背景:由于各种健康状况(尤其是免疫系统减弱)和避孕套的使用率低,性活跃的老年人通常更容易感染HIV和其他性传播感染(STIs)。我们的目标是评估全球,区域,以及1990年至2019年老年人艾滋病毒和其他性传播感染的国家负担和趋势。
方法:我们从全球疾病负担中检索数据,受伤,和风险因素研究(GBD)2019年关于艾滋病毒和其他性传播感染(梅毒,衣原体,淋病,滴虫病,和生殖器疱疹),适用于1990年至2019年204个国家和地区60-89岁的老年人。艾滋病毒和其他性传播感染的年龄标准化发病率和DALY发病率的估计年度百分比变化,按年龄,性别,和社会人口指数(SDI),被计算以量化时间趋势。使用Spearman相关分析来检查年龄标准化率与SDI之间的关系。
结果:2019年,全球老年人中,估计有77327例(95%不确定区间59443~97648)新的HIV病例(年龄标准化发病率为7·6[5·9~9·6]/100000人口)和26414267例(19777666~34860678例)新的其他性传播感染病例(2607·1[1952·1~3440·8]/100000).从1990年到2019年,HIV的年龄标准化发病率平均每年下降2·02%(95%CI-2·38至-1·66),其他性传播感染的发病率保持稳定(-0·02%[-0·06至0·01])。2019年全球DALY的数量为1905099(95%UI1670056至2242807),其他性传播感染为132033(95%UI83512至225630)。从1990年到2019年,年龄标准化的DALY率保持稳定,全球HIV平均每年变化0·97%(95%CI-0·54至2·50),但其他性传播感染的年平均下降1·55%(95%CI-1·66至-1·43)。尽管从1990年到2019年,全球老年人中艾滋病毒的年龄标准化发病率有所下降,但许多地区都在增加。东欧增幅最大(年平均变化17·84%[14·16至21·63],中亚(14·26%[11·35至17·25]),和高收入亚太地区(7·52%[6·54至8·51])。区域,随着SDI的增加,HIV和其他性传播感染的年龄标准化发病率和DALY发病率下降.
结论:尽管从1990年到2019年,艾滋病毒和性传播感染的发病率和死亡率下降或保持稳定,但存在地区和人口差异。卫生保健提供者应意识到老龄化社会和其他社会因素对老年人感染艾滋病毒和其他性传播感染风险的影响,并制定适合年龄的干预措施。应解决不同SDI地区之间老年人保健资源分配的差异。
背景:中国自然科学基金,福建省第三批柔性引进高层次医学人才队伍,新疆维吾尔自治区科技创新团队(天山创新团队)项目,治愈阿尔茨海默氏症基金,他的Sør-Øst,挪威研究理事会,分子/VitaDAO,诺德福斯克基金会,Akershus大学医院,CivitanNorgesForskningsfondforAlzheimersSykdom,捷克共和国-挪威KAPPA方案,和RosaSløyfe/挪威癌症协会和挪威乳腺癌协会。
BACKGROUND: Sexually active older adults are often more susceptible to HIV and other sexually transmitted infections (STIs) due to various health conditions (especially a weakened immune system) and low use of condoms. We aimed to assess the global, regional, and national burdens and trends of HIV and other STIs in older adults from 1990 to 2019.
METHODS: We retrieved data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 on the incidence and disability-adjusted life-years (DALYs) of HIV and other STIs (syphilis, chlamydia, gonorrhoea, trichomoniasis, and genital herpes) for older adults aged 60-89 years in 204 countries and territories from 1990 to 2019. Estimated annual percentage changes in the age-standardised incidence and DALY rates of HIV and other STIs, by age, sex, and Socio-demographic Index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the relationship between age-standardised rates and SDI.
RESULTS: In 2019, among older adults globally, there were an estimated 77 327 (95% uncertainty interval 59 443 to 97 648) new cases of HIV (age-standardised incidence rate 7·6 [5·9 to 9·6] per 100 000 population) and 26 414 267 (19 777 666 to 34 860 678) new cases of other STIs (2607·1 [1952·1 to 3440·8] per 100 000). The age-standardised incidence rate decreased by an average of 2·02% per year (95% CI -2·38 to -1·66) for HIV and remained stable for other STIs (-0·02% [-0·06 to 0·01]) from 1990 to 2019. The number of DALYs globally in 2019 was 1 905 099 (95% UI 1 670 056 to 2 242 807) for HIV and 132 033 (95% UI 83 512 to 225 630) for the other STIs. The age-standardised DALY rate remained stable from 1990 to 2019, with an average change of 0·97% (95% CI -0·54 to 2·50) per year globally for HIV but decreased by an annual average of 1·55% (95% CI -1·66 to -1·43) for other STIs. Despite the global decrease in the age-standardised incidence rate of HIV in older people from 1990 to 2019, many regions showed increases, with the largest increases seen in eastern Europe (average annual change 17·84% [14·16 to 21·63], central Asia (14·26% [11·35 to 17·25]), and high-income Asia Pacific (7·52% [6·54 to 8·51]). Regionally, the age-standardised incidence and DALY rates of HIV and other STIs decreased with increases in the SDI.
CONCLUSIONS: Although the incidence and DALY rates of HIV and STIs either declined or remained stable from 1990 to 2019, there were regional and demographic disparities. Health-care providers should be aware of the effects of ageing societies and other societal factors on the risk of HIV and other STIs in older adults, and develop age-appropriate interventions. The disparities in the allocation of health-care resources for older adults among regions of different SDIs should be addressed.
BACKGROUND: Natural Science Foundation of
China, Fujian Province\'s Third Batch of Flexible Introduction of High-Level Medical Talent Teams, Science and Technology Innovation Team (Tianshan Innovation Team) Project of Xinjiang Uighur Autonomous Region, Cure Alzheimer\'s Fund, Helse Sør-Øst, the Research Council of Norway, Molecule/VitaDAO, NordForsk Foundation, Akershus University Hospital, the Civitan Norges Forskningsfond for Alzheimers Sykdom, the Czech Republic-Norway KAPPA programme, and the Rosa Sløyfe/Norwegian Cancer Society & Norwegian Breast Cancer Society.