Kaldor J, Williamson P, Guinan J J, Imrie A, Gold J
National Centre in HIV Epidemiology and Clinical Research, University of NSW, Sydney.
Aust J Public Health. 1993 Dec;17(4):334-8. doi: 10.1111/j.1753-6405.1993.tb00165.x.
It is widely accepted that changes in sexual behaviour in the mid-1980s drastically reduced the spread of human immunodeficiency virus (HIV) through male homosexual contact in Western countries, but documentation of changes in infection rates has been based on observation of subjects enrolled in cohort studies, who may be highly selected and motivated. In this study, the incidence of HIV seroconversion was investigated among people attending a major site of HIV testing, counselling and patient care in Sydney. Over the period March 1985 to June 1990, 2,301 people were tested for HIV antibody on more than one occasion, following a negative result at the first test. On the basis of subsequent tests, 107 were found to have seroconverted during the study period, including 91 men who reported homosexual or bisexual contact as their only exposure to HIV. Overall, the incidence rate of HIV infection among men reporting homosexual or bisexual contact was 404 per 100 person-years of follow-up. Under various methods of calculation, the incidence was estimated to have declined between 1985 and 1989-1990. However, there was continuing HIV seroconversion in 1989-1990 and no indication of declining incidence in younger men. The fall in HIV incidence documented in this study supports the role of HIV prevention programs aimed at homosexual and bisexual men.
人们普遍认为，20世纪80年代中期性行为的改变极大地减少了西方国家通过男性同性恋接触传播人类免疫缺陷病毒（HIV）的情况，但感染率变化的记录是基于对队列研究中入选受试者的观察，这些受试者可能经过了高度筛选且积极性较高。在本研究中，对悉尼一个主要的HIV检测、咨询和患者护理场所的就诊者中HIV血清转化的发生率进行了调查。在1985年3月至1990年6月期间，2301人在首次检测结果为阴性后不止一次接受了HIV抗体检测。根据后续检测，发现107人在研究期间发生了血清转化，其中包括91名报告称同性恋或双性恋接触是其唯一HIV暴露途径的男性。总体而言，报告有同性恋或双性恋接触的男性中HIV感染的发病率为每100人年随访404例。在各种计算方法下，估计发病率在1985年至1989 - 1990年间有所下降。然而，1989 - 1990年仍有持续的HIV血清转化情况，且没有迹象表明年轻男性的发病率在下降。本研究记录的HIV发病率下降支持了针对同性恋和双性恋男性的HIV预防项目所发挥的作用。
