Deschamps M M, Pape J W, Hafner A, Johnson W D
Cornell University Medical College, New York, New York, USA.
Ann Intern Med. 1996 Aug 15;125(4):324-30. doi: 10.7326/0003-4819-125-4-199608150-00011.
Despite the importance of human immunodeficiency virus (HIV) transmission through heterosexual contact, the incidence of HIV infection in heterosexual cohorts has not been well studied, particularly in the developing world.
To 1) determine the incidence of HIV infection in discordant heterosexual couples (couples in which one partner had HIV infection and the other did not) in Haiti and 2) assess risk factors for and methods of preventing HIV infection.
Prospective study.
National Institute for Laboratory Research, Portau-Prince, Haiti.
475 HIV-infected patients and their noninfected regular sex partners.
Patients and their partners were evaluated at 3- to 6-month intervals for HIV infection, sexually transmitted diseases, and sexual practices. The efficacy of counseling and provision of free condoms was also evaluated.
Among the 177 couples who remained sexually active during the prospective study period, 20 seroconversions to HIV positivity occurred, for an incidence rate of 5.4 per 100 person-years (95% CI, 5.16 to 5.64 per 100 person-years). Thirty-eight couples (21.5%) discontinued sexual activity during the study. Only 1 seroconversion occurred among the 42 sexually active couples (23.7% of the 177 sexually active couples) who always used condoms. In contrast, the incidence in sexually active couples who infrequently used or did not use condoms was 6.8 per 100 person-years (CI, 6.49 to 7.14 per 100 person-years). Transmission of HIV was associated with genital ulcer disease, syphilis, and vaginal or penile discharge in the HIV-negative partner and with syphilis in the HIV-infected partner.
Counseling and the provision of free condoms contributed to the institution of safe sex practices or abstinence in 45% of discordant heterosexual couples. However, 55% of couples reported that they continued to have unprotected sex, resulting in an incidence of HIV infection of 6.8 per 100 person-years.
尽管人类免疫缺陷病毒（HIV）通过异性接触传播很重要，但异性恋人群中HIV感染的发生率尚未得到充分研究，尤其是在发展中国家。
1）确定海地异性性伴侣一方感染HIV而另一方未感染的异性恋伴侣中HIV感染的发生率；2）评估HIV感染的危险因素及预防方法。
前瞻性研究。
海地太子港国家实验室研究所。
475名HIV感染患者及其未感染的固定性伴侣。
患者及其伴侣每隔3至6个月接受HIV感染、性传播疾病及性行为方面的评估。同时评估咨询服务及免费发放避孕套的效果。
在前瞻性研究期间保持性活跃的177对伴侣中，有20例发生血清转化呈HIV阳性，发生率为每100人年5.4例（95%可信区间为每100人年5.16至5.64例）。38对伴侣（21.5%）在研究期间停止了性行为。在始终使用避孕套的42对性活跃伴侣（占177对性活跃伴侣的23.7%）中仅发生1例血清转化。相比之下，不经常使用或不使用避孕套的性活跃伴侣中发生率为每100人年6.8例（可信区间为每100人年6.49至7.14例）。HIV传播与HIV阴性伴侣的生殖器溃疡疾病、梅毒、阴道或阴茎分泌物以及HIV感染伴侣的梅毒有关。
咨询服务及免费发放避孕套促使45%的异性性伴侣一方感染HIV而另一方未感染的异性恋伴侣采取了安全性行为或禁欲措施。然而，55%的伴侣报告他们继续进行无保护性行为，导致HIV感染发生率为每100人年6.8例。
