LONGITUDINAL-STUDY OF HUMAN-IMMUNODEFICIENCY-VIRUS TRANSMISSION BY HETEROSEXUAL PARTNERS
LONGITUDINAL-STUDY OF HUMAN-IMMUNODEFICIENCY-VIRUS TRANSMISSION BY HETEROSEXUAL PARTNERS
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DOI：
10.1056/nejm199408113310601
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发表时间：
1994-08-11
影响因子：
158.5
通讯作者：
DEVINCENZI, I
中科院分区：
文献类型：
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作者：
DEVINCENZI, I
背景在世界范围内，人类免疫缺陷病毒（HIV）传播的主要方式是异性性交，但异性性交传播的风险和预防措施的有效性尚不明确。我们对HIV阴性受试者进行了一项前瞻性研究，这些受试者感染HIV的唯一风险是与HIV感染的伴侣保持稳定的异性恋关系。每六个月，研究对象接受一次访谈，进行HIV检测，并接受有关安全性行为的咨询。共有304名HIV阴性受试者（196名女性和108名男性）接受了平均20个月的随访。在研究期间，130对夫妇（42.8%）结束了他们的性关系，大多数情况下是因为感染艾滋病毒的伴侣的疾病或死亡。在256对参与研究后持续性关系超过三个月的夫妇中，只有124对（48.4%）在阴道和肛门性交时始终使用避孕套。在这些夫妇中，尽管总共发生了大约15 000次性交，但血清反应阴性的伴侣中没有一人感染艾滋病毒。在121对使用避孕套不一致的夫妇中，血清转化率为每100人年4.8人（95%置信区间为2.5至8.4）。11对夫妇拒绝回答有关使用避孕套的问题。随着指标性伴HIV感染的晚期，传播风险增加（P
Background. Worldwide, the predominant mode of human immunodeficiency virus (HIV) transmission is heterosexual intercourse, but the risk of heterosexual transmission and the effectiveness of measures to prevent it are not well defined.Methods. We conducted a prospective study of HIV-negative subjects whose only risk of HIV infection was a stable heterosexual relationship with an HIV-infected partner. Every six months the subjects were interviewed, tested for HIV, and counseled about safe sexual practices.Results. A total of 304 HIV-negative subjects (196 women and 108 men) were followed for an average of 20 months. During the study, 130 couples (42.8 percent) ended their sexual relationships, most often because of the HIV-infected partner's illness or death. Of the 256 couples who continued to have sexual relations for more than three months after enrollment in the study, only 124 (48.4 percent) used condoms consistently for vaginal and anal intercourse. Among these couples, none of the seronegative partners became infected with HIV, despite a total of about 15,000 episodes of intercourse. Among the 121 couples who used condoms inconsistently, the rate of seroconversion was 4.8 per 100 person-years (95 percent confidence interval, 2.5 to 8.4). Eleven couples refused to answer questions about condom use. The risk of transmission increased with advanced stages of HIV infection in the index partners (P