Kelly Robert J, Gray Ronald H, Sewankambo Nelson K, Serwadda David, Wabwire-Mangen Fred, Lutalo Tom, Wawer Maria J
Department of Population and Family Health Sciences, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
J Acquir Immune Defic Syndr. 2003 Apr 1;32(4):446-51. doi: 10.1097/00126334-200304010-00016.
To assess whether differences in age between sexual partners affect the risk of HIV infection in female adolescents and young adults.
A total of 6177 ever sexually active women aged 15 to 29 years completed a sociodemographic and sexual behavior questionnaire and provided a blood sample for HIV-1 serology. The age difference between partners was categorized as men 0 to 4 years older (referent group), 5 to 9 years older and 10 or more years older. HIV prevalence and incidence were assessed, and adjusted RR was estimated by multivariate regression.
Prevalent HIV-1 infection in female participants increased with older male sexual partners. Among women aged 15 to 19 years, the adjusted risk of HIV infection doubled (RR = 2.04; 95% CI: 1.29-3.22) among those reporting male partners 10 or more years older compared with those with male partners 0 to 4 years older; among women 20 to 24 years of age, the RR was 1.24 (95% CI: 0.96-1.60). The attributable fraction (exposed) of prevalent HIV infection in women aged 15 to 24 years associated with partners 10 or more years older was 9.7% (95% CI: 5.2-14.0). HIV incidence did not increase with differences in age of partners.
The age difference between young women and their male partners is a significant HIV risk factor, suggesting that high HIV prevalence in younger women is caused, in part, by transmission from older male partners.
评估性伴侣之间的年龄差异是否会影响女性青少年和年轻成年人感染艾滋病毒的风险。
共有6177名年龄在15至29岁之间有过性活动的女性完成了一份社会人口学和性行为调查问卷，并提供了一份用于艾滋病毒-1血清学检测的血样。伴侣之间的年龄差异分为男性比女性大0至4岁（参照组）、大5至9岁以及大10岁及以上。评估艾滋病毒的流行率和发病率，并通过多变量回归估计调整后的相对危险度（RR）。
女性参与者中艾滋病毒-1感染的流行率随着男性性伴侣年龄的增加而上升。在15至19岁的女性中，报告有年龄大10岁及以上男性伴侣的女性感染艾滋病毒的调整风险是报告有年龄大0至4岁男性伴侣女性（的调整风险）的两倍（RR = 2.04；95%置信区间：1.29 - 3.22）；在20至24岁的女性中，RR为1.24（95%置信区间：0.96 - 1.60）。在15至24岁女性中，与年龄大10岁及以上伴侣相关的艾滋病毒感染流行率的归因分数（暴露）为9.7%（95%置信区间：5.2 - 14.0）。艾滋病毒发病率并未随着伴侣年龄差异而增加。
年轻女性与其男性伴侣之间的年龄差异是一个重要的艾滋病毒风险因素，这表明年轻女性中艾滋病毒的高流行率部分是由年龄较大的男性伴侣传播所致。
