文章摘要
陈方方,王岚,韩娟,王丽艳,何文生,郭巍,周建平,王璐.河南省驻马店市HlV单阳家庭阴性配偶抗体阳转率及其影响因素研究[J].中华流行病学杂志,2013,34(1):10-14
河南省驻马店市HlV单阳家庭阴性配偶抗体阳转率及其影响因素研究
HIV sero-conversion rate and risk factors among HIV discordant couples in Zhumadian city Henan province
收稿日期:2012-08-13  出版日期:2014-09-18
DOI:10.3760/cma.j.issn.0254-6450.2013.01.003
中文关键词: HIV单阳家庭  性传播  阳转率  随访管理
英文关键词: HIV discordant couples  Sexual transmission  Seroconversion rates  Follow-up management
基金项目:
作者单位E-mail
陈方方 102206 北京,中国疾病预防控制中心性病艾滋病预防控制中心  
王岚 102206 北京,中国疾病预防控制中心性病艾滋病预防控制中心  
韩娟 河南省驻与店雨疾  
王丽艳 102206 北京,中国疾病预防控制中心性病艾滋病预防控制中心  
何文生 河南省驻与店雨疾  
郭巍 102206 北京,中国疾病预防控制中心性病艾滋病预防控制中心  
周建平 河南省驻与店雨疾  
王璐 102206 北京,中国疾病预防控制中心性病艾滋病预防控制中心 wanglu64@163.com 
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中文摘要:
      目的了解河南省驻马店市HIV单阳家庭阴性配偶抗体阳转率及其影响因素。方法收集分析当地2006-2011年艾滋病综合防治信息系统和HIV单阳家庭随访管理信息系统中HIV单阳家庭随访信息,每6个月随访一次,包括HIV单阳家庭阴性配偶的人口学信息、原阳性配偶感染特征和抗病毒治疗情况,以及夫妻间性行为特征和社会支持情况,并检测阴性配偶的HIV血清阳转情况。采用Cox比例风险模型分析HIV单阳家庭阴性配偶抗体阳转的影响因素。结果4813户HIV单阳家庭中,127例阴性配偶发生HIV抗体阳转,2006-2011年总HIV抗体阳转率为0.63/100人年,各年抗体阳转率为0.29/100人年~1.28/100人年,维持在1%左右。HIV阴性配偶受教育程度为初中以下(RR=1.50,95%C1:1.02~2.21,P=0.04)、原阳性配偶为未接受抗病毒治疗(RR=3.16, 95%CI: 2.20~4.56,P<0.01)和最近一次CD4+淋巴细胞检测结果<200 cel即1(RR=2.11, 95%C1:1.40~3.19, P<0.01)、最近半年夫妻性生活中性行为频率≥4次/月(RR=4.27, 95%CI: 2.89-6.30, P<0.01)和从不使用安全套(RR=6.40, 95%CI: 3.67-11.17, P<0.01)以及最近半年家庭未获得过经济支持和关怀救助(RR=4.75, 95%CI: 2.34 - 9.64, P<0.01)均是阴性配偶HIV抗体阳转的影响因素。结论近年来驻马店市HIV单阳家庭阴性配偶抗体阳转率趋于稳定,并较之前水平有所下降。随访中需加强感染者抗病毒治疗和依从性管理及夫妻性行为干预,宣传正确的安全套使用知识及搭建社会支持平台。
英文摘要:
      Objective To analyze the sero-conversion rate and risk factors among HIV discordant couples in Zhumadian. Methods Sero-discordant couples had been followed up during2006-2011. Information were collected from the National Comprehensive HIV/AIDS Information Management System and the HIV discordant couples Follow-up Management Information Systemincluding demographic characteristics of sero-negative spouses, the characteristics of infection and antiretroviral therapy information of index spouses, marital sexual behavior and social support etc.,ona biannual basis. Blood specimens of sero-negative spouses were also collected and tested. Cox proportional-hazard model was used to analyze the related risk factors on HIV sero-conversion. Results Among 4813 sero-discordant couples, 127 HIV sero-conversion spouses were identified,with a total sero-conversion rate as 0.63 per 100 person-years. The one-year sero-conversion rate in 2006-2011 ranged from 0.29 to 1.28 per 100 person-years. Factors that associated with increased risk of HIV sero-conversion were: sero-negative spouses with lower education level(RR=1.50, 95%CI:1.02-2.21,P=0.04),index spouses not received ART (RR=3.16, 95%C1: 2.20-4.56, P<0.01)andlast recorded CD4+ cell counts as <200 cells per wl(RR=2.11,95%CI: 1.40-3.19, P<0.01),marital sexual contacts in the past 6 months with frequency of≥4 times per month (RR=4.27, 95% CI:2.89-6.30, P<0.01)but never used condoms (RR=6.40, 95%CI: 3.67-11.17, P<0.01),couples hadnot received any financial support and care assistance in the past 6 months (RR=4.75, 95% Cl:2.34-9.64, P<0.01).Conclusion During 2006-2011,the sero-conversion rate among sero-negative spouses in Zhumadian had been stabilized and the rate was lower than it was in the last years. Theincrease of ART acceptance and its adherence and social support should be improved and focused on the follow-up management towards the serodiscordant couples.
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