Centre for Global Health Research, St. Michael's Hospital, University of Toronto, Li Ka Shing Knowledge Institute, Toronto, ON M5B 1T8, Canada.
Sex Transm Infect. 2011 Oct;87(6):516-20. doi: 10.1136/sextrans-2011-050203. Epub 2011 Aug 24.
Differences in sexual networks probably explain the disparity in the scale of HIV epidemics in sub-Saharan Africa and India. HIV and sexually transmitted infection (STI) discordant couple studies provide insights into important aspects of these sexual networks. The authors quantify the role of male sexual behaviour in HIV transmission in married couples in India.
The authors analysed patterns of HIV and STI discordance in married couples from two community surveys in India: the National Family Health Study-3 for HIV-1 and the Centre for Global Health Research health check-up for HSV-2 and syphilis. A statistical model was used to estimate the fraction of infections introduced by each of the two partners.
Only 0.8%, 16.0% and 3.5% of couples were infected (either partner or both) with HIV-1, HSV-2 and syphilis, respectively. A large proportion of infected couples were discordant (73.0%, 56.3% and 84.2% for HIV-1, HSV-2 and syphilis, respectively). This model estimated that, among couples with any STI, the male partner introduced the infection the majority of the time (HIV-1: 85.4%, HSV-2: 64.1%, syphilis: 75.0%).
Male sexual activity outside of marriage appears to be a driving force for the Indian HIV/STI epidemic. Male client and female sex worker contacts should remain a primary target of the National AIDS Control Program in India.
性网络的差异可能解释了撒哈拉以南非洲和印度艾滋病毒流行规模的差异。艾滋病毒和性传播感染（STI）不一致的夫妇研究为这些性网络的重要方面提供了深入了解。作者量化了男性性行为在印度已婚夫妇中艾滋病毒传播中的作用。
作者分析了来自印度两项社区调查的已婚夫妇中艾滋病毒和 STI 不一致的模式：国家家庭健康研究-3 用于艾滋病毒 1 以及全球健康研究中心健康检查用于单纯疱疹病毒 2 和梅毒。使用统计模型估计两个伴侣中每个伴侣引入的感染部分。
只有 0.8%、16.0%和 3.5%的夫妇分别感染了艾滋病毒 1、单纯疱疹病毒 2 和梅毒。很大一部分感染的夫妇是不一致的（艾滋病毒 1：73.0%、单纯疱疹病毒 2：56.3%和梅毒：84.2%）。该模型估计，在任何 STI 的夫妇中，男性伴侣大多数时候都会引入感染（艾滋病毒 1：85.4%、单纯疱疹病毒 2：64.1%、梅毒：75.0%）。
男性婚外性行为似乎是印度艾滋病毒/性传播感染流行的驱动力。男性客户和女性性工作者接触应继续成为印度国家艾滋病控制计划的主要目标。
