Solomon S, Kumarasamy N, Ganesh A K, Amalraj R E
YRG Centre for AIDS Research and Education, Madras, India.
Int J STD AIDS. 1998 Feb;9(2):98-103. doi: 10.1258/0956462981921756.
We aim to study the factors associated with the prevalence of HIV-1 and HIV-2 infection in the urban and rural areas of Tamil Nadu, India. The population of Tamil Nadu is approximately 60 million. Between April 94 and March 95, 992 samples from 5 representative urban centres and 1071 samples from 5 representative rural centres were collected and studied. A questionnaire was administered privately and it preceded collection of each sample. Samples were screened using ELISA and antibodies to HIV-1 and HIV-2 were confirmed using Western blot. The study was anonymous and unlinked. The prevalence of HIV infection in urban and rural areas was 7.2% (95% CI=6.1 to 8.31%); HIV-1 antibodies were found in 7.4% (95% CI=5.8 to 9.2%) of urban and 7.0% (95% CI=5.6 to 8.7%) of rural population; HIV-2 antibodies were found in 0.8% of urban and 0.3% of rural population. Heterosexual transmission, more so among those with multiple partner sex, was the main mode; higher prevalence of HIV infection among divorced/single individuals both in urban (21.1%) and rural (26.1%) was found. HIV infection among housewives stood at 4.1% (urban) and 3.8% (rural). The strength of association between STDs and HIV was observed to be greater in rural subjects (OR=8.89; 95% CI=5.11 to 15.57) than in urban subjects (OR=1.9; 95% CI=1.14 to 3.18). The prevalence of condom use was found to be less than 2% in the study subjects. HIV-2 is not as widely prevalent in Tamil Nadu as HIV-1. In our study the most common risk factors for HIV infection that emerged were (a) having multiple sexual partners, and (b) history of STDs or Venereal Disease Research Laboratory (VDRL) reactivity. Mobility of individuals between urban and rural areas has furthered the dissemination of HIV infection. Low condom usage among study subjects questions the effectiveness of the existing AIDS awareness and education programme. The study indicates the importance of placing equal emphasis on HIV prevention in rural India. HIV infection among housewives in urban and rural areas is indicative of gender inequalities and the importance of empowering women to prevent infection from spouse.
我们旨在研究印度泰米尔纳德邦城乡地区与HIV-1和HIV-2感染流行率相关的因素。泰米尔纳德邦人口约为6000万。在1994年4月至1995年3月期间，从5个有代表性的城市中心收集了992份样本，从5个有代表性的农村中心收集了1071份样本并进行研究。在采集每个样本之前，私下进行了问卷调查。样本采用酶联免疫吸附测定（ELISA）进行筛查，HIV-1和HIV-2抗体通过蛋白质印迹法进行确认。该研究为匿名且无关联研究。城乡地区HIV感染流行率为7.2%（95%置信区间=6.1%至8.31%）；城市人口中7.4%（95%置信区间=5.8%至9.2%）和农村人口中7.0%（95%置信区间=5.6%至8.7%）检测到HIV-1抗体；城市人口中0.8%和农村人口中0.3%检测到HIV-2抗体。异性传播是主要传播方式，在有多个性伴侣的人群中更为常见；在城市（21.1%）和农村（26.1%）的离婚/单身个体中发现HIV感染率较高。家庭主妇中的HIV感染率城市为4.1%，农村为3.8%。观察到农村人群中STD与HIV之间的关联强度（比值比=8.89；95%置信区间=5.11至15.57）高于城市人群（比值比=1.9；95%置信区间=1.14至3.18）。研究对象中避孕套使用率低于2%。HIV-2在泰米尔纳德邦的流行程度不如HIV-1广泛。在我们的研究中出现的最常见的HIV感染风险因素为：（a）有多个性伴侣，以及（b）有STD病史或性病研究实验室（VDRL）反应阳性。城乡之间人口的流动进一步促进了HIV感染的传播。研究对象中避孕套使用率低对现有的艾滋病宣传和教育项目的有效性提出了质疑。该研究表明在印度农村同等重视HIV预防的重要性。城乡家庭主妇中的HIV感染表明了性别不平等以及赋予女性权力以预防配偶感染的重要性。
