HIV, HSV-2 and syphilis among married couples in India: patterns of discordance and concordance
HIV, HSV-2 and syphilis among married couples in India: patterns of discordance and concordance
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DOI：
10.1136/sextrans-2011-050203
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发表时间：
2011-10-01
影响因子：
3.6
通讯作者：
Jha, Prabhat
中科院分区：
文献类型：
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作者：
Arora, Paul;Nagelkerke, Nico;Jha, Prabhat
性网络的差异可能解释了撒哈拉以南非洲和印度艾滋病毒流行规模的差异。艾滋病毒和性传播感染（STI）不和谐的夫妇研究提供了这些性网络的重要方面的见解。作者量化的作用，男性的性行为在已婚夫妇中的HIV传播在India.Methods的作者分析了模式的HIV和性传播感染不一致的已婚夫妇从两个社区调查在印度：全国家庭健康研究-3 HIV-1和全球健康研究中心健康检查HSV-2和梅毒。一个统计模型被用来估计感染的比例介绍了每两个partner.Results只有0.8%，16.0%和3.5%的夫妇感染（一方或双方）与HIV-1，HSV-2和梅毒，分别。大部分感染的夫妇不一致（HIV-1、HSV-2和梅毒分别为73.0%、56.3%和84.2%）。该模型估计，在任何性传播感染的夫妇，男性伴侣介绍了感染的大部分时间（HIV-1：85.4%，HSV-2：64.1%，梅毒：75.0%）。结论男性婚外性活动似乎是印度艾滋病毒/性传播感染流行的驱动力。男性顾客和女性性工作者的接触应继续成为印度国家艾滋病控制方案的主要目标。
Objectives Differences in sexual networks probably explain the disparity in the scale of HIV epidemics in sub-Saharan Africa and India. HIV and sexually transmitted infection (STI) discordant couple studies provide insights into important aspects of these sexual networks. The authors quantify the role of male sexual behaviour in HIV transmission in married couples in India.Methods The authors analysed patterns of HIV and STI discordance in married couples from two community surveys in India: the National Family Health Study-3 for HIV-1 and the Centre for Global Health Research health check-up for HSV-2 and syphilis. A statistical model was used to estimate the fraction of infections introduced by each of the two partners.Results Only 0.8%, 16.0% and 3.5% of couples were infected (either partner or both) with HIV-1, HSV-2 and syphilis, respectively. A large proportion of infected couples were discordant (73.0%, 56.3% and 84.2% for HIV-1, HSV-2 and syphilis, respectively). This model estimated that, among couples with any STI, the male partner introduced the infection the majority of the time (HIV-1: 85.4%, HSV-2: 64.1%, syphilis: 75.0%).Conclusions Male sexual activity outside of marriage appears to be a driving force for the Indian HIV/STI epidemic. Male client and female sex worker contacts should remain a primary target of the National AIDS Control Program in India.