Gumbe Anne, McLellan-Lemal Eleanor, Gust Deborah A, Pals Sherri L, Gray Kristen Mahle, Ndivo Richard, Chen Robert T, Mills Lisa A, Thomas Timothy K
Kenya Medical Research Institute, Kisumu, Kenya
Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA.
Int J STD AIDS. 2015 Nov;26(13):929-40. doi: 10.1177/0956462414563625. Epub 2014 Dec 12.
We estimated HIV prevalence and identified correlates of HIV infection among 1106 men and women aged 16-34 years residing in Kisumu, Kenya. Demographic, sexual, and other behavioural data were collected using audio computer-assisted self-interview in conjunction with a medical examination, real-time parallel rapid HIV testing, and laboratory testing for pregnancy, gonorrhoea, chlamydia, syphilis, and herpes simplex virus type 2. Multivariate logistic regression was used to identify variables associated with prevalent HIV infection by gender. Overall HIV prevalence was 12.1%. HIV prevalence among women (17.1%) was approximately two-and-one-half times the prevalence among men (6.6%). Odds of HIV infection in men increased with age (aOR associated with one-year increase in age = 1.21, CI = 1.07-1.35) and were greater among those who were uncircumcised (aOR = 4.42, CI = 1.41-13.89) and those who had an herpes simplex virus type 2-positive (aOR = 3.13, CI = 1.12-8.73) test result. Odds of prevalent HIV infection among women also increased with age (aOR associated with one-year increase in age = 1.16, CI = 1.04-1.29). Women who tested herpes simplex virus type 2 positive had more than three times the odds (aOR = 3.85, CI = 1.38-10.46) of prevalent HIV infection compared with those who tested herpes simplex virus type 2 negative. Tailored sexual health interventions and programs may help mitigate HIV age and gender disparities.
我们对居住在肯尼亚基苏木的1106名年龄在16至34岁之间的男性和女性的艾滋病毒感染率进行了估计,并确定了艾滋病毒感染的相关因素。通过音频计算机辅助自我访谈,结合医学检查、实时并行快速艾滋病毒检测以及妊娠、淋病、衣原体、梅毒和2型单纯疱疹病毒的实验室检测,收集了人口统计学、性行为及其他行为数据。采用多变量逻辑回归按性别确定与艾滋病毒现患感染相关的变量。总体艾滋病毒感染率为12.1%。女性的艾滋病毒感染率(17.1%)约为男性(6.6%)的2.5倍。男性感染艾滋病毒的几率随年龄增长而增加(年龄每增加一岁的调整后比值比 = 1.21,可信区间 = 1.07 - 1.35),在未行包皮环切术者(调整后比值比 = 4.42,可信区间 = 1.41 - 13.89)以及2型单纯疱疹病毒检测呈阳性者(调整后比值比 = 3.13,可信区间 = 1.12 - 8.73)中更高。女性艾滋病毒现患感染的几率也随年龄增长而增加(年龄每增加一岁的调整后比值比 = 1.16,可信区间 = 1.04 - 1.29)。与2型单纯疱疹病毒检测呈阴性的女性相比,2型单纯疱疹病毒检测呈阳性的女性现患艾滋病毒感染的几率高出三倍多(调整后比值比 = 3.85,可信区间 = 1.38 - 10.46)。量身定制的性健康干预措施和项目可能有助于减轻艾滋病毒在年龄和性别方面的差异。