Schoub B D, Smith A N, Johnson S, Martin D J, Lyons S F, Padayachee G N, Hurwitz H S
Department of Virology, University of the Witwatersrand, Johannesburg.
S Afr Med J. 1990 Jun 16;77(12):613-8.
An epidemiological composite of the human immunodeficiency virus (HIV) epidemic in South Africa was constructed from reported acquired immunodeficiency syndrome (AIDS) figures, blood donor seroprevalence data and a family of active surveillance studies in the Johannesburg area. Of great concern is the extensive and continuing silent spread of HIV in the urban black population, manifested by doubling times in male and female sexually transmitted disease (STD) clinic attenders of 10.67 and 9.78 months respectively, a doubling time in female family planning (FP) attenders of 6.55 months, and HIV infection rates of 1:56, 1:37 and 1:91, respectively. These data suggest a spread of infection far more extensive than the relatively lower AIDS figures. However, seroprevalence figures in municipal employees of mainly rural origin were considerably lower, only 1:1,250 in black men and none in women, but regular movements between urban and rural areas could well introduce and amplify infection in rural areas. A complete epidemiological picture of HIV can only be attained by employing both the above approach of the family of surveys complemented by a nationwide seroprevalence study to assess HIV penetration into the general 'background' population. Educational interventions should now be particularly targeted to the major risk groups in the urban black heterosexual community.
利用上报的获得性免疫缺陷综合征（艾滋病）数据、献血者血清阳性率数据以及约翰内斯堡地区一系列主动监测研究，构建了南非人类免疫缺陷病毒（HIV）疫情的流行病学综合情况。令人极为担忧的是，HIV在城市黑人人口中广泛且持续地悄然传播，表现为男性和女性性传播疾病（STD）门诊就诊者的翻倍时间分别为10.67个月和9.78个月，女性计划生育（FP）门诊就诊者的翻倍时间为6.55个月，HIV感染率分别为1:56、1:37和1:91。这些数据表明，感染传播的范围远比相对较低的艾滋病数据所显示的更为广泛。然而，主要来自农村的市政雇员的血清阳性率数据要低得多，黑人男性中仅为1:1250，女性中则没有，但城乡之间的定期流动很可能会在农村地区引入并扩大感染。只有采用上述一系列调查方法，并辅以全国血清阳性率研究以评估HIV在一般“背景”人群中的渗透情况，才能全面了解HIV的流行病学情况。现在，教育干预措施应特别针对城市黑人异性恋社区中的主要风险群体。
