Incidence of HIV infection in stable sexual partnerships: A retrospective cohort study of 1802 couples in Mwanza Region, Tanzania
Incidence of HIV infection in stable sexual partnerships: A retrospective cohort study of 1802 couples in Mwanza Region, Tanzania
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DOI：
10.1097/00042560-200205010-00010
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发表时间：
2002-05-01
期刊：
影响因子：
--
通讯作者：
Hayes, R
中科院分区：
文献类型：
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作者：
Hugonnet, S;Mosha, F;Hayes, R
目的：描述坦桑尼亚农村地区稳定性伙伴关系中HIV传播的动态。设计：回顾性队列研究，嵌套在社区随机试验中，以调查性传播疾病治疗计划的影响。方法：对1802对夫妇进行为期2年的随访，在基线和随访时评估每对夫妇的HIV状况。结果：基线时，96.7%的夫妇一致阴性，0.9%一致阳性，1.2%与男性伴侣HIV阳性不一致，1.2%与女性伴侣HIV阳性不一致。与HIV阳性伴侣一起生活的个体在基线时更有可能是HIV阳性（女性：比值比[OR] = 75.7，95%置信区间[CI]：33.4-172;男性：OR = 62.4，CI：28.5-137）。不一致夫妇的血清发病率女性和男性分别为10/100人-年（py）和5/100 py（率比[RR] = 2.0，CI：0.28-22.1）。在一致性阴性夫妇中，血清学阳性率女性为0.17/100 py，女性为0.45/100 py（RR = 0.38，CI：0.12-1.04）。与和谐阴性伴侣关系中的个体相比，生活在不和谐伴侣关系中的个体感染HIV的风险显著增加（女性RR = 57.9，CI：12.0-244;男性RR = 11.0，CI：1.2-47.5）。在不和谐的夫妇中，艾滋病毒阴性妇女的发病率是男子的两倍。在不和谐的伴侣关系中，艾滋病毒抗体阴性的人感染的风险很高，迫切需要针对这些人采取预防性干预措施。
Objective: To describe the dynamics of HIV transmission in stable sexual partnerships in rural Tanzania.Design: Retrospective cohort study nested within community-randomized trial to investigate the impact of a sexually transmitted disease treatment program.Methods: A cohort of 1802 couples was followed up for 2 years, with the HIV status of each couple assessed at baseline and follow-up.Results: At baseline, 96.7% of couples were concordant-negative, 0.9% were concordant-positive, 1.2% were discordant with the male partner being HIV-positive, and 1.2% were discordant with the female partner being HIV-positive. Individuals living with an HIV-positive partner were more likely to be HIV-positive at baseline (women: odds ratio [OR] = 75.7, 95% confidence interval [CI]: 33.4-172; men: OR = 62.4, Cl: 28.5-137). Seroincidence rates in discordant couples were 10 per 100 person-years (py) and 5 per 100 py for women and men, respectively (rate ratio [RR] = 2.0, CI: 0.28-22.1). In concordant-negative couples, seroincidence rates were 0.17 per 100 py in women and 0.45 per 100 py in trien (RR = 0.38, Cl: 0.12-1.04). Individuals living in discordant couples were at a greatly increased risk of infection compared with individuals in concordant-negative couples (RR = 57.9, CI: 12.0-244, for women; RR 11.0, Cl: 1.2-47.5 for men).Conclusion: Men were more likely than women to introduce HIV infection in concordant-negative partnerships. In discordant couples, incidence in HIV-negative women was twice as high as in men. HIV-negative individuals in discordant partnerships are at high risk of infection, and preventive interventions targeted at such individuals are urgently needed.