摘要
目的分析艾滋病单阳夫妻中阴性配偶艾滋病病毒(HIV)新发感染率,判断夫妻间性传播水平,为制定针对性的艾滋病防治措施提供依据。方法建立开放性队列,每6个月随访1次,收集人口学、高危行为特征等信息,采集血样进行检测。采用Kaplan-Meier法和COX比例风险回归模型进行单因素和多因素分析。结果 197对单阳夫妻中4例阴性配偶阳转,HIV新发感染率0.69/100人年[95%可信区间(CI):0.02~1.36/100人年]。COX模型分析结果:阳性方"不愿意使用安全套"(HR=2.149,95%CI=1.278~6.680)、不用安全套时阴性方"不能拒绝性行为"(HR=8.650,95%CI=2.219~13.719)、阴性方安全套低效能(HR=1.356,95%CI=1.177~11.078)、阳性方未接受抗病毒治疗(HR=6.923,95%CI=1.850~27.372)、阳性方病毒载量水平未查者(HR=4.059,95%CI=1.541~12.951)和≥100拷贝/mL者(HR=1.201,95%CI=1.648~10.963)是感染HIV危险因素。结论金华市单阳夫妻阴性配偶新发感染率较低。预防控制夫妻间艾滋病传播关键应定位为夫妻双方,规范阳性告知,推广安全套的持续性使用,进一步提高阳性配偶的抗病毒治疗覆盖率和服药依从性,定期监测病毒载量水平,保证抗病毒治疗效果。
Objective To investigate the new HIV infection of negative spouse in HIV discordant couples, and estimate the sexual transmission level, to provide a basis for the measures of AIDS prevention and control. Methods An open cohort was established, and followed up every six months. The information about demography, high-risk behaviors, and blood samples were collected. Kaplan-meier and Cox proportional risk regression models were used for single and multifactor analysis. Results A total of 197 couples participated in the study, 4 HIV sero-conversion spouses were identified, with the new infection rate of 0.69/100 person-year(95%CI:0.02-1.36/100 person-year).The Cox model analysis result showed that the risk factors of HIV infection included "HIV positive spouse were reluctant to use condoms"(HR=2.149, 95% CI=2.149-6.680);"HIV negative spouse could not refuse sex without a condom(HR=8.650, 95% CI=8.650-13.719);"condom was ineffectively used "(HR=1.356, 95% CI=1.356-11.078);"HIV positive spouse did not receive anti-retrovirus therapy(ART)"(HR=6.923, 95% CI=6.923-27.372);"HIV positive partner did not test for viral load"(HR=4.059, 95% CI=4.059-12.951);and "those viral load was≥100 copies/mL(HR=1.201, 95% CI=1.201-10.963). Conclusion The new infection rate is low among the negative spouses in Jinhua. In the follow-up management of HIV/AIDS, we should normalize the positive notification,promote condom use, expand the coverage of ART, and ensure medication adherence and regular monitoring of viral load levels, so as to prevent HIV spreading among discordant couples.
作者
唐慧玲
张子根
金屡华
张涛
朱淑英
章光明
王凤英
TANG Huiling;ZHANG Zigen;JIN Lyuhua;ZHANG Tao;ZHU Shuying;ZHANG Guangming;WANG Fengying(Jinhua Municipal Center for Disease Control and Prevention,Jinhua 321002,Zhejiang,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2019年第7期699-701,共3页
Chinese Journal of Aids & STD
基金
金华市科学技术研究计划项目(2015-3-072)~~
