Risk factors for recent HIV infection in Uganda
Risk factors for recent HIV infection in Uganda
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DOI：
10.1001/jama.300.5.540
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发表时间：
2008-08-06
影响因子：
120.7
通讯作者：
Bunnell, Rebecca
中科院分区：
文献类型：
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作者：
Mermin, Jonathan;Musinguzi, Joshua;Bunnell, Rebecca
背景与获得人类免疫缺陷病毒（HIV）相关因素的研究往往是基于流行率的数据，可能不反映最近的infection. ObjectiveTo确定人口，生物和行为因素，为最近的HIV感染在Uganda.Design和Setting全国代表性的横断面设计的家庭调查在乌干达进行，从2004年8月至2005年1月;数据分析至2007年11月。参与者有11454名女性和9905名男性，年龄在15至59岁之间。完成了10 826名妇女（95%）和8 830名男子（89%）的问卷调查;在这些被访者中，收集了10227名女性（94%）和8298名男性（94%）的血液样本。2主要结果测量HIV血清阳性的样本用BED IgG捕获酶免疫吸附试验检测，以确定最近的血清转换结果在1023例BED结果的HIV感染者中，172例（17%）为近期检测。在多变量分析中，与近期感染HIV相关的危险因素包括女性（调整后的比值比[ aOR]，2.4; 95%置信区间[ CI]，1.1- 5.2）;当前婚姻状况（丧偶vs未婚，aOR，6.1; 95% CI，2.8- 13.3;离婚vs未婚，aOR，3.0; 95% CI，1.5- 6.1）;地理区域（乌干达中北部vs乌干达中部/坎帕拉，aOR，2.6; 95% CI，1.7- 4.1）;过去一年的性伴侣数量（>= 2与无相比; aOR，2.9; 95% CI，1.6- 5.5）;单纯疱疹病毒2型感染（aOR，3.9; 95% CI，2.6- 5.8）;过去一年报告过性传播疾病（aOR，1.7; 95%CI，1.2- 2.4）;和未行包皮环切术的男性（aOR，2.5; 95%CI，1.1- 5.3）。在已婚参与者中，与没有婚外伴侣的个体相比，近期感染HIV与从未与婚外伴侣使用避孕套有关（aOR，3.2; 95%CI，1.7- 6.1）。与至少1名婚外性伴使用避孕套的已婚个体发生HIV感染的风险与那些没有婚外性伴的个体相似（aOR，1.0; 95%CI，0.3- 2.7）。结论对乌干达接受HIV检测的个体进行调查，以确定近期感染的危险因素，这为预防举措提供了机会。
Context Studies of factors associated with acquiring human immunodeficiency virus ( HIV) are often based on prevalence data that might not reflect recent infections.Objective To determine demographic, biological, and behavioral factors for recent HIV infection in Uganda.Design and Setting Nationally representative household survey of cross- sectional design conducted in Uganda from August 2004 through January 2005; data were analyzed until November 2007.Participants There were 11 454 women and 9905 men aged 15 to 59 years who were eligible. Questionnaires were completed for 10 826 women ( 95%) and 8830 men ( 89%); of those interviewed, blood specimens were collected for 10 227 women ( 94%) and 8298 men ( 94%).Main Outcome Measure Specimens seropositive for HIV were tested with the BED IgG capture- based enzyme immunosorbent assay to identify recent seroconversions ( median, 155 days) using normalized optical density of 0.8 and adjustments.Results Of the 1023 HIV infections with BED results, 172 ( 17%) tested as recent. In multivariate analysis, risk factors associated with recent HIV infection included female sex ( adjusted odds ratio [ aOR], 2.4; 95% confidence interval [ CI], 1.1- 5.2); current marital status ( widowed vs never married, aOR, 6.1; 95% CI, 2.8- 13.3; divorced vs never married, aOR, 3.0; 95% CI, 1.5- 6.1); geographic region ( north central Uganda vs central Uganda/ Kampala, aOR, 2.6; 95% CI, 1.7- 4.1); number of sex partners in past year ( >= 2 compared with none; aOR, 2.9; 95% CI, 1.6- 5.5); herpes simplex virus type 2 infection ( aOR, 3.9; 95% CI, 2.6- 5.8); report of a sexually transmitted disease in the past year ( aOR, 1.7; 95% CI, 1.2- 2.4); and being an uncircumcised man ( aOR, 2.5; 95% CI, 1.1- 5.3). Among married participants, recent HIV infection was associated with never using condoms with partners outside of marriage ( aOR, 3.2; 95% CI, 1.7- 6.1) compared with individuals having no outside partners. The risk of incident HIV infection for married individuals who used condoms with at least 1 outside partner was similar to that of those who did not have any partners outside of marriage ( aOR, 1.0; 95% CI, 0.3- 2.7).Conclusion A survey of individuals in Uganda who were tested with an HIV assay used to establish recent infection identified risk factors, which offers opportunities for prevention initiatives.