From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple
From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple
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DOI：
10.1016/j.socscimed.2009.05.045
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发表时间：
2009-09-01
影响因子：
5.4
通讯作者：
Leroy, Valeriane
中科院分区：
文献类型：
--
作者：
Desgrees-du-Lou, Annabel;Brou, Hermann;Leroy, Valeriane
预防艾滋病毒母婴传播方案的第一步是向孕妇提供艾滋病毒咨询和检测。在艾滋病毒检测仍然很少的发展中国家，这为许多妇女提供了了解其艾滋病毒状况的独特机会。这种产前艾滋病毒检测不仅是预防母婴传播艾滋病毒的切入点，而且也是妇女提高其男性伴侣对性风险认识的一个机会。在科特迪瓦阿比让的Ditrame Plus PMTCT项目中，两组妇女（475名艾滋病毒感染妇女和400名艾滋病毒阴性妇女）在怀孕两年后接受了产前艾滋病毒检测。在每个队列中，我们比较了产前艾滋病毒检测前后与其固定伴侣就性风险进行沟通的女性比例。我们分析了与此通信相关的社会人口因素。我们测量了妇女艾滋病毒检测的两个潜在的夫妻结局：分娩后恢复性生活时的避孕套使用水平和婚姻破裂的风险。产前艾滋病毒检测增加了夫妻关于性风险的沟通，无论妇女的血清状态如何。对于一夫多妻制或不与伴侣住在一起的女性来说，这种沟通不太频繁。大约30%的妇女在恢复性生活时系统地使用避孕套。在HIV感染者中，夫妻间关于性风险的谈话与安全套使用的改善有关。在艾滋病毒检测后，与未感染艾滋病毒的妇女相比，感染艾滋病毒的妇女与其伴侣分开的人数更多，尽管被告知的伴侣很少有负面反应，总之，提供产前艾滋病毒咨询和检测是提高妇女及其伴侣对艾滋病毒预防的敏感性的有效工具。但是，在夫妻关系中预防性行为仍然很困难，需要具体解决。(C)2009爱思唯尔有限公司版权所有。
The first step in preventing mother-to-child HIV transmission (PMTCT) programmes is offering HIV counselling and testing to pregnant women. In developing countries where HIV testing remains rare, it represents a unique opportunity for many women to learn their HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks. Here we explore if these women, HIV-tested as mothers, apply the prevention recommendations they also receive as women.In the Ditrame Plus PMTCT program in Abidjan, Me d'Ivoire, two cohorts of women (475 HIV-infected women and 400 HIV-negative women) were followed up two years after the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women who communicated with their regular partner on sexual risks, prior to and after prenatal HIV testing. We analysed sociodemographic factors related to this communication. We measured two potential conjugal outcomes of women HIV testing: the level of condom use at sex resumption after delivery and the risk of union break-up.Prenatal HIV testing increased conjugal communication regarding sexual risks, whatever the woman's serostatus. This communication was less frequent for women in a polygamous union or not residing with their partner. Around 30% of women systematically used condoms at sex resumption. Among HIV infected ones, conjugal talk on sexual risks was related to improved condom use. After HIV testing, more HIV-infected women separated from their partners than HIV-uninfected women, despite very few negative reactions from the notified partners.In conclusion, offering prenatal HIV counselling and testing is an efficient tool for sensitizing women and their partners to HIV prevention. But sexual prevention in a conjugal context remains difficult and need to be specifically addressed. (C) 2009 Elsevier Ltd. All rights reserved.