Manopaiboon Chomnad, Kilmarx Peter H, Supawitkul Somsak, Chaikummao Supaporn, Limpakarnjanarat Khanchit, Chantarojwong Nartlada, Xu Fujie, van Griensven Frits, Mastro Timothy D
Thailand MOPH-US CDC Collaboration, DMS 6 Building, Ministry of Public Health, Tivanon Road, Nonthaburi 11000, Thailand.
Southeast Asian J Trop Med Public Health. 2007 Mar;38(2):313-24.
In northern Thailand, where substantial male-to-female transmission of HIV has occurred in stable partnerships, the relationships between counseling, communication, and HIV-preventive behaviors in married couples have not been well studied. In a study of HIV incidence among women in northern Thailand, each participant was advised to learn her husband's HIV-infection status and was asked to bring him for an interview at the final 12-month follow-up visit. Of the 337 men interviewed, 58% reported having ever had an HIV test. More men reported testing following their wives' enrollment: 12% in the year prior to enrollment vs 22% during the 1-year study (p < 0.001). In the univariate analysis, men's HIV testing during the 6 months before being interviewed was associated with communication about HIV testing with their wife and extra marital sex with non-FSW while married. Testing following their wife's request was the most common reason reported. Agreement between husband's and wife's reports was poor for most issues, such as whether HIV-related communication had occurred, but agreement as to whether the husband had ever been tested for HIV was relatively high (kappa = 0.62). However, in the logistic regression analysis, only sex with non-FSW while married remained associated with HIV testing (p = 0.02). The results suggest a relationship between counseling, communication, and husband HIV testing. Better communication by couples may result in more effective use of HIV testing, which is already prevalent in this population, to prevent HIV transmission.
在泰国北部，HIV在稳定伴侣关系中存在大量男性向女性传播的情况，但已婚夫妇中咨询、沟通与HIV预防行为之间的关系尚未得到充分研究。在一项针对泰国北部女性HIV发病率的研究中，建议每位参与者了解其丈夫的HIV感染状况，并要求她们在最后一次12个月随访时带丈夫前来接受访谈。在接受访谈的337名男性中，58%报告曾进行过HIV检测。更多男性报告在其妻子入组后进行了检测：入组前一年为12%，而在为期1年的研究期间为22%（p<0.001）。在单因素分析中，男性在接受访谈前6个月的HIV检测与和妻子就HIV检测进行沟通以及已婚期间与非商业性工作者发生婚外性行为有关。最常报告的检测原因是应妻子要求。对于大多数问题，如是否发生过与HIV相关的沟通，丈夫和妻子的报告一致性较差，但关于丈夫是否曾进行过HIV检测的一致性相对较高（kappa=0.62）。然而，在逻辑回归分析中，只有已婚期间与非商业性工作者发生性行为仍与HIV检测相关（p=0.02）。结果表明咨询、沟通与丈夫的HIV检测之间存在关联。夫妻之间更好的沟通可能会导致更有效地利用HIV检测（这在该人群中已经很普遍）来预防HIV传播。
