van der Straten A, King R, Grinstead O, Serufilira A, Allen S
Center for AIDS Prevention Studies, University of California, San Francisco, USA.
AIDS. 1995 Aug;9(8):935-44. doi: 10.1097/00002030-199508000-00016.
To describe sexual interaction and HIV-related communication in Rwandan couples and to examine their relationship to HIV testing and condom use.
Cross-sectional survey of a longitudinal cohort.
In 1988, women recruited for an epidemiological study of HIV, and interested male partners, received confidential HIV testing and counseling. Two years after enrollment, 876 women reporting one steady partner in the past year completed a questionnaire addressing sexual and HIV-related communication, sexual motivation and violence in the partnership.
Men control sexual decision making, and coercive sex and violence between partners is not uncommon. HIV-positive women were more likely to report coercive sex and less likely to have discussed their test results with their partner. Women with HIV-positive partners were more likely to report being physically abused. Condom use was more common if the man had been previously tested, and if women reported discussing or negotiating condom use. HIV-negative women with untested or seronegative partners were the least likely to use condoms or to discuss or attempt to negotiate condom use.
Participation of the male partner is crucial for successful HIV risk reduction in couples. HIV testing and counseling of couples has beneficial long term effects on condom use and HIV-related communication. Couple communication is associated with condom use, but only when the discussion is specific (sexually transmitted disease risks and using condoms). Seronegative women with untested partners are at increased risk for HIV as they are the least likely to discuss or attempt to negotiate condom use.
描述卢旺达夫妇间的性互动及与艾滋病病毒相关的交流情况，并研究它们与艾滋病病毒检测及避孕套使用之间的关系。
对一个纵向队列进行横断面调查。
1988年，参与艾滋病病毒流行病学研究的女性及其感兴趣的男性伴侣接受了保密的艾滋病病毒检测与咨询。入组两年后，876名报告在过去一年中有一位固定伴侣的女性完成了一份问卷，内容涉及性及与艾滋病病毒相关的交流、性动机及伴侣间的暴力行为。
男性掌控着性决策，伴侣间的强迫性行为和暴力行为并不罕见。艾滋病病毒检测呈阳性的女性更有可能报告遭受强迫性行为，且与伴侣讨论检测结果的可能性较小。伴侣艾滋病病毒检测呈阳性的女性更有可能报告遭受身体虐待。如果男性之前接受过检测，以及女性报告曾讨论或协商过避孕套的使用，那么避孕套的使用更为普遍。伴侣未接受检测或检测结果为血清阴性的艾滋病病毒检测呈阴性的女性使用避孕套、讨论或尝试协商使用避孕套的可能性最小。
男性伴侣的参与对于夫妻成功降低艾滋病病毒感染风险至关重要。对夫妻进行艾滋病病毒检测与咨询对避孕套使用及与艾滋病病毒相关的交流有长期有益影响。夫妻间的交流与避孕套使用有关，但前提是讨论要具体（性传播疾病风险及使用避孕套）。伴侣未接受检测的血清阴性女性感染艾滋病病毒的风险增加，因为她们最不可能讨论或尝试协商使用避孕套。
