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目的了解艾滋病配偶间HIV的传播并探讨其相关影响因素。方法采取动态队列研究的方法,通过现场招募百色市202对艾滋病单阳配偶为研究对象,每6个月对患者进行一次随访并对其阴性的配偶进行HIV检测,运用100人年阳转率来计算配偶间HIV的传播率,Kaplan-Meier分析HIV阴性的配偶仍保持阴性的概率,含依时协变量COX比例风险模型分析配偶间HIV传播的相关影响因素。结果单阳配偶中HIV患者平均年龄37.66±11.61岁,基线CD_4~+♂计数均值314.30±215.99个/mm~3,中位随访时间35个月(IQR:16-52),患者以男性、45岁以下、壮族、初中文化、农民及农民工、农村居住和异性性途径感染为主。随访期间共计14例阴性配偶发生了HIV阳转,阳转率为2.21/100人年,配偶1~6年累积HIV阳转率分别为2.11%、5.29%、7.75%、8.92%、8.92%、12.88%。经含依时协变量COX比例风险模型分析结果显示,患者职业(AHR=16.28,95%CI:1.47-180.33)、配偶结果告知时间(AHR=0.10,95%CI:0.02-0.57)和安全套使用频率(AHR=0.02,95%CI:0.00-0.19)与配偶间HIV传播存在统计学关联,患者经HIV确诊后6个月內及时告知配偶结果的HIV传播风险降低了90%,配偶性行为时每次均使用安全套的HIV传播风险则减少了98%。结论加强咨询检测服务,及时告知配偶HIV检测结果,发生性行为时坚持正确使用安全套,可有利于预防配偶间经性传播HIV。
Objective To understand the HIV transmission among spouses of AIDS and to explore the related factors. Methods By means of dynamic cohort study, we recruited 202 couples of single spouse of AIDS in Baise City on the spot as study subjects. Patients were followed up every 6 months and their negative spouses were tested for HIV. Kaplan-Meier analysis of HIV-negative spouses still negative, including covariance COX proportional hazard model was used to analyze the related factors of HIV transmission among spouses. Results The average age of HIV patients in single positive mate was 37.66 ± 11.61 years old, the baseline CD_4 ~ + ♂ count was 314.30 ± 215.99 / mm ~ 3, the median follow-up time was 35 months (IQR: 16-52) Aged, Zhuang, junior high school culture, peasants and migrant workers, living in rural areas and heterosexual infections. During the follow-up period, a total of 14 negative mates were HIV-positive, with a positive rate of 2.21 / 100 person-years. The cumulative HIV positive rates of spouses from 1 to 6 years were 2.11%, 5.29%, 7.75%, 8.92% and 8.92% 12.88%. The analysis of COX proportional hazard model with concurrent covariates showed that the occupational occupations (AHR = 16.28, 95% CI: 1.47-180.33), spousal findings (AHR = 0.10, 95% CI: 0.02-0.57) and condom use The frequency (AHR = 0.02, 95% CI: 0.00-0.19) was statistically associated with spousal HIV transmission, with a 90% reduction in the risk of transmission of HIV by spouses within 6 months of HIV diagnosis, The risk of HIV transmission was reduced by 98% for each condom use. Conclusion Strengthening counseling and testing services, promptly informing spouses of HIV testing results, and ensuring proper use of condoms in the event of sexual intercourse can help prevent sexual transmission of HIV among spouses.