Malamba Samuel S, Mermin Jonathan H, Bunnell Rebecca, Mubangizi John, Kalule Josephine, Marum Elizabeth, Hu Dale J, Wangalwa Sam, Smith Dawn, Downing Robert
CDC-Uganda, Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Acquir Immune Defic Syndr. 2005 Aug 15;39(5):576-80.
To determine correlates of HIV-1 concordance for couples receiving voluntary HIV counseling and testing.
Cross-sectional study of couples receiving voluntary HIV counseling and testing in Kampala, Uganda.
An interview and physical examination were conducted for 49 HIV-1-concordant (both partners infected with HIV) and 126 HIV-1-discordant (1 partner infected with HIV and 1 partner HIV negative) couples. Blood samples from all participants were tested for HIV-1 and syphilis serology. CD4 cell count and HIV load were characterized for all HIV-infected persons. Urine samples were tested for Neisseria gonorrhoeae and Chlamydia trachomatis using ligase chain reaction. Associations between couples' HIV status and key sociodemographic, behavioral, and biomedical factors were analyzed.
Men in HIV-concordant couples were more likely than men in HIV-discordant couples to be living together with their sexual partner (odds ratio [OR], 11.3; 95% confidence interval [CI], 2.8-53.7; P=0.004), to be uncircumcised (OR, 4.5; 95% CI, 1.1-18.8; P=0.042), and to have higher HIV loads (OR for each log increase, 3.0; 95% CI, 2.0-4.7; P<0.001). Women in HIV-concordant couples were more likely than women in HIV-discordant couples to be living together with their sexual partner (OR, 19.0; 95% CI, 3.8-84.8), to have an uncircumcised male partner (OR, 6.5; 95% CI, 1.6-26.4), to have had a sexually transmitted disease in the 6 months before enrollment (OR, 1.9; 95% CI, 0.9-4.5), and to have higher HIV loads (OR for each log increase, 2.2; 95% CI, 1.5-3.2).
Several behavioral and biologic risk factors were associated with HIV concordance for couples. Providing early sexually transmitted disease diagnosis and treatment, antiretroviral therapy, and specially designed counseling to HIV-discordant couples may help prevent HIV transmission in couples where being in a stable sexual relationship is a major risk factor for HIV infection.
确定接受自愿HIV咨询和检测的夫妇中HIV-1一致性的相关因素。
对乌干达坎帕拉接受自愿HIV咨询和检测的夫妇进行横断面研究。
对49对HIV-1一致（双方均感染HIV）和126对HIV-1不一致（一方感染HIV，另一方HIV阴性）的夫妇进行访谈和体格检查。对所有参与者的血样进行HIV-1和梅毒血清学检测。对所有HIV感染者的CD4细胞计数和HIV载量进行测定。使用连接酶链反应对尿样进行淋病奈瑟菌和沙眼衣原体检测。分析夫妇的HIV状况与关键社会人口统计学、行为和生物医学因素之间的关联。
与HIV不一致夫妇中的男性相比，HIV一致夫妇中的男性更有可能与其性伴侣同居（比值比[OR]，11.3；95%置信区间[CI]，2.8 - 53.7；P = 0.004），未行包皮环切术（OR，4.5；95% CI，1.1 - 18.8；P = 0.042），且HIV载量更高（每增加一个对数单位的OR，3.0；95% CI，2.0 - 4.7；P < 0.001）。与HIV不一致夫妇中的女性相比，HIV一致夫妇中的女性更有可能与其性伴侣同居（OR，19.0；95% CI，3.8 - 84.8），有未行包皮环切术的男性伴侣（OR，6.5；95% CI，1.6 - 26.4），在入组前6个月内患有性传播疾病（OR，1.9；95% CI，0.9 - 4.5），且HIV载量更高（每增加一个对数单位的OR，2.2；95% CI，1.5 - 3.2）。
夫妇的HIV一致性与多种行为和生物学风险因素相关。为HIV不一致的夫妇提供早期性传播疾病诊断和治疗、抗逆转录病毒治疗以及专门设计的咨询，可能有助于预防在稳定性关系是HIV感染主要风险因素的夫妇中发生HIV传播。
