Dublin S, Rosenberg P S, Goedert J J
AIDS. 1992 May;6(5):475-82. doi: 10.1097/00002030-199205000-00006.
To characterize and quantify high-risk heterosexual activity in HIV-discordant couples.
Analysis of cross-sectional and longitudinal questionnaire data from 217 HIV-negative female sexual partners of HIV-infected hemophilic men.
Comparison of prevalence rates of anal sex, oral sex, vaginal intercourse with or without condoms, and use of other contraceptives between 1985 and 1991. Logistic regression analysis of demographic, sexual and clinical variables to predict unprotected vaginal sex. Actuarial estimates of semi-annual relapse rates to unsafe sex.
The proportion of women at low risk increased from 7 to 69% between 1985 and 1991, mainly because more women were using condoms during all acts of vaginal intercourse. Other contraceptive practices did not change during this time. The proportion engaging in oral or anal sex decreased (from 26 to 13% and 13 to 4%, respectively). Unprotected vaginal sex was more common among women who enrolled earlier, had less education, engaged in oral or anal sex, and among those whose partners had not had AIDS. Unprotected vaginal sex before enrollment was the strongest predictor of this high-risk activity during follow-up. Two-year rates of relapse to high-risk behavior were significantly higher among women who enrolled at high risk compared with those who enrolled at low risk (39 versus 8%, P = 0.005).
Although high-risk sexual behavior became much less prevalent in this population between 1985 and 1991, many continued to have unprotected vaginal sex occasionally. Counseling efforts should target couples who have been the most sexually active or have less education, and should emphasize not only initial risk reduction but also maintenance of low-risk behavior.
描述并量化HIV抗体不一致的伴侣间的高危异性性行为。
对217名感染HIV的血友病男性的HIV阴性女性性伴侣的横断面和纵向问卷调查数据进行分析。
比较1985年至1991年期间肛交、口交、有无避孕套的阴道性交的发生率以及其他避孕措施的使用情况。对人口统计学、性和临床变量进行逻辑回归分析，以预测无保护阴道性交。对不安全性行为半年复发率进行精算估计。
1985年至1991年期间，低风险女性的比例从7%增加到69%，主要原因是更多女性在所有阴道性交行为中使用避孕套。在此期间，其他避孕措施没有变化。进行口交或肛交的比例下降（分别从26%降至13%和13%降至4%）。未接受保护的阴道性交在较早入组、受教育程度较低、进行口交或肛交的女性以及其伴侣未患艾滋病的女性中更为常见。入组前的未保护阴道性交是随访期间这种高危行为的最强预测因素。与低风险入组的女性相比，高风险入组的女性两年内高危行为复发率显著更高（39%对8%，P = 0.005）。
尽管1985年至1991年期间该人群中高危性行为的发生率大幅下降，但仍有许多人偶尔进行无保护的阴道性交。咨询工作应针对性活动最频繁或受教育程度较低的伴侣，不仅应强调最初降低风险，还应强调维持低风险行为。
