陇川县14个艾滋病单阳家庭阴性配偶HIV阳转的原因分析

Causal analysis of HIV seroconversion among the fourteen HIV discordant families in Longchuan county,Yunnan province

目的分析云南省陇川县艾滋病单阳家庭阴性配偶艾滋病病毒(HIV)阳转的原因。方法对2006年7月31日至2011年8月19日,发生HIV阳转的14个艾滋病单阳家庭进行一对一、面对面访谈。结果 14个艾滋病单阳家庭中,11例(另3例已死亡)HIV感染者和13例(1例已死亡)发生HIV阳转的配偶,在其阳转前一年内与其HIV感染配偶间性行为时均未能坚持使用安全套,其原因为:8个家庭的男性觉得使用安全套不舒服;2个家庭想要小孩;2个家庭的安全套用完后未及时补充;1个家庭属安全套使用方法不当;另有1个家庭的HIV感染者不想让其配偶知道自己感染了HIV。结论艾滋病家庭内二代传播的威胁依然存在,必须深入细致地了解单阳家庭未坚持使用安全套的原因,并促使每次性行为都能坚持正确使用安全套,以降低艾滋病单阳家庭阴性配偶HIV阳转率。

Objective To analyze and understand the reasons for HIV seroconversions among seronegative spouses of HIV discordant families in Longchuan county, Yunnan province. Methods An in-house face-to-face interview was administered to each of the fourteen HIV seroconverted spouses and their HIV-infected spouses from July 2006 through August 2011 in Longchuan county. Result A total of fourteen families including 11 HIV infected individuals （excluding 3 deaths） and 13 HIV seroconverted spouses （excluding 1 death） were interviewed. All seroconverted spouses did not use condoms persistently in sex with their HIV infected spouses in the year before seroconversion. Reasons for inconsistent condom use were.- husbands＇ uncomfortable feeling of using condoms （8 families）, desire to have a child （2 families）, condom stock running short （2 families）, inappropriate use of condoms （1 family）, and unwillingness to disclose HIV infection status to negative spouse （1 family）. Conclusions There are a large number of HIV discordant families in Longchuan county, Yunnan province, and HIV seroconversion frequently occurs among these families , suggesting the existence of continuing threat of familial secondary transmission of HIV. It is essential to closely examine reasons for inconsistent condom use and accordingly to promote persistent condom use and to prevent HIV seroconversion among negative spouses of HIV infected families.