Knapper C M, Roderick J, Smith J, Temple M, Birley H D L
Department of Genitourinary Medicine, Cardiff Royal Infirmary, Newport Road, Cardiff CF240SZ, UK.
Sex Transm Infect. 2008 Oct;84(5):377-80. doi: 10.1136/sti.2008.030536. Epub 2008 Jul 2.
To describe an HIV transmission cluster centred in South Wales by the analysis of partner notification outcomes and demographic characteristics of individuals identified in the sexual network.
After diagnosis of the index case, HIV testing and partner notification were undertaken by Cardiff Genitourinary Medicine Clinic in collaboration with the local Health Protection Team, National Public Health Service for Wales and Terrence Higgins Trust Cymru. Rapid test and standard venepuncture methods were used for HIV screening and the resulting clinical and behavioural data were analysed.
Of the 123 individuals identified in the sexual network, all were men who had sex with men (MSM) except for seven men who self-identified as bisexual and five heterosexual women. Fifteen new cases of HIV were diagnosed; all were men. Partner notification outcomes are as follows: 104 provider referrals were made, 57 were successfully contacted with known outcomes, 14 were successfully contacted but with unknown outcomes and 33 were uncontactable. Fifteen patient referrals were made, 11 had known outcomes but four had unknown outcomes. Four patients self-referred. Eleven reported previous HIV diagnosis. The sexual network was distributed over South and West Wales extending into England, with high reported rates of unprotected anal intercourse, previous HIV tests and concurrent sexually transmitted infections. A one in four positive rate for those with a known HIV status outcome and a 68% provider referral success rate compares favourably with other studies.
Partner notification revealed a relatively young, well-educated HIV network with high-risk behaviour and ongoing transmission despite previous knowledge and awareness of HIV. This analysis adds to the evidence supporting HIV partner notification in MSM.
通过分析性网络中已识别个体的性伴通知结果和人口统计学特征，描述以南威尔士为中心的HIV传播群组。
在确诊索引病例后，加的夫性传播疾病诊所与当地卫生防护小组、威尔士国家公共卫生服务机构以及特伦斯·希金斯信托基金威尔士分部合作，开展HIV检测和性伴通知工作。采用快速检测和标准静脉穿刺方法进行HIV筛查，并对所得的临床和行为数据进行分析。
在性网络中识别出的123名个体中，除7名自称双性恋的男性和5名异性恋女性外，其余均为男男性行为者（MSM）。确诊了15例新的HIV病例；均为男性。性伴通知结果如下：进行了104次向医疗机构的转诊，57次成功联系上且有已知结果，14次成功联系上但结果未知，33次无法联系上。进行了15次患者转诊，11次有已知结果，但4次结果未知。4名患者自行转诊。11人报告曾被诊断为HIV。性网络分布在南威尔士和西威尔士，并延伸至英格兰，报告的无保护肛交、既往HIV检测和同时感染性传播感染的发生率较高。已知HIV状态结果者的阳性率为四分之一，向医疗机构转诊的成功率为68%，与其他研究相比情况较好。
性伴通知显示出一个相对年轻、受过良好教育的HIV网络，尽管此前对HIV已有了解和认识，但仍存在高危行为和持续传播。该分析为支持在男男性行为者中开展HIV性伴通知提供了更多证据。
