Sopheab Heng, Saphonn Vonthanak, Chhea Chhorvann, Fylkesnes Knut
National Center for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia.
AIDS. 2009 Jul 17;23(11):1389-95. doi: 10.1097/QAD.0b013e32832cd95a.
A limited number of studies in Asia have investigated HIV transmission in the general population in order to better guide preventive efforts. We examine HIV prevalence patterns in men and women aged 15-49 years in Cambodia.
The first national population-based survey was conducted in 2005, including HIV-related questionnaires and HIV test. Data were analysed separately for men and women. Logistic regression analysis, adjusted by age, was used to determine factors associated with HIV. To estimate the HIV prevalence, it was standardized by age, sex and place of residence.
Among 6514 men and 8188 women, HIV prevalence was 0.61% [95% confidence interval (CI) 0.2-1.8] and 0.62% (95% CI 0.3-2.1), respectively. The prevalence in urban areas was approximately three times higher than in rural settings. The likelihood among women of being HIV positive increased with increasing age differentials between spouses. HIV among men increased with household wealth (odds ratio 5.7; 95% CI 2.0-16.4) and education (odds ratio 3.7; 95% CI 0.8-17.8). About 10% of men reported multiple partners, a behaviour strongly associated with HIV (odds ratio 4.0; 95% CI 1.3-12.5).
This study revealed HIV prevalence to be relatively low in the general population and substantially below previous estimates. Multiple observations were consistent with the hypothesis that the bulk of infections among men are related to sex work and most women are infected in marriage. Intervention should be focused on reducing the transmission among spouses and empower women with better access to information, education and care while sustaining preventive efforts related to sex work.
亚洲仅有少数研究调查了普通人群中的艾滋病毒传播情况，以便更好地指导预防工作。我们研究了柬埔寨15至49岁男性和女性的艾滋病毒流行模式。
2005年开展了首次全国性的基于人群的调查，包括与艾滋病毒相关的问卷调查和艾滋病毒检测。对男性和女性的数据分别进行了分析。采用按年龄调整的逻辑回归分析来确定与艾滋病毒相关的因素。为估计艾滋病毒流行率，按年龄、性别和居住地点进行了标准化。
在6514名男性和8188名女性中，艾滋病毒流行率分别为0.61%[95%置信区间（CI）0.2 - 1.8]和0.62%（95%CI 0.3 - 2.1）。城市地区的流行率约为农村地区的三倍。女性感染艾滋病毒呈阳性的可能性随配偶年龄差异增大而增加。男性中的艾滋病毒感染率随家庭财富（优势比5.7；95%CI 2.0 - 16.4）和教育程度（优势比3.7；95%CI 0.8 - 17.8）的增加而上升。约10%的男性报告有多个性伴侣，这种行为与艾滋病毒感染密切相关（优势比4.0；95%CI 1.3 - 12.5）。
本研究表明普通人群中的艾滋病毒流行率相对较低，且大幅低于先前的估计。多项观察结果与以下假设一致，即男性中的大部分感染与性工作有关，而大多数女性是在婚姻中感染的。干预措施应侧重于减少配偶间的传播，并使妇女有更多机会获取信息、接受教育和获得护理，同时持续开展与性工作相关的预防工作。
