Zheng Zhigang, Li Yong, Jiang Yi, Liang Xu, Qin Shanfang, Nehl Eric J
Department of HIV/AIDS Program, Guangxi Zhuang Autonomous Center for Disease Control and Prevention, Nanning HIV/AIDS Treatment Center, Long Tan Hospital, Liuzhou Department of HIV/AIDS Program, Wuzhou Center for Disease Control and Prevention, Wuzhou Department of HIV/AIDS Program, Baise Center for Disease Control and Prevention, Baise, China Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA.
Medicine (Baltimore). 2018 Sep;97(36):e12077. doi: 10.1097/MD.0000000000012077.
We evaluated the risk of human immunodeficiency virus (HIV) transmission among serodiscordant couples with low adherence to antiretroviral therapy (ART).Data of heterosexual couples/partners in 2010 were extracted from an Internet-based system. Participants were then followed over the course of a year with 6- and 12-month assessments. Prevalence and density of HIV seroconversion were calculated for spouses/partners who did not have a positive HIV test results at baseline. We calculated the transmission odds ratio (OR) value stratified by personal characteristics and behavioral correlates at 6- and 12-month follow-up, as well as seroconversion in spouses/partners over the year.A total of 5544 HIV/AIDS patients and their spouses/partners were recruited in this cohort. Incidence of HIV seroconversion among HIV-negative spouse/partner was 63.7/100 person years (PYs) (430/674.9) at the 6-month follow-up and 33.2/100PYs (567/1707.1PYs) at 12 months. The OR value of transmission from female to male was 2.1 times higher than from male to females at 6 months and 2.3 times higher at 12 months (P < .001). The 55- to 64-year age group was most likely to transmit HIV to their spouses/partners, 2.2 times greater than the participants who were 65 years and older. Married participants were 2.4 times higher at 6 months and 2.5 times higher at 12 months to transmit HIV than divorced/widowed participants. Lastly, transmission among illiterate participants was 6.7 times higher at 6 months and 2.3 times higher at 12 months than those with an educational attainment of community college or above.High HIV seroconversion was observed in this cohort. Spouses/partners who were male had the highest risk of HIV acquisition; those aged 55 to 64 years, having married status, and are HIV-positive with less education were more likely to transmit HIV.
我们评估了抗逆转录病毒疗法（ART）依从性低的血清学不一致夫妇之间的人类免疫缺陷病毒（HIV）传播风险。2010年异性恋夫妇/伴侣的数据从一个基于互联网的系统中提取。然后对参与者进行为期一年的随访，分别在6个月和12个月时进行评估。计算基线时HIV检测结果为阴性的配偶/伴侣的HIV血清转化患病率和密度。我们计算了在6个月和12个月随访时按个人特征和行为相关因素分层的传播优势比（OR）值，以及一年中配偶/伴侣的血清转化情况。
该队列共招募了5544名HIV/AIDS患者及其配偶/伴侣。HIV阴性配偶/伴侣中HIV血清转化的发生率在6个月随访时为63.7/100人年（430/674.9），在12个月时为33.2/100人年（567/1707.1人年）。6个月时女性向男性传播的OR值比男性向女性传播高2.1倍，12个月时高2.3倍（P<0.001）。55至64岁年龄组最有可能将HIV传播给其配偶/伴侣，比65岁及以上的参与者高2.2倍。已婚参与者在6个月时传播HIV的可能性比离婚/丧偶参与者高2.4倍，在12个月时高2.5倍。最后，文盲参与者在6个月时传播HIV的可能性比具有社区大学及以上学历的参与者高6.7倍，在12个月时高2.3倍。
该队列中观察到较高的HIV血清转化率。男性配偶/伴侣感染HIV的风险最高；年龄在55至64岁、已婚、HIV阳性且受教育程度较低的人更有可能传播HIV。
