De Gruttola V, Mayer K H
Channing Laboratory, Harvard Medical School, Boston, Massachusetts 02115.
Rev Infect Dis. 1988 Jan-Feb;10(1):138-50. doi: 10.1093/clinids/10.1.138.
Epidemiologic investigation of the AIDS epidemic among heterosexuals has consisted chiefly of studies of partners of individuals infected with the human immunodeficiency virus (HIV) and population surveillance. Heterosexual partners of infected individuals appear to be at high risk of infection, but only a small proportion of cases of AIDS have been attributed to heterosexual contact in the United States and Europe. An epidemic model for heterosexual spread of HIV infection is developed and fit to surveillance data. Fitted values are restricted to a range consistent with findings from partner studies. Because, at present, most HIV-infected heterosexuals and bisexuals have been infected through other means (intravenous drug use or homosexual contact), the model considers two interacting populations: a small population of individuals rapidly infected by high-risk activity and a large population of individuals at risk only from heterosexual contact. No precise predictions concerning the AIDS epidemic among heterosexuals are possible now, but current epidemiologic findings neither predict nor preclude a major heterosexual epidemic. Projections depend strongly on the delay between infection and infectivity. The model can also be used to demonstrate how interpretation of results of case-control studies of HIV infection depends on underlying assumptions about the dynamics of the epidemic.
对异性恋者中艾滋病流行情况的流行病学调查主要包括对感染人类免疫缺陷病毒（HIV）个体的性伴侣的研究以及人群监测。受感染个体的异性性伴侣似乎感染风险很高，但在美国和欧洲，仅有一小部分艾滋病病例被归因于异性接触。我们建立了一个HIV感染异性传播的流行模型，并将其与监测数据拟合。拟合值被限制在与性伴侣研究结果一致的范围内。由于目前大多数感染HIV的异性恋者和双性恋者是通过其他途径（静脉吸毒或同性恋接触）感染的，该模型考虑了两个相互作用的人群：一小部分因高危行为而迅速感染的个体和一大群仅因异性接触而有感染风险的个体。目前还无法对异性恋者中的艾滋病流行情况做出精确预测，但当前的流行病学研究结果既未预测也未排除大规模异性传播流行的可能性。预测在很大程度上取决于感染与传染性之间的延迟。该模型还可用于说明对HIV感染病例对照研究结果的解释如何取决于关于流行动态的潜在假设。
