Hudson C P, Hennis A J, Kataaha P, Lloyd G, Moore A T, Sutehall G M, Whetstone R, Wreghitt T, Karpas A
School of Clinical Medicine, University of Cambridge.
AIDS. 1988 Aug;2(4):255-60.
Before commencing rational control programmes for AIDS in Africa it is desirable to determine the relative importance of heterosexual and various non-sexual modes of transmission. We investigated this by comparing the seroepidemiologies of AIDS, hepatitis B and syphilis at two rural hospitals in southwest Uganda. During August 1986, 3% of 357 outpatients, reflecting the age and sex composition of the general population, were anti-HIV positive. Anti-HIV seropositivity, both in the outpatients and among 36 suspected prostitutes and 14 suspected AIDS cases, was confined to individuals aged 20 or over. For men, seropositivity was associated with sexual contact with prostitutes (a risk factor for 61% of young men in the study). In the prostitute group, 25% were anti-HIV positive and 46% were positive on the Treponema pallidum haemagglutination (TPHA) test for syphilis. The risk factors for HIV, but not hepatitis B, were the same as for having a history of sexually transmitted disease (STD). However, there was, surprisingly, an association between a history of STD and seropositivity for hepatitis B virus but not for HIV infection. The geographical and age distributions of seropositivity for HIV and hepatitis B virus were also quite different. Finally, blood transfusions, scarification and exposure to mosquitoes (as assessed by a history of malaria) were not evident risk factors for either HIV or hepatitis B virus. AIDS in rural Africa seems to differ in its epidemiology from hepatitis B and appears to be spread predominantly by pre-existing patterns of heterosexual activity responsible for high rates of other sexually transmitted diseases.
在非洲开展合理的艾滋病防控项目之前，确定异性传播和各种非性传播方式的相对重要性是很有必要的。我们通过比较乌干达西南部两家农村医院艾滋病、乙型肝炎和梅毒的血清流行病学来对此进行了调查。1986年8月期间，357名门诊病人中有3%的人抗HIV呈阳性，这些门诊病人反映了普通人群的年龄和性别构成。门诊病人以及36名疑似妓女和14名疑似艾滋病病例中，抗HIV血清阳性仅限于20岁及以上的个体。对于男性而言，血清阳性与与妓女的性接触有关（在该研究中，这是61%的年轻男性的一个风险因素）。在妓女群体中，25%的人抗HIV呈阳性，46%的人梅毒螺旋体血凝试验（TPHA）检测呈梅毒阳性。HIV而非乙型肝炎的风险因素与有性传播疾病（STD）病史的风险因素相同。然而，令人惊讶的是，有STD病史与乙型肝炎病毒血清阳性之间存在关联，但与HIV感染无关。HIV和乙型肝炎病毒血清阳性的地理分布和年龄分布也有很大差异。最后，输血、划痕和接触蚊子（通过疟疾病史评估）似乎都不是HIV或乙型肝炎病毒的明显风险因素。非洲农村地区的艾滋病在流行病学上似乎与乙型肝炎不同，而且似乎主要是通过导致其他性传播疾病高发的既有的异性性行为模式传播的。
