Concurrent sexual partnerships and HIV prevalence in five urban communities of sub-Saharan Africa
Concurrent sexual partnerships and HIV prevalence in five urban communities of sub-Saharan Africa
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DOI：
10.1097/00002030-200105040-00008
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发表时间：
2001-05-04
期刊：
影响因子：
3.8
通讯作者：
Buvé, A
中科院分区：
文献类型：
--
作者：
Lagarde, E;Auvert, B;Buvé, A
目的：估计撒哈拉以南非洲5个城市人群同时发生性关系的参数，并评估其与HIV感染和其他性传播感染(STI)水平的关系。方法：对决定非洲5个城市HIV传播速度差异的因素进行多中心研究。同意的参与者接受了关于性行为的采访，在五个地点中的四个还提供了血液和尿液样本，用于检测艾滋病毒和其他性传播感染。有关性行为的数据包括面谈前12个月内的伙伴关系数量以及每一伙伴关系开始和结束的日期。结果：共有1819名15-49岁的成年人在塞内加尔的达喀尔、2116名在贝宁的科托努、2089名在喀麦隆的雅温得、1889名在肯尼亚的基苏木和1730名在恩多拉接受了调查。艾滋病毒感染率科托努为3.4%，雅温得为5.9%，基苏木为25.9%，恩多拉为28.4%，达喀尔约为1%。约谈时同时存在的性伙伴关系的估计比例(指数k)在雅温得相对较高(0.98)，在基苏木(0.44)和科托努(0.33)居中，在恩多拉(0.26)和达喀尔(0.18)较低。制定了一个独立的并发指标，该指标既不取决于合作伙伴的数量，也不依赖于伙伴关系的持续时间，并估计在参与另一个伙伴关系之前保持(正值)或解散(负值)正在进行的伙伴关系的个人倾向。这一衡量标准没有区分艾滋病毒感染水平较高的城市和艾滋病毒感染水平合法的城市。此外，在收集艾滋病毒状况数据的四个城市中，艾滋病毒感染者和非感染者之间的IIC没有显著差异。结论：我们没有找到证据表明，在撒哈拉以南非洲的五个城市，同时发生性关系是艾滋病毒传播率的主要决定因素。艾滋病毒流行是许多因素的结果，既有行为因素，也有生物因素，同时发生性关系只是其中之一。(C)2001年，Lippincott Williams&Wilkins。
Objective: To estimate parameters of concurrent sexual partnerships in five urban populations in sub-Saharan Africa and to assess their association with levels of HIV infection and other sexually transmitted infections (STI).Methods: Data were obtained from a multicentre study of factors which determine the differences in rate of spread of HIV in five African cities. Consenting participants were interviewed on sexual behaviour and at four of the five sites also provided a blood and a urine sample for testing for HIV and other STI. Data on sexual behaviour included the number of partnerships in the 12 months preceding the interview as well as the dates of the start and end of each partnership. Summary indices of concurrent sexual partnerships - some of which were taken from the literature, while others were newly developed - were computed for each city and compared to HIV and STI prevalence rates.Results: A total of 1819 adults aged 15-49 years were interviewed in Dakar (Senegal), 2116 in Cotonou (Benin), 2089 in Yaounde (Cameroon), 1889 in Kisumu (Kenya) and 1730 in Ndola (Zambia). Prevalence rates of HIV infection were 3.4% for Cotonou, 5.9% for Yaounde, 25.9% for Kisumu and 28.4% for Ndola, and around 1% for Dakar. The estimated fraction of sexual partnerships that were concurrent at the time of interview (index k) was relatively high in Yaounde (0.98), intermediate in Kisumu (0.44) and Cotonou (0.33) and low in Ndola (0.26) and in Dakar (0.18). An individual indicator of concurrency (iic) was developed which depends neither on the number of partners nor on the length of the partnerships and estimates the individual propensity to keep (positive values) or to dissolve (negative values) on-going partnership before engaging in another one. This measure iic did not discriminate between cities with high HIV infection levels and cities with law HIV infection levels. In addition, iic did not differ significantly between HIV-infected and uninfected people in the four cities where data on HIV status were collected.Conclusion: We could not find evidence that concurrent sexual partnerships were a major determinant of the rate of spread of HIV in five cities in sub-Saharan Africa. HIV epidemics are the result of many factors, behavioural as well as biological, of which concurrent sexual partnerships are only one. (C) 2001 Lippincott Williams & Wilkins.