EFFECT OF SEROTESTING WITH COUNSELING ON CONDOM USE AND SEROCONVERSION AMONG HIV DISCORDANT COUPLES IN AFRICA
EFFECT OF SEROTESTING WITH COUNSELING ON CONDOM USE AND SEROCONVERSION AMONG HIV DISCORDANT COUPLES IN AFRICA
复制标题
DOI：
10.1136/bmj.304.6842.1605
复制
发表时间：
1992-06-20
影响因子：
--
通讯作者：
HULLEY, S
中科院分区：
文献类型：
--
作者：
ALLEN, S;TICE, J;HULLEY, S
HIV-确定HIV检测和咨询是否增加避孕套的使用和减少不和谐夫妇中HIV的异性性传播。设计-前瞻性研究。设置-卢旺达首都基加利。受试者-HIV血清学结果不一致的同居夫妇。主要结果测量-夫妇中避孕套的使用和阴性伴侣中HIV血清转化。结果-确定了60对HIV不和谐夫妇，其中53人接受了平均2.2年的随访。随访一年后，使用避孕套的不和谐夫妇比例从4%上升到57%。在随访期间，23名艾滋病毒阴性男性中有2名和30名艾滋病毒阴性女性中有6名发生血清转化（血清转化率为每100人年4人和9人）。妇女中的这一比率不到不和谐夫妇中类似妇女估计的一半，这些夫妇的伴侣没有进行血清检测。避孕套的使用是不太常见的那些血清转换（100%对5%，P=0.01的男性; 67%对25%，P=0.14的妇女）。结论，大约七分之一的同居夫妇在基加利有不一致的艾滋病毒血清学结果。保密的艾滋病毒血清检测和咨询导致安全套使用率大幅增加，并与较低的艾滋病毒新感染率有关。艾滋病毒检测是预防艾滋病毒在非洲城市传播的一项有希望的干预措施。
Objective-To determine whether HIV testing and counselling increased condom use and decreased heterosexual transmission of HIV in discordant couples.Design-Prospective study.Setting-Kigali, the capital of Rwanda.Subjects-Cohabiting couples with discordant HIV serology results.Main outcome measures-Condom use in the couple and HIV seroconversion in the negative partners.Results-60 HIV discordant couples were identified, of whom 53 were followed for an average of 2.2 years. The proportion of discordant couples using condoms increased from 4% to 57% after one year of follow up. During follow up two of the 23 HIV negative men and six of the 30 HIV negative women seroconverted (seroconversion rates of 4 and 9 per 100 person years). The rate among women was less than half that estimated for similar women in discordant couples whose partners had not been serotested. Condom use was less common among those who seroconverted (100% v 5%, p=0.01 in men; 67% v 25%, p=0.14 in women).Conclusions-Roughly one in seven cohabiting couples in Kigali have discordant HIV serological results. Confidential HIV serotesting with counselling caused a large increase in condom use and was associated with a lower rate of new HIV infections. HIV testing is a promising intervention for preventing the spread of HIV in African cities.