中国 HIV 感染者告知性伴的比例：一项系统评价和荟萃分析。
The proportion of HIV disclosure to sexual partners among people diagnosed with HIV in China: A systematic review and meta-analysis.
机构信息
Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China.
Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China.
出版信息
Front Public Health. 2022 Oct 17;10:1004869. doi: 10.3389/fpubh.2022.1004869. eCollection 2022.
BACKGROUND
Sexual behavior is one of the main routes of HIV/AIDS spread. HIV disclosure to sexual partners has been confirmed to be an important strategy for HIV/AIDS prevention and control. We conducted a systematic review and meta-analysis to pool proportions and characteristics of HIV disclosure to sexual partners among people diagnosed with HIV in China.
METHODS
We searched eight databases and extracted the data on HIV disclosure to partners. Heterogeneity of the data was tested with . Published bias subjectively and objectively analyzed through the funnel plot and Egger's regression test. Subgroup analyses were performed to explore the variation in the proportion by sexual partnership types (unclassified, regular, casual sexual partners), whether being men who have sex with men (MSM), and when to diagnose. The sources of heterogeneity were analyzed. Sensitivity analysis was carried out to evaluate the stability of the results.
RESULTS
Out of 3,698 studies, 44 were included in the review; 11 targeted on MSM. The pooled proportion of HIV disclosure to sexual partners was 65% (95% CI: 56%-75%; 34 studies). Sub-group analyses indicated the proportions of HIV disclosure to regular, casual and unclassified sexual partners were 63% (95% CI: 45%-81%; 31 studies), 20% (95% CI: 8%-33%; nine studies), and 66% (95% CI: 59%-73%; 14 studies), respectively. Fifty-seven percent (95% CI: 45%-69%; three studies) disclosed on the day of diagnosis, 62% (95% CI: 42%-82%; four studies) disclosed within 1 month, and 39% (95% CI: 2%-77%; four studies) disclosed 1 month later. Among MSM, the disclosure to regular male partners, regular female sexual partners, spouses, and casual partner were 47% (95% CI: 29%-65%; six studies), 49% (95% CI: 33%-65%; three studies), 48% (95% CI: 18%-78%; seven studies), and 34% (95% CI: 19%-49%; four studies), respectively.
CONCLUSIONS
The disclosure prevalence of people diagnosed with HIV to sexual partners still need improving in China, and it varies among partner types, key populations, and time being diagnosed. HIV disclosure strategies and procedures need to be developed more detailed and tailored based on the pain points of disclosure status, so as to ultimately prevent HIV transmission through sexual contact.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022291631, identifier: CRD42022291631.
背景
性行为是 HIV/AIDS 传播的主要途径之一。向性伴侣透露 HIV 状况已被证实是 HIV/AIDS 防控的重要策略。我们进行了系统评价和荟萃分析，以汇总中国 HIV 感染者向性伴侣透露 HIV 状况的比例和特征。
方法
我们检索了 8 个数据库，并提取了有关向伴侣透露 HIV 状况的数据。使用. 检验评估数据的异质性。通过漏斗图和 Egger 回归检验主观和客观地分析发表偏倚。进行亚组分析，以探讨不同性伴类型（未分类、固定、偶然性伴）、是否为男男性行为者（MSM）以及诊断时的差异对比例的影响。分析异质性的来源。进行敏感性分析以评估结果的稳定性。
结果
在 3698 项研究中，有 44 项研究纳入综述，其中 11 项针对 MSM。向性伴侣透露 HIV 状况的总体比例为 65%（95%CI：56%-75%；34 项研究）。亚组分析表明，向固定、偶然和未分类性伴透露 HIV 状况的比例分别为 63%（95%CI：45%-81%；31 项研究）、20%（95%CI：8%-33%；9 项研究）和 66%（95%CI：59%-73%；14 项研究）。57%（95%CI：45%-69%；3 项研究）在诊断当天透露，62%（95%CI：42%-82%；4 项研究）在 1 个月内透露，39%（95%CI：2%-77%；4 项研究）在 1 个月后透露。在 MSM 中，向固定男性伴侣、固定女性性伴、配偶和偶然伴侣透露的比例分别为 47%（95%CI：29%-65%；6 项研究）、49%（95%CI：33%-65%；3 项研究）、48%（95%CI：18%-78%；7 项研究）和 34%（95%CI：19%-49%；4 项研究）。
结论
中国 HIV 感染者向性伴侣透露 HIV 状况的比例仍有待提高，且在性伴类型、重点人群和诊断时间上存在差异。需要制定更详细和针对性的 HIV 披露策略和程序，以解决披露状况的痛点，最终通过性接触预防 HIV 传播。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022291631，标识符：CRD42022291631。
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