| 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].Chinese journal of Epidemiology,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 |
| Received:May 25, 2016 |
| DOI：10.3760/cma.j.issn.0254-6450.2016.11.013 |
| KeyWord: 艾滋病病毒 传播 配偶 |
| English Key Word: Human immunodeficiency virus Transmission Couple |
| FundProject: |
| Author Name | Affiliation | E-mail | | Li Jian | Division of Integrated Prevention and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Tang Houlin | Division of Integrated Prevention and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Han Jing | Division of Integrated Prevention and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Xu Juan | Division of Integrated Prevention and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Shen Zhiyong | Institute for AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China | | | Lai Wenhong | Institute for AIDS/STD Control and Prevention, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China | | | Shi Yuhua | Institute for AIDS/STD Control and Prevention, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China | | | Sun Dingyong | Institute for AIDS/STD Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China | | | Ni Mingjian | Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830001, China | | | Mao Yurong | Division of Integrated Prevention and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China | maoyr@chinaaids.cn |
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| Abstract: |
| 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。 |
| English Abstract: |
| 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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