包含所有传播途径的网络成员在内的艾滋病传播社会-分子整体网络实证模型。通过社会网络分析、社会-分子分析和BP-人工神经网络模型，依据高危性网络特征，开展中老年男性HIV感染风险预测。研究发现：中老年男性PLHIV亲密关系网络规模较小，较少获得社会支持，感染前极少接受艾滋病宣传，尤其是正式渠道，较少从性网络成员处获得社会支持，生殖保健概念和风险意识缺乏，安全套使用率低。分子网络分析显示县级市范围中老年男性PLHIV毒株亚型多样，进入分子传播网络的比例高，传播来源多元化，HIV传播呈现聚集性，传播机制复杂。社会传播网络与分子关联关系相互印证，县级市范围中老年男性HIV传播呈现聚集性，不排除社会网络调查中老年男性PLHIV存在瞒报同性性行为的可能，尚需基于分子传播网络的溯源调查提供更为精确的传播证据。本研究为社会传播网络信息与分子传播网络信息如何结合，精准预防提供理论和实证支持。目前公开发表期刊论文6篇，其中SCI论文1篇，The Lancet Regional Health - Western Pacific论文1篇，北大中文核心3篇。新建基于分子网络的艾滋病感染者溯源调查数据库2个。