埃塞俄比亚迪拉地区接受HIV检测的夫妇中HIV不一致情况及相关危险因素的评估。
Assessment of HIV discordance and associated risk factors among couples receiving HIV test in Dilla, Ethiopia.
作者信息
Tadesse Moges
机构信息
Dilla University, College of health sciences and medicine, Dilla, Ethiopia.
出版信息
BMC Res Notes. 2014 Dec 10;7:893. doi: 10.1186/1756-0500-7-893.
BACKGROUND
About 60% of new HIV infections occur in HIV sero-discordant couples as 30% of married HIV positives have negative spouse. Although HIV-discordant couples are at 10% annual risk of acquiring HIV infection and large number of new HIV infections occur in stable partnerships, most HIV prevention programs focus on reducing casual sexual partners, condom use, and increasing fidelity among married partners. The purpose is assessment of sero-discordance among couples and associated factors.
METHODS
The study was facility based cross sectional survey of couples who tested for HIV in 2011 and lived together at least 1 year period. The sample size was 154 couples (308 individuals) and necessary ethical issues were considered.
RESULTS
Among 152 couples (304 individuals) who received VCT, HIV sero-prevalence in this study was found to be 11(3.6%). The prevalence in females 8(5.3%) was higher than that in males 3(2.0%). Of all participants, 9(3.0%) were found to be sero-discordant, 2(0.7%) concordant positive and 293(96.4%) concordant negative. Of all couples 9(5.9%) were found to be sero-discordant, 2(1.3%) concordant positive and 141(92.8%) concordant negative. Of the 9 sero-discordant couples, the 7(4.6%) prevalence in females was higher than 2(1.3%) in males. And, among 9 discordant couples, 5 of them were premarital sex partner and the rest 4 were married couples. Premarital couples were significantly discordant than married couples, AOR=1.68; 95%CI (1.36- 5.40). HIV discordance was also significantly associated with having number of two or more sexual partners than one sexual partner AOR=4.06; 95%CI (2.41-10.13).
CONCLUSION
The study indicated high prevalence of HIV discordance and increased risk of vulnerability. Therefore, couples should be aware of their own and their partners' sero-status before and after engagement. Again, the following risk reduction methods were recommended: education of discordant couples on 100% correct condom use, and if condom breaks, or if they forget to use, Post-Exposure Prophylaxis must be established; for those who are not volunteer to use condom and/or have a child, early initiation of ART to positive partner.
背景
约60%的新发艾滋病毒感染发生在艾滋病毒血清学不一致的夫妻中，因为30%已婚的艾滋病毒阳性者其配偶为阴性。尽管血清学不一致的夫妻每年有10%感染艾滋病毒的风险，且大量新发艾滋病毒感染发生在稳定的伴侣关系中，但大多数艾滋病毒预防项目都侧重于减少性伴侣、使用避孕套以及提高已婚伴侣之间的忠诚度。目的是评估夫妻间的血清学不一致情况及相关因素。
方法
该研究是以机构为基础的横断面调查，对象为2011年进行艾滋病毒检测且共同生活至少1年的夫妻。样本量为154对夫妻（308人），并考虑了必要的伦理问题。
结果
在152对（304人）接受自愿咨询检测的夫妻中，本研究发现艾滋病毒血清学患病率为11例（3.6%）。女性患病率为8例（5.3%）高于男性的3例（2.0%）。在所有参与者中，9例（3.0%）被发现血清学不一致，2例（0.7%）一致阳性，293例（96.4%）一致阴性。在所有夫妻中，9例（5.9%）被发现血清学不一致，2例（1.3%）一致阳性，141例（92.8%）一致阴性。在9对血清学不一致的夫妻中，女性患病率7例（4.6%）高于男性的2例（1.3%）。而且，在9对不一致的夫妻中，其中5对是婚前性伴侣，其余4对是已婚夫妻。婚前夫妻的不一致情况显著高于已婚夫妻，调整后比值比=1.68；95%置信区间（1.36 - 5.40）。艾滋病毒不一致情况还与有两个或更多性伴侣显著相关，而不是只有一个性伴侣，调整后比值比=4.06；95%置信区间（2.41 - 10.13）。
结论
该研究表明艾滋病毒不一致情况的患病率较高且易感染风险增加。因此，夫妻在订婚前后应了解自己及伴侣的血清学状况。此外，建议采取以下降低风险的方法：对血清学不一致的夫妻进行100%正确使用避孕套的教育，如果避孕套破裂或忘记使用，必须进行暴露后预防；对于那些不愿意使用避孕套和/或有孩子的人，对阳性伴侣尽早启动抗逆转录病毒治疗。
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