CAJ | 학술논문

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％CI: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+T淋巴细胞检测结果＜200 cell/μl (RR=2.11,95％CI: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.
목적 료해하남성주마점시HIV단양가정음성배우항체양전솔급기영향인소.방법 수집분석당지2006-2011년애자병종합방치신식계통화HIV단양가정수방관리신식계통중HIV단양가정수방신식,매6개월수방일차,포괄HIV단양가정음성배우적인구학신식、원양성배우감염특정화항병독치료정황,이급부처간성행위특정화사회지지정황,병검측음성배우적HIV혈청양전정황.채용Cox비례풍험모형분석HIV단양가정음성배우항체양전적영향인소.결과 4813호HIV단양가정중,127례음성배우발생HIV항체양전,2006-2011년총HIV항체양전솔위0.63/100인년,각년항체양전솔위0.29/100인년～1.28/100인년,유지재1％좌우.HIV음성배우수교육정도위초중이하(RR=1.50,95％CI:1.02 ～ 2.21,P=0.04)、원양성배우위미접수항병독치료(RR=3.16,95％CI:2.20 ～ 4.56,P＜0.01)화최근일차CD4+T림파세포검측결과＜200 cell/μl (RR=2.11,95％CI:1.40～ 3.19,P＜0.01)、최근반년부처성생활중성행위빈솔≥4차/월(RR=4.27,95％CI:2.89～6.30,P＜0.01)화종불사용안전투(RR=6.40,95％CI:3.67～11.17,P＜0.01)이급최근반년가정미획득과경제지지화관부구조(RR=4.75,95％CI:2.34～9.64,P＜0.01)균시음성배우HIV항체양전적영향인소.결론 근년래주마점시HIV단양가정음성배우항체양전솔추우은정,병교지전수평유소하강.수방중수가강감염자항병독치료화의종성관리급부처성행위간예,선전정학적안전투사용지식급탑건사회지지평태.
Objective To analyze the sero-conversion rate and risk factors among HIV discordant couples in Zhumadian.Methods Sero-discordant couples had been followed up during 2006-2011.Information were collected from the National Comprehensive HIV/AIDS Information Management System and the HIV discordant couples Follow-up Management Information System including demographic characteristics of sero-negative spouses,the characteristics of infection and antiretroviral therapy information of index spouses,marital sexual behavior and social support etc.,on a 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％CI:2.20-4.56,P＜0.01) and last recorded CD4+ cell counts as ＜200 cells per μl (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 had not received any financial support and care assistance in the past 6 months (RR=4.75,95％ CI: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.The increase of ART acceptance and its adherence and social support should be improved and focused on the follow-up management towards the serodiscordant couples.