Establishment of a predictive model for HIV infection risk among college student MSM and validation of its performance
HUANG Che-chi1,2,3,4, HU Zhi-li1,2,3, HU Qing-hai1,2,3, CHU Zhen-xing1,2,3, ZHANG Jing1,2,3, XU Jun-jie1,2,3
1. NHC Key Laboratory of AIDS Immunology (China Medical University), Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China; 2. Key Laboratory of AIDS Immunology of Liaoning Province, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning110001, China; 3. Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China; 4. Information Center of Liaoning Province, Shenyang, Liaoning 110001, China
摘要目的 建立并验证大学生男男性行为者(men who have sex with men,MSM)的HIV感染风险预测模型。 方法 利用我国7大城市(上海、南京、长沙、郑州、济南、沈阳和昆明)MSM横断面调查数据库中在校大学生MSM相关信息,通过单因素和多因素logistic回归建立模型并采用Stepwise逐步回归法筛选模型变量;采用C-statistics检验、Hosmer-Lemeshow检验(H-L检验)对模型进行判别能力和拟合效果的内部验证和评价;采用Bootstrap重抽样技术进行模型内部验证。 结果 共纳入742名大学生MSM参加研究,其HIV感染率为5.9%(44/742)。经logistic回归模型拟合并通过stepwise法筛选,以下变量进入最终模型:有性传播疾病感染史(OR=5.4,95%CI:2.5~11.4,P<0.01)(5分);近半年使用过新型毒品(OR=2.2,95%CI:1.2~4.2,P=0.016)(2分);最近一次男男性行为方式为被插入方或同时为插入方和被插入方(OR=2.3,95%CI:1.0~5.0,P=0.044)(2分)。模型的C-statistic检验的统计量AUC为0.71,H-L检验的卡方值为1.35(P=0.717);各变量在1 000个Bootstrap样本中出现的频率均>50%。 结论 大学生MSM人群HIV感染风险预测模型具有较好的判别能力和拟合效果,有助于大学生MSM人群比较客观地评估其自身HIV感染风险,以及促进其参与后续HIV检测等防控活动。
Abstract：Objective To develop and validate a predictive model for HIV infection risk in college student MSM. Methods The information related to college student MSM was collected from the database of MSM cross-sectional survey in 7 cities(including Shanghai, Nanjing, Changsha, Zhengzhou, Jinan, Shenyang and Kunming). Univariate and multivariate logistic regression was used to develop the model, and a stepwise procedure was used to select variables. C-statistics test was employed to assess the model discrimination, and Hosmer–Lemeshow test was used to estimate the model calibration. Bootstrap resampling technology was used for model validation. Results A total of 742 college student MSM were enrolled in this study, and the prevalence rate of HIV was 5.9% (44/742). According to logistic regression and stepwise procedure, the variables and their scores in the pred-ictive model for HIV infection risk among college student MSM were having a history of infection with sexual transmitted diseases (OR=5.4, 95%CI:2.5-11.4, P<0.01) (5 points), new-type drug abuse in the past six months (OR=2.2, 95%CI:1.2-4.2, P=0.016) (2 points), and practicing receptive or both insertive and receptive anal intercourse in the most recent homosexual behavior (OR=2.3, 95%CI:1.0-5.0, P=0.044) (2 points). The area under the curve (AUC) of C-statistics was 0.71, and the Chi-square value of Hosmer-Lemeshow test was 1.35 (P=0.717). The frequency of each variable in the final model appeared in 1,000 Bootstrap samples were all greater than 50%. Conclusions The said predictive model for HIV infection risk among college student MSM has better judgment ability and fitting effect. It is conducive to objectively self-evaluating the risk for HIV infection among college student MSM and promoting them to participate in HIV detection and other prevention and control activities.
黄掣驰 , 呼志丽 , 胡清海 , 楚振兴 , 张晶 , 徐俊杰. 大学生MSM人群HIV感染风险预测模型建立及效果验证研究[J]. 实用预防医学, 2020, 27(2): 156-159.
HUANG Che-chi, HU Zhi-li, HU Qing-hai, CHU Zhen-xing, ZHANG Jing, XU Jun-jie. Establishment of a predictive model for HIV infection risk among college student MSM and validation of its performance. , 2020, 27(2): 156-159.
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