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[应用伯努利过程模型拟合干预措施对HIV血清学不一致夫妻间性传播的影响]

[Application of Bernoulli Process Model fitting the effect of intervention measures on sexual transmission among HIV sero-discordant couples].

作者信息

Tang H L, Mao Y R, Wu Z Y

机构信息

Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jun 10;39(6):755-759. doi: 10.3760/cma.j.issn.0254-6450.2018.06.012.

Abstract

To undersand the outcomes of major intervention measures on sexual transmission among HIV sero-discordant couples. Bernoulli Process Model was applied to model the major influencing factors of HIV transmission among HIV sero-discordant couples. The major influencing factors appeared as consistent condom use, antiretroviral therapy, frequency of sexual behavior. These parameters were from the HIV sero-discordant couples in 30 counties in 4 provinces (Guangxi Zhuang Autonomous Region, Yunnan Province, Xinjiang Uygur Autonomous Region and Henan provinces) from January 1, 2011 to December 31, 2012. According to the main factors, modeling-intervention strategies and measures on reduction HIV transmission among serodiscordant couples were formed. Data from the present proportion of consistent condom use (85) modeling and the coverage of antiretroviral treatment (60) showed that, the proportion of cumulative seroconversion among the spouses was 1.76. Results from the sensitivity analysis on modeling the consistent condom use and the antiretroviral treatment showed that, when the coverage of antiretroviral treatment was as 90 and the proportion of consistent condom use increased from 50 to 90, with 80.7 of the risk of spouse seroconversion could be reduced. Or, when the proportion of consistent condom use was as 90 and the coverage of antiretroviral treatment increased from 50 to 90, with 64.5 of the risk of spouse seroconversion could be reduced. With measures as consistent condom use plus provision of timely antiretroviral therapy to HIV positive index spouses, the risk of sexual transmission among sero-discordant couples could be greatly reduced.

摘要

为了解针对HIV血清学不一致夫妻性传播的主要干预措施的效果。应用伯努利过程模型对HIV血清学不一致夫妻间HIV传播的主要影响因素进行建模。主要影响因素包括坚持使用安全套、抗逆转录病毒治疗、性行为频率。这些参数来自2011年1月1日至2012年12月31日期间广西壮族自治区、云南省、新疆维吾尔自治区和河南省4个省份30个县的HIV血清学不一致夫妻。根据主要因素,制定了减少血清学不一致夫妻间HIV传播的建模干预策略和措施。目前坚持使用安全套比例(85)建模和抗逆转录病毒治疗覆盖率(60)的数据显示,配偶间血清阳转累积比例为1.76。对坚持使用安全套和抗逆转录病毒治疗建模的敏感性分析结果显示,当抗逆转录病毒治疗覆盖率为90且坚持使用安全套比例从50增加到90时,配偶血清阳转风险可降低80.7。或者,当坚持使用安全套比例为90且抗逆转录病毒治疗覆盖率从50增加到90时,配偶血清阳转风险可降低64.5。通过坚持使用安全套并为HIV阳性的索引配偶及时提供抗逆转录病毒治疗等措施,血清学不一致夫妻间性传播风险可大幅降低。

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