中国HIV单阳家庭配偶间传播影响因素的Meta分析

Risk factors for spousal transmission of HIV among single-positive families in China:a Meta-analysis

目的系统评价我国人类免疫缺陷病毒(human immunodeficiency virus,HIV)单阳家庭配偶间传播的影响因素,为早期干预提供理论依据。方法系统检索中国知网、万方、维普、中国生物医药文献数据库(CBM)、PubMed、Web of Science、Embase和The Cochrane Library数据库中公开发表的有关我国HIV单阳家庭配偶间传播影响因素的研究,检索时限为建库至2024年1月15日。由2名研究员独立完成文献检索和筛选、质量评价和数据提取过程,并使用RevMan5.3软件进行Meta分析。结果最终共纳入18篇文献。Meta分析结果显示,年龄≥40岁[OR=0.73,95%CI(0.54,0.99),P=0.047]、文化程度[OR=0.49,95%CI(0.38,0.63),P<0.001]、坚持使用安全套[OR=0.17,95%CI(0.09,0.31),P<0.001]、接受抗病毒治疗[OR=0.27,95%CI(0.17,0.42),P<0.001]和基线CD4细胞计数[OR=0.43,95%CI(0.31,0.58),P<0.001]是HIV单阳家庭配偶间传播的保护因素,近6个月性行为频次[OR=2.31,95%CI(1.19,4.50),P=0.014]和感染途径[OR=3.68,95%CI(1.28,10.59),P=0.016]是HIV单阳家庭配偶间传播的危险因素。结论我国HIV单阳家庭配偶间传播受多种因素的影响,对其中可干预性影响因素实施控制,有利于降低HIV单阳家庭配偶间传播的风险,减轻社会和家庭的负担,促进人类的健康。

Objective To systematically evaluate the risk factors for spousal transmission of human immunodeficiency virus(HIV)among single-positive families in China and provide theoretical basis for early intervention.Methods Databases including CNKI,WanFang Data,CBM,VIP,PubMed,Web of Science,Embase and The Cochrane Library were searched for studies on the risk factors for spousal transmission of HIV in Chinese singlepositive families.The search time limit was from the establishment of the databases to January 15,2024.Two researchers independently completed the literature search and screening,quality assessment and data extraction process,and RevMan 5.3 software was used for Metaanalysis.Results A total of 18 articles were included.The results of Meta-analysis showed that age≥40 years[OR=0.73,95%CI(0.54,0.99),P=0.047],education level[OR=0.49,95%CI(0.38,0.63),P<0.001],consistent condom use[OR=0.17,95%CI(0.09,0.31),P<0.001],receiving antiretroviral therapy[OR=0.27,95%CI(0.17,0.42),P<0.001]and baseline CD4 cell count[OR=0.43,95%CI(0.31,0.58),P<0.001]were protective factors for spousal transmission of HIV in single-positive families.The frequency of sexual behavior in the past 6 months[OR=2.31,95%CI(1.19,4.50),P=0.014]and transmission route[OR=3.68,95%CI(1.28,10.59),P=0.016]were the risk factors for spousal transmission of HIV in single-positive families.Conclusion The spousal transmission of HIV in single-positive families is affected by many factors in China.Prevention and control of intervention risk factors can help to reduce the risk of spousal transmission of HIV in single-positive families,reduce the burden on society and family,and promote human health.