Li J, Han J, Xu J, Tang H L, Mao Y R
Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Jun 10;38(6):750-753. doi: 10.3760/cma.j.issn.0254-6450.2017.06.012.
To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made, among men who have sex with men (MSM) in China. Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System. Infected MSM who were older than 22 years of age were included in this study. HIV cases were divided into sero-concordant or sero-discordant group, according to the HIV status of the couple who were tested 180 days post-diagnosis. Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made. A total of 5 081 (22.7) of the HIV infected MSM who had couples, were included in this study. A total of 3 715 cases had their couples tested 180 days after the diagnosis was made. 7.6 (282) had positive couples. Results from the multivariate logistic regression analysis showed that factors as: older than 60 (=2.64, 95: 1.50-4.65) years of age, being minorities (=1.93, 95: 1.13-3.29), having CD(4)(+)T cells less than 500 cells/μl (<200: =2.91, 95: 1.82-4.65; 200-349: =1.98, 95: 1.22-3.23; 350-500: =1.69, 95: 1.00-2.86), with self-reported unsafe behaviors (=1.92, 95: 1.44-2.58) , were more likely to transmit HIV to their couples before the diagnosis was made. Behavior interventions and early HIV testing should be promoted, especially among those MSM who had couples, to avoid inter-spousal transmission.
为分析中国男男性行为者(MSM)新报告艾滋病病毒(HIV)病例确诊前配偶间的婚姻状况及HIV传播情况。从中国HIV/AIDS综合防治信息管理系统收集2014年新报告病例的基线和随访信息。本研究纳入年龄大于22岁的感染MSM。根据确诊后180天检测的配偶双方HIV感染状况,将HIV病例分为血清学一致组或血清学不一致组。采用多因素logistic回归方法分析确诊前配偶间HIV传播的相关潜在因素。本研究共纳入5081名(22.7%)有配偶的HIV感染MSM。共有3715例患者的配偶在确诊后180天接受检测。其中7.6%(282例)配偶检测结果为阳性。多因素logistic回归分析结果显示,年龄大于60岁(比值比[OR]=2.64,95%置信区间[CI]:1.50 - 4.65)、为少数民族(OR = 1.93,95%CI:1.13 - 3.29)、CD4+T淋巴细胞计数低于500个/μl(低于200个/μl:OR = 2.91,95%CI:1.82 - 4.65;200 - 349个/μl:OR = 1.98,95%CI:1.22 - 3.23;350 - 500个/μl:OR = 1.69,95%CI:1.00 - 2.86)、自述有不安全行为(OR = 1.92,95%CI:1.44 - 2.58)的患者在确诊前更有可能将HIV传播给其配偶。应推广行为干预措施和早期HIV检测,尤其是在有配偶的MSM中,以避免配偶间传播。