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浙江省263对男性HIV抗体阳性配偶间艾滋病传播的相关因素分析
作者:陈琳 潘晓红 杨介者 徐云 王憓 周欣 蒋婷婷 马瞧勤

摘要:

目的  分析浙江省男性HIV抗体阳性的配偶间HIV传播情况及其相关因素。方法  采用横断面研究,于2013年1—7月,以浙江省所有地区新检测发现的男性HIV阳性的单阳家庭(单阳家庭)和男性先感染HIV的双阳家庭(双阳家庭)为研究对象,共纳入单阳家庭210对,双阳家庭53对。对其进行问卷调查,包括基本情况(仅男性)、HIV感染意识、HIV检测意识和检测行为、性关系权利、女性的安全套使用效能、性行为等。采用χ2检验或Fisher确切概率法分析单阳家庭和双阳家庭上述信息的差异,采用多因素二分类非条件logistic回归模型分析男性HIV抗体阳性配偶间HIV传播的相关因素。结果  263对研究对象中,男性以30~50岁为主,占57.8%(152例),女性以初中及以下文化程度为主,占79.1%(208例);HIV感染者和艾滋病患者共占41.1%(217例)。单阳家庭中,疾病病程为HIV感染者、发生男男性行为和听说过艾滋病的男性分别占61.9%(130例)、38.3%(80例)和81.9% (172例),均高于双阳家庭[47.2%(25例)、7.5 %(4例)和64.2%(34例)](χ2值为3.80、18.33和7.86 ,P值分别为0.051、0.001和0.005);单阳家庭和双阳家庭中,最近6个月感染过性病的女性占9.3%(19例)和18.9%(10例)(χ2=3.89 ,P=0.049)。与疾病进程为HIV感染者的男性相比,艾滋病患者的配偶感染HIV的OR (95 %CI)值为2.93(1.05~8.21);与感染之前未听说过艾滋病的男性相比,听说过者的配偶感染HIV的OR (95%CI)值为0.13(0.04~0.41);与未发生男男性行为者相比,发生该行为者的配偶传播HIV的OR (95%CI)值为0.14(0.03~0.73);与最近6个月未感染过性病的女性相比,感染过的女性被配偶感染HIV的OR (95%CI)值为4.86(1.23~19.11)。结论  浙江省男性HIV抗体阳性家庭中,配偶感染HIV的风险与男性疾病病程、性取向及艾滋病知识知晓情况有关;女性近6个月感染过性病可能是其被配偶传播HIV的危险因素。

关键词:HIV;获得性免疫缺陷综合征;影响因素;横断面研究

Abstract:

Objective  To identify the status and risk factors of transmission in couples which males was HIV-positive in Zhejiang province.Methods  A cross-sectional study was conducted among HIV-serodiscordant couple (male positive) and HIV-seroconcordant couple (male first infected). A self-designed questionnaire was complimented containing basic information, the awareness of infection and HIV-testing, sexual relationship power, self-efficacy of condom use, sex. The univariated and multivariate logistic regression methods were used to analyze the influence factors.Results  A total of 263 couples were enrolled in this study, including 210 HIV HIV-serodiscordant couples and 53 HIV-seroconcordant couples. HIV-positive males aged 30-50 accounted for 57.8% (152 cases) and females under junior high school accounted for 79.1% (208 cases). HIV/AIDS accounted for 41.1% (217 cases). The proportion of man who were diagnosed as HIV, MSM and ever heard HIV were 61.9% (130 cases), 38.3% (80 cases) and 81.9% (172 cases), which were higher than that in HIV positive 47.2% (25 cases), 7.5% (4 cases), 64.2% (34 cases); χ2=3.80, 18.33, 7.86;P=0.051, 0.001, 0.005. The results revealed that AIDS patients had high risk to infect their spouse than HIV patients (OR=2.93, 95%CI: 1.05-8.21). Male patients who had ever heard " HIV" before were less likely pass virus to their wives than those who had never heard " HIV" (OR=0.13, 95%CI: 0.04-0.41). Compared with heterosexuality man, homosexuality man' wives had high risk to get virus from their husbands (OR=0.14, 95%CI: 0.03-0.73). Female infected with STIs was the independent factors for HIV infection (OR=4.86, 95%CI: 1.23-19.11).Conclusion  Among the couples of male HIV-positive in Zhejiang Province, the risk of spouses infected with HIV virus has relationship with male disease progression, sexual orientation and awareness of AIDS knowledge. For females who infected with sexual diseases in last 6 months might be infected by their spouses.

Key words: HIV;Acquired immunodeficiency syndrome;Influence factors;Cross-sectional studies

发表日期:2016/2

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2016.02.011.T001:表1 浙江省不同HIV感染状况家庭基本情况比较

    10.3760/cma.j.issn.0253-9624.2016.02.011.T001:表1 浙江省不同HIV感染状况家庭基本情况比较

  • 10.3760/cma.j.issn.0253-9624.2016.02.011.T002:表2 浙江省不同HIV感染状况家庭HIV感染危险意识、检测意识情况比较

    10.3760/cma.j.issn.0253-9624.2016.02.011.T002:表2 浙江省不同HIV感染状况家庭HIV感染危险意识、检测意识情况比较

  • 10.3760/cma.j.issn.0253-9624.2016.02.011.T003:表3 浙江省不同HIV感染状况家庭中配偶关系、性关系权力与安全套使用效能情况比较

    10.3760/cma.j.issn.0253-9624.2016.02.011.T003:表3 浙江省不同HIV感染状况家庭中配偶关系、性关系权力与安全套使用效能情况比较

  • 10.3760/cma.j.issn.0253-9624.2016.02.011.T004:表4 浙江省不同HIV感染状况家庭中男男性行为及配偶间性行为情况比较

    10.3760/cma.j.issn.0253-9624.2016.02.011.T004:表4 浙江省不同HIV感染状况家庭中男男性行为及配偶间性行为情况比较

  • 10.3760/cma.j.issn.0253-9624.2016.02.011.T005:表5 浙江省男性HIV抗体阳性配偶间HIV传播相关因素的多因素logistic回归模型分析结果

    10.3760/cma.j.issn.0253-9624.2016.02.011.T005:表5 浙江省男性HIV抗体阳性配偶间HIV传播相关因素的多因素logistic回归模型分析结果

参考文献:

[1]中华人民共和国卫生部,联合国艾滋病规划署,世界卫生组织.2011中国艾滋病疫情估计[J].中国艾滋病性病,2012,18(1):1-5.
[2]王前,王临虹,方利文,等.艾滋病高发地区HIV感染孕产妇分娩情况及妊娠结局[J].中国公共卫生,2013,29(10):1417-1419. DOI: 10.11847/zgggws2013-29-10-05.
[3]邓为民,赵城寒,刘藏,等.浙江省乐清市2005-2012年老年人艾滋病流行特点分析[J].中华疾病控制杂志,2014,18(12):1237-1238.
[4]甘志勇,黄荣师,谢世英,等.2010-2012年来宾市中老年人艾滋病病例流行特征分析[J].应用预防医学,2015,21(3):168-169.
[5]RojanawiwatA, AriyoshiK, PathipvanichP, et al. Substantially exposed but HIV-negative individuals are accumulated in HIV-serology-discordant couples diagnosed in a referral hospital in Thailand[J]. Jpn J Infect Dis, 2009, 62(1): 32-36.
[6]PinkertonSD. Probability of HIV transmission during acute infection in Rakai, Uganda[J]. AIDS Behav, 2008, 12(5): 677-684.
[7]LingappaJR, LambdinB, BukusiEA, et al. Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial[J]. PLoS One, 2008, 3(1): e1411. DOI: 10.1371/journal.pone.0001411.
[8]李宁,戴建英,高静儒.2012中国同性恋调查报告及对同性婚姻合法化的思考[J].中国性科学,2014,23(1):93-100. DOI: 10.3969/j.issn.1672-1993.2014.01.032.
[9]郭燕丽,周建波,郝超,等.江苏省常州市男男性行为者婚姻状况及其对艾滋病高危行为和感染率的影响[J].中华流行病学杂志,2013,34(1):19-23. DOI: 10.3760/cma.j.issn.0254-6450.2013.01.005.
[10]HatcherAM, TsaiAC, KumbakumbaE, et al. Sexual relationship power and depression among HIV-infected women in Rural Uganda[J]. PLoS One, 2012, 7(12): e49821. DOI: 10.1371/journal.pone.0049821.
[11]GuiellaG, MadiseN. HIV/AIDS and sexual-risk behaviors among adolescents: factors influencing the use of condoms in Burkina Faso[J]. Afr J Reprod Health, 2007, 11(3): 182-196.
[12]褚梅青.人工流产妇女避孕现状调查及分析[J].医学理论与实践,2013,26(6):831-832. DOI: 10.3969/j.issn.1001-7585.2013.06.091.
[13]ErausquinJT, DuanN, GruskyO, et al. Increasing the reach of HIV testing to young Latino MSM: results of a pilot study integrating outreach and services[J]. J Health Care Poor Underserved, 2009, 20(3): 756-765. DOI: 10.1353/hpu.0.0189.
[14]冯艳洁,曹丛烨,王志刚,等.主动求询与被动检测的男男性行为人群艾滋病性病感染情况分析[J].中国皮肤性病学杂志,2013,27(11):1134-1136.
[15]陈琳,潘晓红,杨介者,等.浙江省843对HIV单阳夫妻危险行为及血清检测[J].中国公共卫生,2011,27(1):63-64. DOI: 10.11847/zgggws2011-27-01-29.
[16]陈琳,潘晓红,杨介者,等.2007-2010年浙江省HIV双阳夫妻对流行病学特征分析[J].中国预防医学杂志,2011,12(11):928-931.
[17]潘晓红,陈琳,杨介者,等.浙江省2012年艾滋病感染者和病人检测发现特征及影响因素分析[J].中华预防医学杂志,2014,48(5):380-385. DOI: 10.3760/cma.j.issn.0253-9624.2014.05.010.

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