Serwadda D, Gray R H, Wawer M J, Stallings R Y, Sewankambo N K, Konde-Lule J K, Lainjo B, Kelly R
Institute of Public Health, Makerere University, Kampala, Uganda.
AIDS. 1995 Jul;9(7):745-50. doi: 10.1097/00002030-199507000-00012.
To describe the role of men and women as sources of HIV transmission and to estimate HIV incidence among discordant couples resident in diverse rural communities in Uganda.
Rakai, a rural district in Uganda, East Africa.
A population-based cohort study, which has been conducted as annual serological and behavioral surveys since 1989. Community clusters were stratified into trading centers on main roads, intermediate trading villages on secondary roads and agricultural villages off roads. In the 1990 survey round, serological data were available for 79 discordant and 411 concordant HIV-negative couples aged 13-49 years. The present analysis examines sex-specific seropositivity associated with place of residence and the incidence of seroconversion among discordant couples between 1990 and 1991.
Seventy-nine discordant couples were followed; the HIV-positive partner was male in 44 couples (57%) and female in 35 couples (43%). There was marked variation in the sex of the seropositive partner by place of residence: women were the HIV-positive partner in 57% of couples from trading centers, 52% from intermediate villages, and 20% from agricultural communities (P < 0.008). Condom use was higher in discordant couples in which the man was the uninfected partner (17.1%) rather than the woman (9.5%). HIV-positive women, but not HIV-positive men, reported significantly more sexual partners and more genital ulcers than seronegative individuals of the same sex. Seroincidence rates among men and women in discordant relationship were 8.7 and 9.2 per 100 person-years (PY), respectively, which was much higher than in concordant seronegative couples (men, 0.82; women, 0.87 per 100 PY).
In this Ugandan population, men are the predominant source of new infections in rural villages. Risk factors and preventive behaviors vary with the sex of the infected partner, and seroconversion rates are similar in both sexes.
描述男性和女性作为艾滋病毒传播源的作用，并估计乌干达不同农村社区中配偶双方艾滋病毒检测结果不同的夫妇的艾滋病毒感染率。
东非乌干达的一个农村地区拉凯。
一项基于人群的队列研究，自1989年以来每年进行血清学和行为调查。社区群组分为主干道上的贸易中心、次干道上的中间贸易村庄和道路沿线的农业村庄。在1990年的调查轮次中，有79对配偶双方艾滋病毒检测结果不同以及411对配偶双方艾滋病毒检测结果均为阴性的13至49岁夫妇的血清学数据。本分析研究了与居住地相关的性别特异性血清阳性率以及1990年至1991年期间配偶双方艾滋病毒检测结果不同的夫妇中血清转化的发生率。
对79对配偶双方艾滋病毒检测结果不同的夫妇进行了随访；44对夫妇（57%）中艾滋病毒呈阳性的伴侣为男性，35对夫妇（43%）中为女性。血清阳性伴侣的性别因居住地不同而有显著差异：在贸易中心的夫妇中，57%的夫妇中女性为艾滋病毒阳性伴侣；在中间村庄的夫妇中，这一比例为52%；在农业社区的夫妇中，这一比例为20%（P<0.008）。在配偶双方艾滋病毒检测结果不同的夫妇中，未感染伴侣为男性的夫妇使用避孕套的比例（17.1%）高于未感染伴侣为女性的夫妇（9.5%）。与同性血清阴性个体相比，艾滋病毒呈阳性的女性报告的性伴侣和生殖器溃疡明显更多，但艾滋病毒呈阳性的男性并非如此。配偶双方艾滋病毒检测结果不同的夫妇中男性和女性的血清转化率分别为每100人年8.7例和9.2例，远高于配偶双方艾滋病毒检测结果均为阴性的夫妇（男性为每100人年0.82例；女性为每100人年0.87例）。
在这一乌干达人群中，男性是农村地区新感染的主要来源。危险因素和预防行为因感染伴侣的性别而异，男女的血清转化率相似。
