Yeganeh Nava, Simon Mariana, Dillavou Claire, Varella Ivana, Santos Breno Riegel, Melo Marineide, Fonseca Rosana, Lira Rita, Gorbach Pamina, Nielsen-Saines Karin
a Department of Pediatrics, Division of Infectious Disease , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA.
AIDS Care. 2014;26(6):790-4. doi: 10.1080/09540121.2013.855297. Epub 2013 Nov 8.
Pregnant women have a significantly higher risk of HIV acquisition during gestation than their non-pregnant counterparts due to behavioral and biological factors. Acute seroconversion during gestation results in increased HIV mother-to-child transmission rates and has been identified as a major public health challenge. In order to address potential HIV seroconversion in our pregnant patients, we conducted a prospective cohort study to evaluate the acceptability of offering HIV testing to sexual partners of HIV-negative pregnant women receiving antenatal care at two hospitals in Porto Alegre, Brazil. Over a 14-month study period, HIV-negative pregnant women at two hospital-based clinic sites were encouraged to bring their stable sexual partner for HIV voluntary counseling and testing during prenatal care. Women were re-interviewed following delivery to measure success of the intervention. Of the 1223 HIV-negative pregnant women enrolled in the study, 663 (54%) of their male sexual partners received HIV testing during antenatal care and 4 (0.6%) were diagnosed with HIV infection. A total of 645 women were interviewed at the time of delivery, with 620 (97%) confirming that HIV testing was suggested to their partner. The most common reason provided by women as to why partners did not come for testing was work (69%) and lack of perceived risk (14%). Independent predictors of successful partner testing included being white (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.18-2.12), married (OR 1.78, 95% CI 1.08-2.94), having an older age of sexual debut (OR 0.94, 95% CI 0.9-0.98), and being recruited at Hospital Conceiçao (OR 2.1, 95% CI 1.52-2.88). We conclude that HIV partner testing during prenatal care is acceptable, rendering this intervention attractive to public health programs targeting prevention of sexually transmitted infections.
由于行为和生物学因素，孕妇在孕期感染艾滋病毒的风险显著高于非孕妇。孕期急性血清转化会导致艾滋病毒母婴传播率增加，这已被确定为一项重大的公共卫生挑战。为了解决我们的孕妇患者潜在的艾滋病毒血清转化问题，我们进行了一项前瞻性队列研究，以评估在巴西阿雷格里港的两家医院，为接受产前护理的艾滋病毒阴性孕妇的性伴侣提供艾滋病毒检测的可接受性。在为期14个月的研究期间，鼓励两家医院门诊的艾滋病毒阴性孕妇在产前护理期间带其固定性伴侣接受艾滋病毒自愿咨询和检测。在分娩后对这些女性进行再次访谈，以衡量干预措施的成效。在参与该研究的1223名艾滋病毒阴性孕妇中，其男性性伴侣中有663人（54%）在产前护理期间接受了艾滋病毒检测，4人（0.6%）被诊断为艾滋病毒感染。共有645名女性在分娩时接受了访谈，其中620人（97%）确认已向其伴侣建议进行艾滋病毒检测。女性给出的伴侣不来检测的最常见原因是工作（69%）和认为没有风险（14%）。伴侣检测成功的独立预测因素包括白人（优势比[OR]1.59，95%置信区间[CI]1.18 - 2.12）、已婚（OR 1.78，95%CI 1.08 - 2.94）、首次性行为年龄较大（OR 0.94，95%CI 0.9 - 0.98）以及在康塞桑医院招募（OR 2.1，95%CI 1.52 - 2.88）。我们得出结论，产前护理期间的艾滋病毒伴侣检测是可接受的，这使得该干预措施对旨在预防性传播感染的公共卫生项目具有吸引力。
