| 汤后林,毛宇嵘,吴尊友.应用贝努利过程模型拟合艾滋病病毒感染单阳家庭配偶间性传播及干预措施效果分析[J].中华流行病学杂志,2018,39(6):755-759 |
| 应用贝努利过程模型拟合艾滋病病毒感染单阳家庭配偶间性传播及干预措施效果分析 |
| Application of Bernoulli Process Model fitting the effect of intervention measures on sexual transmission among HIV sero-discordant couples |
| 收稿日期:2018-01-15 出版日期:2018-06-20 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.06.012 |
| 中文关键词: 艾滋病病毒 配偶 贝努利过程模型 性行为 传播 |
| 英文关键词: HIV Couples Bernoulli process model Sexual behavior Transmission |
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| 中文摘要: |
| 目的 了解艾滋病病毒感染单阳家庭配偶间性传播风险，并通过统计学模型分析预防单阳家庭配偶阳转措施的效果。方法 根据广西壮族自治区、云南省、新疆维吾尔自治区和河南省4个省的30个县（市、区）4 481个单阳家庭数据库，在2011年1月1日至2012年12月31日队列观察分析配偶间性行为、安全套坚持使用率和抗病毒治疗比例等影响因素，拟合配偶间性传播的贝努利过程模型（Bernoulli process model），运用Excel 2010软件编制计算公式，纳入相关参数进行模型模拟过程和敏感性分析，模拟不同干预措施的覆盖面对减少单阳家庭配偶阳转的作用。结果 在安全套坚持使用率85%和抗病毒治疗覆盖60%的情况下，年性行为频次40次，单阳家庭配偶年阳转概率为1.76%；若抗病毒治疗覆盖率为90%且安全套坚持使用率为90%的情况下，单阳家庭配偶年阳转累积概率仅为0.55%；在抗病毒治疗覆盖率为90%水平下，如果安全套坚持使用率从50%提高到90%，可以减少80.7%配偶阳转的风险；在安全套坚持使用率为90%水平下，抗病毒治疗覆盖率从50%提高到90%，可以减少64.5%的配偶阳转的风险。结论 提高单阳家庭安全套坚持使用率、阳性一方及时抗病毒治疗并保持良好依从性，可以使其配偶间性传播风险保持在非常低的水平。 |
| 英文摘要: |
| Objectives To undersand the outcomes of major intervention measures on sexual transmission among HIV sero-discordant couples.Methods Bernoulli Process Model was applied to model the major influencing factors of HIV transmission among HIV sero-discordant couples. The major influencing factors appeared as consistent condom use, antiretroviral therapy, frequency of sexual behavior. These parameters were from the HIV sero-discordant couples in 30 counties in 4 provinces (Guangxi Zhuang Autonomous Region, Yunnan Province, Xinjiang Uygur Autonomous Region and Henan provinces) from January 1, 2011 to December 31, 2012. According to the main factors, modeling-intervention strategies and measures on reduction HIV transmission among sero-discordant couples were formed.Results Data from the present proportion of consistent condom use (85%) modeling and the coverage of antiretroviral treatment (60%) showed that, the proportion of cumulative seroconversion among the spouses was 1.76%.Results from the sensitivity analysis on modeling the consistent condom use and the antiretroviral treatment showed that, when the coverage of antiretroviral treatment was as 90% and the proportion of consistent condom use increased from 50% to 90%, with 80.7% of the risk of spouse seroconversion could be reduced. Or, when the proportion of consistent condom use was as 90% and the coverage of antiretroviral treatment increased from 50% to 90%, with 64.5% of the risk of spouse seroconversion could be reduced.Conclusions With measures as consistent condom use plus provision of timely antiretroviral therapy to HIV positive index spouses, the risk of sexual transmission among sero-discordant couples could be greatly reduced. |
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