文章摘要
李健,汤后林,韩晶,许娟,沈智勇,赖文红,施玉华,孙定勇,倪明健,毛宇嵘.中国5省份2011-2014年新发现HIV感染者检测阳性前配偶感染情况及影响因素分析[J].中华流行病学杂志,2016,37(11):1497-1502
中国5省份2011-2014年新发现HIV感染者检测阳性前配偶感染情况及影响因素分析
HIV transmission in newly reported HIV infected couples before diagnoses in five provinces, China, 2011-2014
收稿日期:2016-05-25  出版日期:2016-11-10
DOI:10.3760/cma.j.issn.0254-6450.2016.11.013
中文关键词: 艾滋病病毒;传播;配偶
英文关键词: Human immunodeficiency virus;Transmission;Couple
基金项目:
作者单位E-mail
李健 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
汤后林 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
韩晶 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
许娟 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
沈智勇 530028 南宁, 广西壮族自治区疾病预防控制中心艾滋病防治所  
赖文红 610041 成都, 四川省疾病预防控制中心性病艾滋病预防控制所  
施玉华 650022 昆明, 云南省疾病预防控制中心性病艾滋病预防控制所  
孙定勇 450016 郑州, 河南省疾病预防控制中心性病艾滋病预防控制所  
倪明健 830001 乌鲁木齐, 新疆维吾尔自治区疾病预防控制中心  
毛宇嵘 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室 maoyr@chinaaids.cn 
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中文摘要:
      目的 分析检测发现前配偶之间HIV传播的情况及其影响因素。方法 收集国家艾滋病综合防治信息系统中2011-2014年云南、广西、四川、河南和新疆5省份新报告已婚有配偶的HIV感染者的信息,其中HIV双阳性夫妻中选择研究确定的先感染者。应用logistic回归分析检测发现前配偶之间HIV传播的情况及其影响因素,应用Cochran-Armitage趋势检验分析不同年份HIV双阳性夫妻构成变化趋势。结果 共纳入新报告病例48 931人,其中24.6%(12 051/48 931)在首次检测阳性前将HIV传给了配偶。多因素logistic回归分析显示,女性、≥45岁、初中及以下文化程度、农民或民工职业、注射吸毒或异性传播途径感染、CD4+T淋巴细胞计数<500个、自我报告非安全性行为者检测发现前发生HIV配偶间传播的比例较高。经异性传播途径感染的病例在检测发现前将HIV传给配偶的比例从2011年的28.9%(2 631/9 102)降至2014年的25.5%(3 009/11 787),传播比例缓慢降低。结论 不同特征的艾滋病感染者在检测发现前将HIV传给配偶的比例不同,需采取针对性的措施以减少传播,重点是加强高危人群行为干预,促进艾滋病早检测,尽早将HIV感染者纳入随访管理系统。
英文摘要:
      Objective To understand the HIV transmission and associated factors in newly reported HIV infected couples before diagnosis. Methods The information about newly reported HIV infected couples in Yunnan, Guangxi, Sichuan, Henan and Xinjiang provinces (autonomous region) were collected from National HIV/AIDS Information System from 2011 to 2014. The infection order of the sero-concordant couples were determined. Logistic regression model was used to analyze the HIV transmission between couples and identify the associated factors. Cochran-Armitage trend analysis was conducted to understand the annual sero-concordant couple proportion. Results A total of 48 931 HIV cases in couples were included in this study, among whom 12 051(24.6%) were sero-concordant couples, indicating HIV transmissions occurred between them. Multivariate logistic regression analysis showed that those who were females (OR=1.98, 95%CI: 1.89-2.08), aged >45 years (45-59 yrs: OR=1.32, 95%CI: 1.23-1.42; >60 yrs: OR=1.72, 95%CI: 1.58-1.86), had educational level of middle school education or below (illiteracy and primary school: OR=1.33, 95%CI: 1.23-1.44; middle school: OR=1.19, 95%CI: 1.10-1.28), were farmers or migrate workers (OR=1.23, 95%CI: 1.17-1.30), were infected through injecting drug use or heterosexual intercourse (injecting drug use: OR=1.33, 95%CI: 1.03-1.72; heterosexual intercourse: OR=3.65, 95%CI: 2.89-4.61), had CD4+T cells of <500 cells/μl (<200 cells/μl: OR=5.05, 95%CI: 4.62-5.52; 200-349 cells/μl: OR=3.58, 95%CI: 3.26-3.93; 350-500 cells/μl: OR=2.14, 95%CI: 1.94-2.36), reported unprotected sexual behaviors (OR=1.56, 95%CI: 1.49-1.64), were more likely to infect their couples before diagnosis. The HIV transmission proportion between couples before diagnosis decreased significantly from 28.9% (2 631/9 102) in 2011 to 25.5% (3 009/11 787) in 2014 among those infected through heterosexual intercourse. Conclusion The proportion of HIV transmission between couples before diagnosis varied among different populations. Behavior intervention and early HIV test promoting are needed to prevent HIV transmission between couples before diagnosis in populations at high risk for HIV infection. HIV infection cases should be included in the HIV care system after diagnosis as early as possible.
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