艾滋病夫妻传播队列研究

Cohort study on the transmission of human immunodeficiency virus between spouses

目的研究HIV夫妻间传播率,为预防控制性传播提供科学依据。方法选择一方HIV阳性,另一方HIV阴性,且没有静脉吸毒、多性伴、有偿献血、输血等HIV感染高危行为史,有稳定婚姻的夫妻,双阳夫妻采用回顾性队列研究方法,单阳家庭采用采用前瞻性队列方法。结果夫妻间传播率为30.00%(39/130),男传女传播率为33.78%(25/74),女传男传播率为25.00%(14/56)。夫妻性生活年限越长、先症病例感染后与配偶开始同居年龄越大,性行为频次越高,传播率越高。多因素非条件Logistic回归分析显示,性别、夫妻性生活年限、年龄及性行为频次均为夫妻HIV传播的相关因素。结论 HIV夫妻传播率较高,与性别、夫妻性生活年限、年龄及性行为频次有关。加大早期发现力度,采取有针对性的干预措施,才能有效遏制HIV性传播。

Objectives To study the transmission rate of human immunodeficiency virus between wife and husband and provide scientific data for the prevention and control of HIV sexual transmission. Methods The spouses with stable marriage were selected. In each spouse, one was HIV positive and the other had no risk behavior, such as drug injection, multi-sexual partnem, history of paid blood donation, blood transfusion. When people with HIV/AIDS positive were found, serum specimens were collected from their spouses and tested for HIV antibody. The probands and secondary cases were confirmed by epidemiology, clinical stage and CD4 cell counting. Retrospective cohort study was performed for spouses both with HIV positive, while prospective cohort study was performed for single-HIV positive of the spouse. All the data were analyzed with Excel 2003 and SPSS 18.0 statisticalsoftwares. Results Transmission rate of HIV in spouses was 30. 00%. The HIV transmission rate of male-to- female and female-to-male were 33.78% and 25.00% respectively. The longer the couples livedtogether,the longer the exposure age, and the higher the frequency of sexual behavior, the higher would be the transmission rate between them. Gender, sexual life, age and frequency of sexual behavior were the leading factors playing important role in promoting HIV transmission rate in the couples. Conclusions The transmission rate of HIV in spouses, which was related to gender, sexual life, age and frequency of sexual behavior, was high. To strengthen the early detection and conduct the specific intervention were the effective measures for controlling HIV spreading between couples.