确定纽约市 HIV 血清不一致性伴侣关系中的相关因素。

From the HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York City, NY.

Sex Transm Dis. 2013 Oct;40(10):784-91. doi: 10.1097/OLQ.0000000000000007.

BACKGROUND

Identification and characterization of patients in HIV-serodiscordant partnerships can inform strategies to improve HIV prevention efforts for this group.

METHODS

We conducted a case-control analysis using New York City Department of Health and Mental Hygiene HIV surveillance and partner services (PS) data from July 2006 to July 2010. HIV-infected index patients reported and interviewed for PS who named 1 or more sex and/or syringe-sharing partner (n = 1309) and their sex partners notified by New York City Department of Health and Mental Hygiene with confirmed HIV serostatus (n = 1564) were selected for analysis. Index patients were classified into either serodiscordant or seroconcordant-positive partnerships based on the HIV serostatus of their partner(s). Multivariable regression analysis was conducted to examine the likelihood of membership in a serodiscordant partnership by a range of individual- and partnership-level variables.

RESULTS

Of the 1309 index patients, 624 (48%) were in HIV-serodiscordant partnerships. In multivariable analysis, the likelihood of serodiscordant partnership membership was slightly higher among women, individuals with unknown HIV transmission risk, and those with 2 to 3 named partners versus 1. Index patients claimed more partners than they named; for example, index patients who named 1 partner claimed an average of 2.3 partners in the past 12 months.

CONCLUSIONS

Many HIV-infected patients who received PS were in HIV-serodiscordant partnerships, with characteristics indicating potential for HIV transmission. Our findings suggest several potential programmatic and policy needs, including enhanced linkage-to-care efforts for this population, especially HIV-infected individuals with uncontrolled viremia; ongoing PS for individuals with evidence of continuing exposure of others; and participation by patients and their serodiscordant, steady partners in local prevention interventions.

背景

识别和描述 HIV 血清不一致伴侣中的患者可以为改善该人群的 HIV 预防工作提供信息。

方法

我们使用纽约市卫生和心理卫生部 HIV 监测和伙伴服务（PS）数据进行了病例对照分析，数据来源于 2006 年 7 月至 2010 年 7 月。报道并接受 PS 访谈的 HIV 感染的索引患者（n=1309）为报告了 1 个或多个性伴和/或共用注射器的伙伴（n=1309），并通知纽约市卫生和心理卫生部确认 HIV 血清状态（n=1564）的性伙伴入选分析。根据其性伙伴的 HIV 血清状态，将索引患者分为血清不一致或血清一致阳性的伴侣。采用多变量回归分析，考察了一系列个体和伴侣水平变量对血清不一致伴侣关系的可能性。

结果

在 1309 名索引患者中，624 名（48%）处于 HIV 血清不一致的伴侣关系中。在多变量分析中，女性、未知 HIV 传播风险、报告 2-3 名性伴而非 1 名性伴的个体，发生血清不一致伴侣关系的可能性略高。索引患者报告的性伴数量多于他们所报告的数量；例如，报告 1 名性伴的索引患者，在过去 12 个月中平均报告了 2.3 名性伴。

结论

许多接受 PS 的 HIV 感染患者处于 HIV 血清不一致的伴侣关系中，具有潜在的 HIV 传播特征。我们的研究结果表明，存在一些潜在的方案和政策需求，包括为该人群，特别是 HIV 感染且病毒载量未得到控制的个体加强提供与关怀服务的努力；为有证据表明继续使他人面临感染风险的个体持续提供 PS；以及让患者及其血清不一致的稳定伴侣参与当地预防干预措施。