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

陈方方; 王岚; 韩娟; 王丽艳; 何文生; 郭巍; 周建平; 王璐

Abstract

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].Chinese journal of Epidemiology,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

Received:August 13, 2012

DOI：10.3760/cma.j.issn.0254-6450.2013.01.003

KeyWord: HIV单阳家庭性传播阳转率随访管理

English Key Word: HIV discordant couples Sexual transmission Seroconversion rates Follow-up management

FundProject:

Author Name	Affiliation	E-mail
Chen Fang-fang	National Center for STD/AIDS Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
Wang Lan	National Center for STD/AIDS Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
Han Juan	Zhumadian Center for Disease Control and Prevention
Wang Li-yan	National Center for STD/AIDS Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
He Wen-sheng	Zhumadian Center for Disease Control and Prevention
Guo wei	National Center for STD/AIDS Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhou Jian-ping	Zhumadian Center for Disease Control and Prevention
Wang Lu	National Center for STD/AIDS Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China	wanglu64@163.com

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Abstract:

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。

English Abstract:

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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