肯尼亚内罗毕的血清学不一致伴侣中 HIV 阳性女性的社会心理因素、无保护性行为和可检测到的病毒载量。
Psychosocial Factors, Condomless Sex, and Detectable Viral Load in HIV-Positive Women in Serodiscordant Couples in Nairobi, Kenya.
机构信息
Department of Medicine, University of Washington, 1959 NE Pacific Street, UW Box 356423, Seattle, WA, 98195, USA.
Department of Biostatistics, University of Washington, Seattle, USA.
出版信息
AIDS Behav. 2020 Dec;24(12):3346-3358. doi: 10.1007/s10461-020-02907-0.
This prospective study of HIV-positive Kenyan women in serodiscordant couples examined relationships between psychosocial factors, viral suppression, and condomless sex. Participants were screened for alcohol use disorders and intimate partner violence (IPV) annually and depressive symptoms every 6 months. Prostate specific antigen (PSA) detection was used as a marker for condomless sex. A total of 151 participants contributed 349 person-years of follow-up. Hazardous/harmful alcohol use was associated with increased risk of detecting PSA in vaginal secretions (aRR 1.99, 95%CI 1.08-3.66, χ = 4.85 (1)), while IPV and depression were not. Events representing HIV transmission potential, where there was biological evidence of condomless sex at a visit with a detectable plasma viral load, were observed at 2% of visits. The high prevalence of IPV and association between alcohol use and sexual risk suggest the need for monitoring and support for these conditions as part of comprehensive HIV care for women.
本前瞻性研究调查了性伴间 HIV 血清不一致的肯尼亚 HIV 阳性女性的社会心理因素、病毒抑制与无保护性行为之间的关系。参与者每年接受酒精使用障碍和亲密伴侣暴力（IPV）筛查，每 6 个月接受一次抑郁症状筛查。前列腺特异性抗原（PSA）检测被用作无保护性行为的标志物。共有 151 名参与者提供了 349 人年的随访数据。危险/有害饮酒与阴道分泌物中检测到 PSA 的风险增加相关（aRR 1.99，95%CI 1.08-3.66，χ = 4.85 (1)），而 IPV 和抑郁则没有。在具有可检测血浆病毒载量的就诊时存在无保护性行为的生物学证据的 HIV 传播潜在事件，在 2%的就诊中观察到。IPV 的高流行率以及酒精使用与性风险之间的关联表明，需要对这些情况进行监测和支持，作为女性综合 HIV 护理的一部分。
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