Sexual partnership age pairings and risk of HIV acquisition in rural South Africa.
Sexual partnership age pairings and risk of HIV acquisition in rural South Africa.
复制标题
DOI：
10.1097/qad.0000000000001553
复制
发表时间：
2017-07-31
期刊：
影响因子：
--
通讯作者：
Tanser F
中科院分区：
文献类型：
--
作者：
Akullian A;Bershteyn A;Klein D;Vandormael A;Bärnighausen T;Tanser F
量化南非高流行地区特定性伴侣年龄组对男性和女性感染艾滋病毒风险的贡献。我们于2004年至2015年在南非夸祖鲁-纳塔尔的女性（15-49岁）和男性（15-55岁）中进行了一项基于人群的队列研究。广义加性模型被用来估计平滑的艾滋病毒发病率跨伴侣年龄配对的男性和女性。考克斯比例风险回归用于估计按伴侣年龄组的HIV感染相对风险。在15 935人-年中，女性共观察到882例HIV血清转换，发病率= 5.5/100人-年[95%置信区间（CI），5.2-5.9]，男性在9372人-年中观察到270例HIV血清转换，发病率= 2.9/100人-年（95% CI，2.6-3.2）。 报告与30-34岁男子有伴侣关系的15-24岁妇女中艾滋病毒发病率最高，发病率= 9.7/100人-年（95% CI，7.2-13.1）。 相对于35岁及以上的男性伴侣，女性感染艾滋病毒的风险与25-29岁的男性伴侣（调整后的风险比; aHR = 1.44，95%CI，1.02-2.04）和30-34岁的男性伴侣（aHR =1.50，95%CI，1.08-2.09）相关。 与15-19岁女性的伴侣关系相比，男性感染艾滋病毒的风险与25-29岁（aHR = 1.72，95%CI，1.02-2.90）和30-34岁女性（aHR = 2.12，95%CI，1.03-4.39）相关。 性伴侣的年龄是男性和女性感染艾滋病毒的主要风险因素，与自己的年龄无关。伴侣年龄配对在推动艾滋病毒传播周期方面发挥着关键作用。
To quantify the contribution of specific sexual partner age groups to the risk of HIV acquisition in men and women in a hyperendemic region of South Africa. We conducted a population-based cohort study among women (15–49 years of age) and men (15–55 years of age) between 2004 and 2015 in KwaZulu-Natal, South Africa. Generalized additive models were used to estimate smoothed HIV incidence rates across partnership age pairings in men and women. Cox proportional hazards regression was used to estimate the relative risk of HIV acquisition by partner age group. A total of 882 HIV seroconversions were observed in 15 935 person-years for women, incidence rate = 5.5 per 100 person-years [95% confidence interval (CI), 5.2–5.9] and 270 HIV seroconversions were observed in 9372 person-years for men, incidence rate = 2.9 per 100 person-years (95% CI, 2.6–3.2). HIV incidence was highest among 15–24-year-old women reporting partnerships with 30–34-year-old men, incidence rate = 9.7 per 100 person-years (95% CI, 7.2–13.1). Risk of HIV acquisition in women was associated with male partners aged 25–29 years (adjusted hazard ratio; aHR = 1.44, 95% CI, 1.02–2.04) and 30–34 years (aHR = 1.50, 95% CI, 1.08–2.09) relative to male partners aged 35 and above. Risk of HIV acquisition in men was associated with 25–29-year-old (aHR = 1.72, 95% CI, 1.02–2.90) and 30–34-year-old women (aHR = 2.12, 95% CI, 1.03–4.39) compared to partnerships with women aged 15–19 years. Age of sexual partner is a major risk factor for HIV acquisition in both men and women, independent of one's own age. Partner age pairings play a critical role in driving the cycle of HIV transmission.