Outside sexual partnerships and risk of HIV acquisition for HIV uninfected partners in African HIV serodiscordant partnerships.
Outside sexual partnerships and risk of HIV acquisition for HIV uninfected partners in African HIV serodiscordant partnerships.
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DOI：
10.1097/qai.0b013e318237b864
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Partners in Prevention HSVHIV Transmission Study Team
中科院分区：
文献类型：
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作者：
Ndase P;Celum C;Thomas K;Donnell D;Fife KH;Bukusi E;Delany-Moretlwe S;Baeten JM;Partners in Prevention HSVHIV Transmission Study Team
随着非洲国家扩大夫妻艾滋病毒检测，在已知的艾滋病毒血清不一致的关系中，对未感染艾滋病毒的伴侣的性行为和艾滋病毒风险知之甚少。我们对来自7个非洲国家的3380名HIV血清不一致的伙伴进行了一项前瞻性研究。每季度从未感染艾滋病毒的伴侣中收集自我报告的性行为数据。在随访期间，未感染艾滋病毒的伴侣报告与其已知的原发感染艾滋病毒的伴侣发生性行为的比例下降（从基线前一个月的93.5%降至24个月时的73.2%,p<0.001）。同时，报告与外部伴侣发生性行为的比例也在增加（从3.1%增加到13.9%,p<0.001）。一小部分（<5%，在整个随访期间稳定）报告在同一个月内与受感染的伴侣和外部伴侣发生性行为（同时发生）。无保护的性行为与外界性伴侣比与其已知的主要艾滋病毒感染的性伴侣更常见（风险比4.6；95%可信区间4.2-5.2）。与报告有外部伴侣的人相比，仅与原发HIV感染者发生性行为的人的HIV发病率相似（2.87 vs 3.02 / 100人-年，p=0.7），尽管有外部伴侣的人更有可能获得病毒学上不同于原发伴侣的HIV （p<0.001）。对于艾滋病毒血清不一致的未感染伴侣，随着与外部伴侣的性行为增加，与感染伴侣的性行为减少，这可能反映了关系破裂和从已知感染伴侣转移的风险。在血清不一致的伙伴关系中，向未感染艾滋病毒的伙伴提供的减少风险信息应包括减少从外部伙伴感染艾滋病毒的战略。
As African countries scale up couples HIV testing, little is known about sexual behaviors and HIV risk for HIV uninfected partners in known HIV serodiscordant relationships. We conducted a prospective study of 3,380 HIV serodiscordant partnerships from 7 African countries. Self-reported sexual behavior data were collected quarterly from HIV uninfected partners. The proportion of HIV uninfected partners reporting sex with their known primary HIV infected partner decreased during follow-up (from 93.5% in the prior month at baseline to 73.2% at 24 months, p<0.001). Simultaneously, an increasing proportion reported sex with an outside partner (from 3.1% to 13.9%, p<0.001). A small proportion (<5%, stable throughout follow-up) reported sex with the infected partner and an outside partner in the same month (concurrent). Unprotected sex was more common with outside partners than with their primary known HIV infected partners (risk ratio 4.6; 95% CI 4.2–5.2). HIV incidence was similar for those reporting sex only with their primary HIV infected partner compared to those who reported an outside partner (2.87 vs. 3.02 per 100 person-years, p=0.7), although those who had outside partners were more likely to acquire HIV that was virologically distinct from that of their primary partner (p<0.001). For uninfected members of HIV serodiscordant couples, sex with the infected partner declined as sex with outside partners increased, likely reflecting relationship dissolution and risk shifting from a known infected partner. Risk reduction messages for HIV uninfected partners in serodiscordant partnerships should include strategies to reduce HIV acquisition from outside partners.