HIV Transmission in the United States: Considerations of Viral Load, Risk Behavior, and Health Disparities
HIV Transmission in the United States: Considerations of Viral Load, Risk Behavior, and Health Disparities
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DOI：
10.1007/s10461-013-0426-z
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发表时间：
2013-06-01
影响因子：
4.4
通讯作者：
Rhodes, Philip
中科院分区：
文献类型：
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作者：
Hall, H. Irene;Holtgrave, David R.;Rhodes, Philip
持续的艾滋病毒传播与艾滋病毒感染者的患病率、危险行为和病毒载量有关。我们评估了这些因素对艾滋病毒传播的贡献，传播率模型和数据报告给国家艾滋病毒监测和公布的风险行为率。我们还估计了性风险人群中有风险行为和未抑制病毒载量的人数。考虑到危险行为，传播率（每100名艾滋病毒感染者中有18.5人感染）高于未抑制病毒载量（4.6）。由于没有危险行为或抑制病毒载量的人传播HIV的可能性很低，因此传播可归因于这些因素的组合（28.9）。男男性行为者的服务需求最大;他们的病毒载量未受抑制，从事无保护的不和谐性行为的人数是男性异性恋者人数的8倍，是具有高风险传播潜力的女性异性恋者人数的两倍多。虽然所有艾滋病毒感染者都需要最佳护理，但当艾滋病毒载量未受抑制的人存在危险行为时，治疗作为预防最为重要。
Ongoing HIV transmission is related to prevalence, risk behavior and viral load among persons with HIV. We assessed the contribution of these factors to HIV transmission with transmission rate models and data reported to National HIV Surveillance and published rates of risk behavior. We also estimated numbers of persons with risk behaviors and unsuppressed viral load among sexual risk groups. The transmission rate is higher considering risk behavior (18.5 infections per 100 people with HIV) than that attributed to unsuppressed viral load (4.6). Since persons without risk behavior or suppressed viral load presumably transmit HIV at very low rates, transmission can be attributed to a combination of these factors (28.9). Service needs are greatest for MSM; their number with unsuppressed viral load engaging in unprotected discordant sex was 8 times the number of male heterosexuals and more than twice the number of female heterosexuals with high-risk transmission potential. While all persons with HIV need optimal care, treatment as prevention is most relevant when risk behavior is present among persons with unsuppressed HIV viral load.