配偶间HIV性传播危险因素研究

Risk factors associated with HIV transmission between spouses in Taishan city

目的探讨台山市艾滋病配偶间传播率及其危险因素,为制定有效的艾滋病防治措施提供科学依据。方法筛查2012年6月~2014年8月可随访现住址台山的HIV确证阳性且有配偶的142对感染者或患者资料,对配偶间HIV抗体检测结果和高危行为进行追踪调查和分析。结果 HIV双阳率38.73%,单阳率61.27%。双阳组传播方和单阳组先感染方在性别、年龄、CD4细胞计数、抗病毒治疗、告知前安全套使用情况、性频次等方面的差异有统计学意义（P均〈0.05）;配偶告知后,75.86%HIV＂单阳家庭＂和69.09%＂双阳家庭＂的性行为频次减少,HIV＂单阳家庭＂夫妻间安全套使用率从告知前的14.94%上升到告知后的95.71%,＂双阳家庭＂从3.64%上升到56.86%;经Logistic回归分析结果显示：抗病毒治疗（OR=0.012,95%CI 0.001~0.225）和性频次（OR=248.066,95%CI 28.249~2 178.332）是影响配偶间HIV传播的主要因素。结论台山市配偶间HIV传播率较高,配偶告知可使配偶间性行为频次和安全套使用发生明显变化。配偶中先感染一方未接受抗病毒治疗和夫妻间性生活频次较高是夫妻间HIV传播的独立危险因素。

Objective To explore the transmission of HIV among spouses and the relevant risk factors in order to providescientific evidence for the prevention and control of HIV/AIDS by investigating HIV transmission rate between spouses andrelated risk factors. Methods Data of the HIV/AIDS infection status of 142 HIV- positive spouses or AIDS patients inTaishan from June 2012 to August 2014 were collected and the factors associated with high-risk behaviors of the cases weresurveyed and the antibody to HIV was detected. Results The positive rate of HIV-sero-accordant spouses was 38.73% and61.27% for HIV-sero-discordant spouses. Statisticaly significant differences were observed between the first HIV positive ofHIV-sero-accordant spouses and the first infected spouse of the HIV-sero-discordant spouses in gender,age,CD4 cell count,anti-virus treatment,condom use rate before informed of HIV infection and frequency of sexual contacts（P〈0.05）.The sexualfrequencies in 75.86% HIV- sero- discordant spouses and 69.09% HIV- sero- accordant spouses were reduced after beinginformed of HIV infection.. Meanwhile the condom use rate in HIV-sero-discordant spouses increased from 14.94% beforeinformed of HIV infection to 95.71% after informed of HIV infection, while that in HIV-sero-accordant spouses were increasedfrom3.64% to 56.86%. The rates of consistent condom use among HIV-sero-discordant spouses after informed of infection withHIV increased from 14.94% to 95.71%,and in HIV-sero-accordant spouses after informed of infection with HIV increasedfrom 3.64% to 56.86%. Logistic regression analysis revealed that antiretroviral treatment（OR=0.012,95%CI 0.001~0.225）and frequencies of sexual contact（OR=248.066,95% CI 28.249~2178.332）were the main risk factors affecting HIVtransmission between spouses. Conclusions The infection rate of HIV sexual transmission between spouses was high.Thefrequencies of sexual contact among the spouses were reduced and the condom use rates increased after being informed of HIVinfection. Without receiving antiretroviral therapy and frequency of sexual contacts between spouses are the independent riskfactors for HIV transmission