Matheson P B, Thomas P A, Abrams E J, Pliner V, Lambert G, Bamji M, Krasinski K, Steketee R, Chiasson M A, Thea D M
Medical and Health Research Association of New York City, Inc., New York, USA.
AIDS. 1996 Sep;10(11):1249-56. doi: 10.1097/00002030-199609000-00011.
To determine the relationship between maternal heterosexual activity during pregnancy and perinatal transmission of HIV-1.
A retrospective analysis of 175 New York City HIV-1-seropositive women enrolled during pregnancy or immediately post-partum from 1986 to 1994 in a prospective cohort study.
Frequency of heterosexual intercourse and condom use during pregnancy was determined from self-report measures. Unprotected intercourse was defined as follows: 'none', consistent condom use or abstinence; 'moderate', inconsistent condom use and fewer than 80 episodes of intercourse; and 'high', inconsistent condom use and 80 or more episodes.
The rate of perinatal HIV-1 transmission was 9.1% (four out of 44) among women with no unprotected intercourse during pregnancy, 22.2% (20 out of 90) among those with moderate frequency, and 39.0% (16 out of 41) among those with high frequency (P < 0.01). The relative risk (RR) of perinatal transmission was higher among women with moderate [RR, 2.4; 95% confidence interval (Cl), 0.9-6.7] and high frequency of unprotected sexual intercourse (RR, 4.3; 95% Cl, 1.6-11.8) compared with women with no unprotected sexual intercourse. When potential covariates (maternal injecting drug use, CD4 lymphocyte count, AIDS, zidovudine use, pelvic inflammatory disease or sexually transmitted disease during pregnancy, delivery mode, and extreme prematurity) were included in a logistic regression model (n = 128), the rate of perinatal transmission remained significantly higher among women with any unprotected sexual intercourse during pregnancy.
Data suggest that unprotected sexual intercourse during pregnancy influences perinatal HIV-1 transmission.
确定孕期孕产妇异性性行为与HIV-1围产期传播之间的关系。
对1986年至1994年期间纳入一项前瞻性队列研究的175名纽约市HIV-1血清阳性孕妇或产后即刻妇女进行回顾性分析。
通过自我报告测量确定孕期异性性交频率和避孕套使用情况。无保护性交定义如下：“无”，持续使用避孕套或禁欲；“中度”，避孕套使用不规律且性交次数少于80次；“高度”，避孕套使用不规律且性交次数为80次或更多。
孕期无无保护性交的妇女中，HIV-1围产期传播率为9.1%（44例中有4例），性交频率为中度的妇女中为22.2%（90例中有20例），性交频率为高度的妇女中为39.0%（41例中有16例）（P<0.01）。与无无保护性交的妇女相比，无保护性交频率为中度[相对危险度（RR），2.4；95%置信区间（Cl），0.9 - 6.7]和高度的妇女围产期传播的相对危险度更高（RR，4.3；95%Cl，1.6 - 11.8）。当将潜在协变量（孕产妇注射吸毒、CD4淋巴细胞计数、艾滋病、齐多夫定使用、孕期盆腔炎或性传播疾病、分娩方式和极度早产）纳入逻辑回归模型（n = 128）时，孕期有任何无保护性交的妇女围产期传播率仍然显著更高。
数据表明孕期无保护性交会影响HIV-1围产期传播。
