Sexual behavior of HIV discordant couples after HIV counseling and testing
Sexual behavior of HIV discordant couples after HIV counseling and testing
复制标题
DOI：
10.1097/00002030-200303280-00012
复制
发表时间：
2003-03-28
期刊：
影响因子：
3.8
通讯作者：
Haworth, A
中科院分区：
文献类型：
--
作者：
Allen, S;Meinzen-Derr, L;Haworth, A
背景和目的：对963对有1个HIV阳性和1个HIV阴性的同居异性伴侣(不和谐夫妻)进行自愿HIV咨询和检测(VCT)后的性行为进行了描述。用生物标记物评估自我报告的效度。方法：夫妇从赞比亚卢萨卡的一家当天的VCT中心招募。每隔3个月记录一次使用和不使用避孕套的性接触情况。对阴道涂片、妊娠和性传播疾病(包括HIV、淋病、梅毒和阴道毛滴虫)检出的精子进行检测。结果：在VCT之前，不到3%的夫妇报告当前使用避孕套。在VCT后的一年里，80%被报告的不和谐夫妇的性行为包括使用避孕套。报告100%使用避孕套与生物标志物减少39%-70%有关；然而，大多数报告的无保护措施性行为的间隔时间所有生物标志物都是阴性的。漏报是很常见的：当夫妇报告总是使用避孕套时，50%的精子和32%的怀孕和艾滋病毒传播被检测到。性传播疾病和报告的婚外性行为的实验室检测呈阳性的情况相对较少。DNA测序证实，87%的新HIV感染是通过配偶感染的。结论：联合VCT促使HIV感染不和谐的夫妇持续但不完美地使用安全套。生物标记物不敏感，但为无保护措施性行为的严重漏报提供了证据。迫切需要鼓励如实报告性行为和敏感的暴露生物标志物的战略。应该用行为和生物措施来评估预防计划的影响。(C)2003年，里平科特·威廉姆斯·威尔金斯。
Background and objectives: Sexual behavior following voluntary HIV counseling and testing (VCT) is described in 963 cohabiting heterosexual couples with one HIV positive and one HIV negative partner ('discordant couples'). Biological markers were used to assess the validity of self-report.Methods: Couples were recruited from a same-day VCT center in Lusaka, Zambia. Sexual exposures with and without condoms were recorded at 3-monthly intervals. Sperm detected on vaginal smears, pregnancy, and sexually transmitted diseases (STD) including HIV, gonorrhea, syphilis, and Trichomonas vaginalis were assessed.Results: Less than 3% of couples reported current condom use prior to VCT. In the year after VCT, >80% of reported acts of intercourse in discordant couples included condom use. Reporting 100% condom use was associated with 39-70% reductions in biological markers; however most intervals with reported unprotected sex were negative for all biological markers. Under-reporting was common: 50% of sperm and 32% of pregnancies and HIV transmissions were detected when couples had reported always using condoms. Positive laboratory tests for STD and reported extramarital sex were relatively infrequent. DNA sequencing confirmed that 87% of new HIV infections were acquired from the spouse.Conclusions: joint VCT prompted sustained but imperfect condom use in HIV discordant couples. Biological markers were insensitive but provided evidence for a significant under-reporting of unprotected sex. Strategies that encourage truthful reporting of sexual behavior and sensitive biological markers of exposure are urgently needed. The impact of prevention programs should be assessed with both behavioral and biological measures. (C) 2003 Lippincott Williams Wilkins.