中国2014年新报告男男性行为者中HIV感染者婚姻及配偶感染现状

李健; 韩晶; 许娟; 汤后林; 毛宇嵘

文章摘要

李健,韩晶,许娟,汤后林,毛宇嵘.中国2014年新报告男男性行为者中HIV感染者婚姻及配偶感染现状[J].中华流行病学杂志,2017,38(6):750-753

中国2014年新报告男男性行为者中HIV感染者婚姻及配偶感染现状

Status of marriage and HIV transmission between couples in newly reported HIV cases before diagnosis was made, among men who have sex with men in China, 2014

收稿日期:2016-11-01 出版日期:2017-06-19

DOI：10.3760/cma.j.issn.0254-6450.2017.06.012

中文关键词: 艾滋病男男性行为者配偶传播

英文关键词: AIDS Men who have sex with men Couple Transmission

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
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
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
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:

目的分析我国2014年新报告MSM中HIV感染者（MSM感染者）婚姻及配偶感染现况及相关因素。方法收集国家艾滋病综合防治信息系统2014年新报告、经男男性行为途径感染HIV、≥22周岁的MSM感染者基线和随访信息。根据确诊后180 d内配偶首次HIV检测结果，分为“检测发现前发生配偶传播”和“检测发现前未发生配偶传播”两种感染类型。应用logistic回归分析检测发现前发生配偶间传播的相关因素。结果共有22 337例MSM感染者纳入分析，22.7%（5 081/22 337）为已婚有配偶者，3 715例感染者确证后180 d内其配偶进行首次检测，7.6%（282/3 715）配偶为HIV阳性。多因素logistic回归分析显示，检测发现前发生配偶传播的相关因素包括MSM感染者年龄≥60岁（OR=2.64， 95% CI：1.50～4.65）、少数民族（OR=1.93， 95% CI：1.13～3.29）、CD₄⁺T淋巴细胞（CD₄）≤500个/μl［CD₄<200个/μl： OR=2.91（95% CI： 1.82～4.65）；CD₄为200～349个/μl： OR=1.98（95% CI： 1.22～3.23）；CD₄为350～500个/μl： OR=1.69（95% CI：1.00～2.86）］、自我报告不安全性行为（OR=1.92， 95% CI： 1.44～2.58）。结论应加强MSM感染者中的已婚有配偶者的行为干预和HIV检测，尽早发现感染者，减少其传播给配偶的机会。

英文摘要:

Objective To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made, among men who have sex with men (MSM) in China. Methods Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System. Infected MSM who were older than 22 years of age were included in this study. HIV cases were divided into sero-concordant or sero-discordant group, according to the HIV status of the couple who were tested 180 days post-diagnosis. Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made. Results A total of 5 081 (22.7%) of the HIV infected MSM who had couples, were included in this study. A total of 3 715 cases had their couples tested 180 days after the diagnosis was made. 7.6% (282) had positive couples. Results from the multivariate logistic regression analysis showed that factors as:older than 60 (OR=2.64, 95%CI:1.50-4.65) years of age, being minorities (OR=1.93, 95%CI:1.13-3.29), having CD₄⁺T cells less than 500 cells/μl (<200:OR=2.91, 95%CI:1.82-4.65; 200-349:OR=1.98, 95%CI:1.22-3.23; 350-500:OR=1.69, 95%CI:1.00-2.86), with self-reported unsafe behaviors (OR=1.92, 95%CI:1.44-2.58) etc., were more likely to transmit HIV to their couples before the diagnosis was made. Conclusion Behavior interventions and early HIV testing should be promoted, especially among those MSM who had couples, to avoid inter-spousal transmission.

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