HIV transmission networks.
HIV transmission networks.
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DOI：
10.1097/coh.0b013e32832c7cfc
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发表时间：
2009-07
影响因子：
4.1
通讯作者：
Rothenberg R
中科院分区：
文献类型：
--
作者：
Rothenberg R
在过去的几年里，艾滋病毒传播动力学的复杂领域的一部分-异性恋网络-已占主导地位的理论和实证研究。这篇评论概述了最近关于艾滋病毒风险和网络的工作，重点是异性恋网络动态的最新研究结果。定性（人种学）评估显示了异性恋关系的异质性和复杂性，特别是在非洲，传统、官方的一夫多妻制和非官方的多人安排导致了性伙伴关系的并发性。在马拉维利科马岛进行的一项大型定量研究表明，即使长期伴侣关系的平均数量较低（低程度），高并发性环境也会产生相当多的连锁性关系。人种学研究表明，这种环境在非洲可能很常见，再加上关于急性和早期感染期间传播性的最新信息，可能为地方性传播和艾滋病毒的快速传播提供一个合理的解释。识别高并发、低度网络是理解HIV传播动力学的重要进展。它们与异性性传播的相关性，以及可能扩展到其他流行病学环境，加强了艾滋病毒传播动态的异质性和复杂性。
Over the past several years, one segment of the complex field of HIV transmission dynamics —heterosexual networks—has dominated theoretical and empirical investigation. This review provides an overview of recent work on HIV risks and networks, with a focus on recent findings in heterosexual network dynamics. Qualitative (ethnographic) assessments have demonstrated the heterogeneity and complexity of heterosexual connections, particular in Africa where tradition, official polygamy, and unofficial multi-person arrangements lead to concurrency of sexual partnerships. A large, quantitative study on Likoma Island, Malawi, demonstrated the considerable, interlocking sexual connections that arise from a high-concurrency sexual setting, even with a low average number of partnerships (low-degree) of long duration. Such settings, as suggested by ethnographic studies, may be common in Africa and, coupled with newer information about transmissibility during acute and early infection, may provide a plausible explanation for endemic transmission and possibly for rapid HIV propagation. Recognition of high- concurrency, low-degree networks is an important development for understanding HIV transmission dynamics. Their relevance to heterosexual transmission, and possible extension to other epidemiologic settings, reinforces the heterogeneity and complexity of HIV transmission dynamics.