Matovu Joseph K B
Makerere University School of Public Health, Kampala, Uganda.
Curr HIV Res. 2010 Sep;8(6):430-40. doi: 10.2174/157016210793499303.
Most new HIV infections in sub-Saharan Africa now occur in married and cohabiting couples, many of whom do not realize that only one of them may be infected with HIV. HIV-negative individuals living in stable HIV-discordant partnerships (in which one partner is HIV-infected while the other one is not) are twice as likely to get infected with HIV as those living in concordant HIV-negative relationships. Since HIV transmission occurs mainly from HIV-infected persons who are unaware of their status, a combination of interventions including behavioral and biomedical interventions is urgently needed to increase knowledge of HIV status as well as reduce the risk of HIV transmission within married and cohabiting couples. Behavioral interventions include promotion of couples' counseling, testing and disclosure; condom promotion as well as alcohol risk-reduction, while biomedical interventions include provision of antiretroviral treatment to the HIV-infected partner, medical male circumcision and treatment of sexually transmitted infections. Since no single intervention can turn around the current HIV tide in married and cohabiting couples, we argue for the inclusion of these interventions in a combination prevention package for married and cohabiting HIV-discordant couples in sub-Saharan Africa.
目前，撒哈拉以南非洲地区大多数新的艾滋病毒感染发生在已婚和同居伴侣中，其中许多人并未意识到他们中只有一人可能感染了艾滋病毒。生活在稳定的艾滋病毒不一致伴侣关系（其中一方感染艾滋病毒而另一方未感染）中的艾滋病毒阴性个体感染艾滋病毒的可能性是生活在一致的艾滋病毒阴性关系中的个体的两倍。由于艾滋病毒传播主要发生在未意识到自己感染状况的艾滋病毒感染者身上，因此迫切需要采取包括行为和生物医学干预在内的一系列干预措施，以提高对艾滋病毒感染状况的认识，并降低已婚和同居伴侣之间的艾滋病毒传播风险。行为干预包括促进夫妻咨询、检测和信息披露；推广使用避孕套以及降低酒精风险，而生物医学干预包括为感染艾滋病毒的伴侣提供抗逆转录病毒治疗、男性包皮环切术以及治疗性传播感染。由于没有单一的干预措施能够扭转目前已婚和同居伴侣中的艾滋病毒感染趋势，我们主张将这些干预措施纳入撒哈拉以南非洲地区已婚和同居的艾滋病毒不一致伴侣的综合预防方案中。
