Institute for Microbiology,Charité - University Medicine Berlin,Berlin,Germany.
Department of Microbiology and Hospital Hygiene,Bundeswehr Hospital Hamburg,Hamburg,Germany.
Epidemiol Infect. 2018 Jun;146(8):1015-1025. doi: 10.1017/S0950268818000845. Epub 2018 Apr 15.
Risk populations for HIV infections tend to neglect condom use, making alternative preventive approaches necessary. Accordingly, we modelled the risk of sexual HIV transmission for condom use vs. use of rapid diagnostic test (RDT) systems with subsequent exclusion of potential sexual partners with a correctly or falsely positive test from unprotected sex with and without the use of HIV pre-exposure prophylaxis (PrEP) in a bio-statistical approach. We combined a previously described model of transmission risk for HIV-exposed individuals with a newly suggested model of risk of HIV exposure for sexually active HIV-negative individuals. The model was adapted for several stages of infection and different strategies of HIV infection prevention.HIV prevention with RDTs can reduce the transmission risk by up to 97% compared with having sex without any prevention and up to 80% compared with condom use. Nevertheless, RDT-based prevention strategies demonstrate a lack of protection in several stages of infection; in particular, RNA-based RDT systems may fail under treatment. RDT-based pre-screening of potential sex partners prior to unprotected sexual contacts substantially reduces HIV transmission risk. Combination of different prevention strategies is advisable for high-risk groups.
艾滋病毒感染的风险人群往往忽视使用避孕套，因此需要采取其他预防方法。因此，我们采用生物统计学方法，针对避孕套使用与快速诊断测试（RDT）系统的使用进行建模，以预测性传播艾滋病毒的风险，随后将检测结果正确或错误呈阳性的潜在性伴侣排除在未使用 HIV 暴露前预防（PrEP）的无保护性行为之外。我们结合了先前描述的艾滋病毒暴露个体的传播风险模型和新提出的艾滋病毒阴性个体性活跃的艾滋病毒暴露风险模型。该模型适用于感染的几个阶段和不同的 HIV 感染预防策略。与不采取任何预防措施相比，RDT 可将 HIV 传播风险降低多达 97%，与使用避孕套相比，可将 HIV 传播风险降低多达 80%。然而，基于 RDT 的预防策略在感染的几个阶段均未能提供保护；特别是，基于 RNA 的 RDT 系统在治疗下可能会失效。在无保护的性接触之前，对潜在性伴侣进行基于 RDT 的预筛选可大大降低 HIV 传播风险。对于高风险群体，建议采用不同预防策略的组合。
