Timing is everything: international variations in historical sexual partnership concurrency and HIV prevalence.
Timing is everything: international variations in historical sexual partnership concurrency and HIV prevalence.
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DOI：
10.1371/journal.pone.0014092
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发表时间：
2010-11-24
期刊：
影响因子：
3.7
通讯作者：
Wawer M
中科院分区：
文献类型：
--
作者：
Morris M;Epstein H;Wawer M
同时性伙伴关系的普遍性较高是南部非洲国家艾滋病毒流行严重程度的一种假设。但仅衡量并发性的普遍程度并不能充分捕捉并发性对传输动态的影响。这里探讨了重叠持续时间和性交暴露的重要性。我们对 20 世纪 90 年代初在乌干达、泰国和美国进行的三项性行为研究的数据进行了比较。使用累积并发度量，这三个国家显得有些相似。超过 50% 的泰国和乌干达男性表示在过去 3 次伴侣关系中有过同性行为，超过 20% 的男性表示在去年有过同性行为，而美国男性中黑人和西班牙裔的相应比例接近 20%，其他种族/族裔群体的比例约为 10%。然而，对重叠持续时间更敏感的并发度量显示出很大的差异。乌干达男性在采访当天的并发点发生率超过 10%，而泰国男性为 1%。乌干达的并发性行为持续时间比泰国（1 天）或美国的并发性行为（所有群体均为 4-9 个月）要长得多（中位数约为两年），并且与频率较低的伴侣发生性关系的风险要高出 5-10 倍。在美国，黑人和西班牙裔的患病率比白人更高，持续时间更长，性交暴露程度更高，但几乎在所有指标上都低于乌干达人。总之，观察到的同时伴侣关系的流行率、持续时间和性交暴露的差异与收集数据时这些人群中观察到的艾滋病毒流行率差异一致。人群内部和人群之间同时存在的伙伴关系模式存在很大差异。在艾滋病毒流行严重程度较高的人群中，发现了更多长期重叠的伙伴关系，以及定期性交暴露。
Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance of overlap duration and coital exposure are examined here. We conducted a comparison of data from three studies of sexual behavior carried out in the early 1990s in Uganda, Thailand and the US. Using cumulative concurrency measures, the three countries appeared somewhat similar. Over 50% of both Thai and Ugandan men reported a concurrency within the last three partnerships and over 20% reported a concurrency in the last year, the corresponding rates among US men were nearly 20% for Blacks and Hispanics, and about 10% for other racial/ethnic groups. Concurrency measures that were more sensitive to overlap duration, however, showed large differences. The point prevalence of concurrency on the day of interview was over 10% among Ugandan men compared to 1% for Thai men. Ugandan concurrencies were much longer duration – a median of about two years – than either the Thai (1 day) or US concurrencies (4–9 months across all groups), and involved 5–10 times more coital risk exposure with the less frequent partner. In the US, Blacks and Hispanics reported higher prevalence, longer duration and greater coital exposure than Whites, but were lower than Ugandans on nearly every measure. Together, the differences in the prevalence, duration and coital exposure of concurrent partnerships observed align with the HIV prevalence differentials seen in these populations at the time the data were collected. There were substantial variations in the patterns of concurrent partnerships within and between populations. More long-term overlapping partnerships, with regular coital exposure, were found in populations with greater HIV epidemic severity.
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影响因子：
5.4
作者：
Adimora, AA;Schoenbach, VJ;Stancil, TR
通讯作者：
Stancil, TR
影响因子：
12.7
作者：
Adimora, Adaora A.;Schoenbach, Victor J.;Doherty, Irene A.
通讯作者：
Doherty, Irene A.
DOI：
10.1097/00042560-200205010-00010
发表时间：
2002-05-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Hugonnet, S;Mosha, F;Hayes, R
通讯作者：
Hayes, R
影响因子：
4.4
作者：
Eaton, Jeffrey W.;Hallett, Timothy B.;Garnett, Geoffrey P.
通讯作者：
Garnett, Geoffrey P.
影响因子：
3.8
作者：
Lagarde, E;Auvert, B;Buvé, A
通讯作者：
Buvé, A