Marfatia Yogesh S, Naik Eknath, Singhal Priyanka, Naswa Smriti
Department of Skin VD, Medical College, Vadodara, Gujarat, India.
Indian J Sex Transm Dis AIDS. 2013 Jan;34(1):5-9. doi: 10.4103/0253-7184.112862.
Heterosexual transmission of HIV among married couples is the commonest mode of transmission seen in India. Intramarital transmission is associated with several challenges which need to be further researched.
To study level of seroconcordance and serodiscordance among HIV positive couples and factors affecting intramarital sexual transmission in terms of safe sexual practice, and the presence of Sexually transmitted infections (STI)/circumcision.
Ninety-one monogamous married cohabiting HIV-positive cases (index cases) attending Department of Skin and Venereology, Medical College Baroda, from January 2009 to August 2009 were studied. Their spouses were tested for HIV. A structured proforma was used to study various factors like condom use, circumcision, and the presence of sexually transmitted infections.
Ninety-one monogamous married cohabiting HIV-positive cases were included in the study and considered as index cases. There were 51 males and 40 females. On testing their spouses for HIV, both the spouses were positive in 55 couples giving rise to 60% seroconcordance rate. Out of 55 seroconcordant couples, male spouses used condom in 16 cases (29%). Out of 36 serodiscordant couples 17 male spouses (47%) used condom. Evidence of STD was observed in one of the spouses in 6 out of 55 seroconcordant couples and 6 out of 36 serodiscordant couples. Thus, out of 91 couples one of the partners was having STI in 12 couples. Overall rate of circumcision was 12.2%.
The prevention of transmission of HIV to the HIV negative partner is of paramount importance. Serodiscordant couples, specially the HIV negative female partner is at higher risk. Less acceptability of condoms among married couples may be one of the factors responsible in transmission. Further studies are needed to explore other risk factors associated with HIV transmission in discordant couples.
在印度，已婚夫妇间的异性传播是最常见的HIV传播方式。婚内传播存在若干挑战，有待进一步研究。
研究HIV阳性夫妇间的血清学一致率和不一致率，以及从安全性行为、性传播感染（STI）/包皮环切术方面探讨影响婚内性传播的因素。
对2009年1月至2009年8月在巴罗达医学院皮肤性病科就诊的91例一夫一妻制已婚同居HIV阳性病例（索引病例）进行研究。对其配偶进行HIV检测。使用结构化表格研究诸如避孕套使用、包皮环切术以及性传播感染的存在等各种因素。
91例一夫一妻制已婚同居HIV阳性病例纳入研究并被视为索引病例。其中男性51例，女性40例。对其配偶进行HIV检测时，55对夫妇双方均呈阳性，血清学一致率为60%。在55对血清学一致的夫妇中，16例男性配偶（29%）使用了避孕套。在36对血清学不一致的夫妇中，17例男性配偶（47%）使用了避孕套。在55对血清学一致的夫妇中有6对、36对血清学不一致的夫妇中有6对，其配偶之一有性传播疾病的证据。因此，在91对夫妇中，12对夫妇的一方患有性传播感染。总体包皮环切率为12.2%。
预防HIV传播给HIV阴性伴侣至关重要。血清学不一致的夫妇，尤其是HIV阴性的女性伴侣风险更高。已婚夫妇对避孕套的接受度较低可能是传播的原因之一。需要进一步研究以探索血清学不一致夫妇中与HIV传播相关的其他风险因素。
