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首页> 外文期刊>BMC Public Health >Estimating the size of the MSM populations for 38 European countries by calculating the survey-surveillance discrepancies (SSD) between self-reported new HIV diagnoses from the European MSM internet survey (EMIS) and surveillance-reported HIV diagnoses among MSM in 2009
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Estimating the size of the MSM populations for 38 European countries by calculating the survey-surveillance discrepancies (SSD) between self-reported new HIV diagnoses from the European MSM internet survey (EMIS) and surveillance-reported HIV diagnoses among MSM in 2009

机译：通过计算2009年欧洲MSM互联网调查（EMIS）自我报告的新HIV诊断与MSM监测报告的HIV诊断之间的调查监视差异（SSD），估算38个欧洲国家的MSM人群数量

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Background Comparison of rates of newly diagnosed HIV infections among MSM across countries is challenging for a variety of reasons, including the unknown size of MSM populations. In this paper we propose a method of triangulating surveillance data with data collected in a pan-European MSM Internet Survey (EMIS) to estimate the sizes of the national MSM populations and the rates at which HIV is being diagnosed amongst them by calculating survey-surveillance discrepancies (SSD) as a measure of selection biases of survey participants. Methods In 2010, the first EMIS collected self-reported data on HIV diagnoses among more than 180,000 MSM in 38 countries of Europe. These data were compared with data from national HIV surveillance systems to explore possible sampling and reporting biases in the two approaches. The Survey-Surveillance Discrepancy (SSD) represents the ratio of survey members diagnosed in 2009 (HIVsvy) to total survey members (Nsvy), divided by the ratio of surveillance reports of diagnoses in 2009 (HIVpop) to the estimated total MSM population (Npop). As differences in household internet access may be a key component of survey selection biases, we analysed the relationship between household internet access and SSD in countries conducting consecutive MSM internet surveys at different time points with increasing levels of internet access. The empirically defined SSD was used to calculate the respective MSM population sizes (Npop), using the formula Npop?=?HIVpop*Nsvy*SSD/HIVsvy. Results Survey-surveillance discrepancies for consecutive MSM internet surveys between 2003 and 2010 with different levels of household internet access were best described by a potential equation, with high SSD at low internet access, declining to a level around 2 with broad access. The lowest SSD was calculated for the Netherlands with 1.8, the highest for Moldova with 9.0. Taking the best available estimate for surveillance reports of HIV diagnoses among MSM in 2009 (HIVpop), the relative MSM population sizes were between 0.03% and 5.6% of the adult male population aged 15–64. The correlation between recently diagnosed (2009) HIV in EMIS participants and HIV diagnosed among MSM in 2009 as reported in the national surveillance systems was very high (R2?=?0.88) when using the calculated MSM population size. Conclusions Npop and HIVpop were unreliably low for several countries. We discuss and identify possible measurement errors for countries with calculated MSM population sizes above 3% and below 1% of the adult male population. In most cases the number of new HIV diagnoses in MSM in the surveillance system appears too low. In some cases, measurement errors may be due to small EMIS sample sizes. It must be assumed that the SSD is modified by country-specific factors. Comparison of community-based survey data with surveillance data suggests only minor sampling biases in the former that – except for a few countries - do not seriously distort inter-country comparability, despite large variations in participation rates across countries. Internet surveys are useful complements to national surveillance systems, highlighting deficiencies and allowing estimates of the range of newly diagnosed infections among MSM in countries where surveillance systems fail to accurately provide such data.
机译：背景由于各种原因，包括不明MSM人群的数量，比较各国之间MSM中新诊断出的HIV感染率具有挑战性。在本文中，我们提出了一种将监视数据与泛欧洲MSM互联网调查（EMIS）中收集的数据进行三角剖分的方法，以通过计算调查监视来估计全国MSM人口的规模以及其中的艾滋病毒诊断率差异（SSD）作为衡量调查参与者选择偏见的一种方法。方法2010年，第一个EMIS收集了来自欧洲38个国家/地区的18万多名MSM中自我诊断的艾滋病毒报告数据。将这些数据与来自国家艾滋病毒监测系统的数据进行比较，以探索两种方法中可能的抽样和报告偏见。调查与监视差异（SSD）代表2009年诊断出的调查成员（HIVsvy）与总调查成员（Nsvy）的比率除以2009年诊断出的监测报告（HIVpop）与MSM估计总人数（Npop）的比率）。由于家庭互联网访问的差异可能是调查选择偏见的关键组成部分，我们分析了随着互联网访问水平的提高，在不同时间点连续进行MSM网络调查的国家中家庭互联网访问与SSD的关系。使用公式Npop？=？HIVpop * Nsvy * SSD / HIVsvy，根据经验定义的SSD用于计算相应的MSM人口规模（Npop）。结果2003年至2010年间，连续的MSM网络调查在不同水平的家庭互联网访问下的调查监视差异最好用一个潜在方程式来描述，其中SSD高但互联网访问低，下降到2左右且访问广泛。计算得出的荷兰最低SSD为1.8，摩尔多瓦最高SSD为9.0。对2009年MSM中的HIV诊断监测报告（HIVpop）进行最佳估计，相对MSM人群规模为15-64岁成年男性人群的0.03％至5.6％。当使用计算得出的MSM人群时，根据国家监测系统的报告，最近（2009）EMIS参与者中的HIV与2009年MSM中的HIV被诊断之间的相关性非常高（R 2 ？=？0.88）。尺寸。结论在几个国家，Npop和HIVpop的低得不可靠。我们讨论并确定了MSM人口规模大于成年男性人口3％且低于1％的国家可能的测量误差。在大多数情况下，监视系统中MSM中新诊断出的HIV数量似乎太少。在某些情况下，测量误差可能归因于较小的EMIS样本量。必须假定SSD已因国家/地区特定因素而修改。将基于社区的调查数据与监测数据进行比较表明，前者中的抽样偏差很小，除了少数国家以外，尽管国家间的参与率差异很大，但不会严重扭曲国家间的可比性。互联网调查是对国家监控系统的有益补充，突出了不足之处，并可以估计监控系统无法准确提供此类数据的国家中MSM中新诊断的感染范围。

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