四川省凉山彝族自治州布拖县HIV感染单阳家庭阴性配偶干预效果评价

时路; 李咸志; 杨文; 杨一挥; 冯燎; 吉克尔沙; 张建华; 栾荣生

Abstract

时路,李咸志,杨文,杨一挥,冯燎,吉克尔沙,张建华,栾荣生.四川省凉山彝族自治州布拖县HIV感染单阳家庭阴性配偶干预效果评价[J].Chinese journal of Epidemiology,2023,44(1):139-144

四川省凉山彝族自治州布拖县HIV感染单阳家庭阴性配偶干预效果评价

Study on effect of intensive intervention on negative spouses in HIV sero-discordant couples in Butuo County of Liangshan Yi Autonomous Prefecture, Sichuan Province

Received:June 07, 2022

DOI：10.3760/cma.j.cn112338-20220607-00505

KeyWord: 艾滋病病毒/艾滋病单阳家庭评价干预

English Key Word: HIV/AIDS Sero-discordant couples Evaluation Intervention

FundProject:国家科技重大专项（2018ZX10715-003)

Author Name	Affiliation	E-mail
Shi Lu	West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu 610041, China
Li Xianzhi	Meteorological Medicine Research Center, Panzhihua Central Hospital, Panzhihua 617067, China
Yang Wen	Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China
Yang Yihui	Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China
Feng Liao	Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China
Jike Ersha	Butuo County Center for Disease Control and Prevention, Butuo 616350, China
Zhang Jianhua	Liangshan Yi Autonomous Region Center for Disease Control and Prevention, Xichang 615000, China
Luan Rongsheng	West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu 610041, China	luan_rs@scu.edu.cn

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Abstract:

目的评价强化干预措施对HIV感染单阳家庭（单阳家庭）阴性配偶的干预效果。方法 2019年12月至2020年12月，将凉山彝族自治州布拖县7个乡镇按照单阳家庭配偶间传播状况匹配分为常规干预组和强化干预组，该乡镇内所有研究对象分别纳入到常规干预组和强化干预组，开展为期1年的综合干预。在干预措施实施前后第6个月分别开展基线调查和随访，对2组单阳家庭夫妻双方进行问卷调查和血清学检测。采用Cox比例风险回归模型和双重差分模型评价强化干预效果。结果基线调查899户单阳家庭（强化干预组393户和常规干预组506户），随访806户（强化干预组349户和常规干预组457户）。与常规干预措施相比，强化干预措施未能提高阴性配偶对每个艾滋病知识的知晓率（P>0.05），但能够提高其艾滋病基本知识知晓率（β=1.40，P=0.008）；与常规干预措施相比，强化干预措施能够降低单阳家庭配偶间性行为频次（β=-0.73，P=0.021），提高安全套坚持使用率（β=0.19，P=0.007），但并未降低阴性配偶HIV抗体阳转率（β=-0.61，OR=0.55，95%CI：0.18~1.66，P=0.294）。结论强化干预措施能够提高单阳家庭阴性配偶的艾滋病认知水平，促进其采取安全性行为措施，但未能降低阴性配偶的HIV抗体阳转率。需要进一步增加干预措施实施以及随访的时长来客观评价强化干预的效果。

English Abstract:

Objective To evaluate the effects of intensive intervention on negative spouses in sero-discordant couples. Methods From December 2019 to December 2020, all HIV sero-discordant couples in seven townships in Butuo County of Liangshan were enrolled and divided into intensive intervention group and routine intervention group. Both intensive intervention and routine intervention were conducted for one year. Baseline survey and follow-up were conducted respectively with a questionnaire survey and a serological testing in HIV sero-discordant couples in the two groups at 6^th month before and after the interventions. Multivariable Cox proportional hazards model and difference-in-difference model were used to evaluate the effect of the intensive intervention. Results A total of 899 sero-discordant couples were enrolled (393 of intensive intervention group and 506 of routine intervention group), in whom 806 completed the follow up survey (349 of intensive intervention group and 457 of routine intervention group). Compared with routine intervention, intensive intervention had no effect to improve the correct answer rate of an AIDS related question in negative spouses (P>0.05), but could improve their awareness of AIDS related knowledge (β=1.40, P=0.008). Compared with routine intervention, intensive intervention could reduce the frequency of sex between HIV sero-discordant couples (β=-0.73, P=0.021), and increase the frequency of condom use (β=0.19, P=0.007), but had no effect to decrease the positive conversion rate in negative spouses (β=-0.61, OR=0.55,95%CI:0.18-1.66, P=0.294). Conclusions The intensive interventions could improve the awareness of AIDS related knowledge in negative spouses in sero-disordant couples and promote their safe sexual behavior, but had no effect to decrease the positive conversion in negative spouses. It is necessary to continue the intensive intervention and follow up to evaluate the effects of the intervention.

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