Morin Stephen F, Myers Janet J, Shade Starley B, Koester Kimberly, Maiorana Andre, Rose Carol Dawson
Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale St., Suite 1300, San Francisco, CA 94105, USA.
AIDS Behav. 2007 Sep;11(5 Suppl):S6-16. doi: 10.1007/s10461-007-9253-4. Epub 2007 Jun 19.
We assessed risk of transmission among 4,016 HIV-infected patients in primary care, including men who have sex with men (MSM, n = 2,109), women (n = 1,104) and men who had sex with women (MSW, n = 803) in clinics in 15 cities across the U.S. A transmission risk act, assessed by computer assisted interviews, was defined as unprotected vaginal or anal sex with a partner who was HIV-uninfected or of unknown HIV status. MSM were more than twice as likely to report transmission risk acts than MSW (Odds Ratio [OR] = 2.35; 95% Confidence Interval [CI] = 1.84, 3.00; P < or = .001). Women were also more likely to report transmission risk acts than MSW (OR = 1.56; 95% CI = 1.19, 2.05; P < or = .001). Stimulant use was associated with transmission risk in all three groups (P < or = .05). MSM were more likely to use methamphetamines (8% versus 2% and 3% respectively), while MSW (17%) and women (12%, compared to 11% for MSM) were more likely to use cocaine. Clinical settings offer opportunities for preventing HIV transmission, particularly if interventions are tailored to sub-populations of HIV-infected patients.
我们评估了美国15个城市诊所中4016名接受初级护理的艾滋病毒感染患者的传播风险，其中包括男男性行为者（MSM，n = 2109）、女性（n = 1104）和异性性行为男性（MSW，n = 803）。通过计算机辅助访谈评估的传播风险行为被定义为与未感染艾滋病毒或艾滋病毒感染状况未知的伴侣进行无保护的阴道或肛交。男男性行为者报告传播风险行为的可能性是异性性行为男性的两倍多（优势比[OR] = 2.35；95%置信区间[CI] = 1.84, 3.00；P≤.001）。女性报告传播风险行为的可能性也高于异性性行为男性（OR = 1.56；95% CI = 1.19, 2.05；P≤.001）。在所有三组中，使用兴奋剂都与传播风险相关（P≤.05）。男男性行为者更有可能使用甲基苯丙胺（分别为8%，而异性性行为男性和女性分别为2%和3%），而异性性行为男性（17%）和女性（12%，男男性行为者为11%）更有可能使用可卡因。临床环境为预防艾滋病毒传播提供了机会，特别是如果干预措施是针对艾滋病毒感染患者的亚人群量身定制的。
