Padian N S, O'Brien T R, Chang Y, Glass S, Francis D P
Department of Obstetrics and Gynecology, University of California-San Francisco 04110.
J Acquir Immune Defic Syndr (1988). 1993 Sep;6(9):1043-8.
In the absence of an effective vaccine, behavior change remains the most effective means to prevent the spread of HIV. We examined behavior change over time and rates of HIV seroconversion in a cohort of HIV individuals and their heterosexual partners recruited since 1985. Participants were recruited from various HIV counseling and testing sources throughout California and were usually interviewed and tested in their own homes. Couple counseling and risk assessments were conducted at average intervals of six months. Data from 144 couples who were discordant for HIV serostatus are reported. Of the index cases, 78% were men. Most male index cases were bisexuals, and most female index cases were infected through heterosexual intercourse with a previous sexual partner. The mean duration of the relationship for the couple at intake was 5.6 years. Both condom use and sexual abstinence increased over time (p < 0.001 for both), and most behavior change occurred between intake and first follow-up visit. We observed no seroconversion after 193 couple-years of follow-up. Couple counseling in combination with social support appears to be an effective means to promote and sustain behavior change among HIV-infected individuals and their heterosexual partners.
在缺乏有效疫苗的情况下，行为改变仍然是预防艾滋病毒传播的最有效手段。我们研究了自1985年以来招募的一组艾滋病毒感染者及其异性伴侣随时间推移的行为改变情况和艾滋病毒血清转化发生率。参与者从加利福尼亚州各地的各种艾滋病毒咨询和检测机构招募，通常在他们自己家中接受访谈和检测。夫妻咨询和风险评估平均每六个月进行一次。报告了144对艾滋病毒血清学状态不一致的夫妻的数据。在索引病例中，78%为男性。大多数男性索引病例为双性恋者，大多数女性索引病例是通过与前性伴侣的异性性行为感染的。夫妻在入组时关系的平均持续时间为5.6年。随着时间的推移，避孕套使用和性禁欲都有所增加（两者p均<0.001），并且大多数行为改变发生在入组和首次随访之间。在193对夫妻年的随访后，我们未观察到血清转化情况。夫妻咨询与社会支持相结合似乎是促进和维持艾滋病毒感染者及其异性伴侣行为改变的有效手段。
