HIV seroincidence and correlates of seroconversion in a cohort of male factory workers in Harare, Zimbabwe
HIV seroincidence and correlates of seroconversion in a cohort of male factory workers in Harare, Zimbabwe
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DOI：
10.1097/00002030-199607000-00013
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发表时间：
1996-07-01
期刊：
影响因子：
3.8
通讯作者：
Katzenstein, D
中科院分区：
文献类型：
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作者：
Mbizvo, MT;Machekano, R;Katzenstein, D
目的：鉴于有关艾滋病毒和其他性传播疾病(STD)传播的健康促进信息在20世纪80年代末在津巴布韦和其他地方得到了广泛宣传，分析哪些风险事件仍使个人受到感染至关重要。建立了一个队列，目的是估计HIV血清发病率、感染的行为和生物决定因素，并最终评估工作场所艾滋病预防干预措施的影响。方法：在工作场所艾滋病预防干预之前，对津巴布韦哈拉雷招募的工厂男性工人进行前瞻性跟踪调查，估计HIV血清发病率。结果：在1607名HIV阴性参与者中，经过1738人年的观察，有51人发生了HIV血清转换[血清发病率为2.93/100 PY；95%可信区间为2.18-3.86]。队列中HIV感染率为19.1%。HIV血清发病率在以下男性中显著增加[每年风险比(HR)0.96；95%CI，0.93-0.99]，单身(HR，3.29；95%CI，1.56-6.96)，已婚但与妻子分开居住(HR，2.18；95%CI，0.99-4.80)，报告有任何性病(HR，3.00；95%CI，1.53-5.86)，报告有生殖器溃疡(HR，4.87；95%CI，2.18-10.91)，并报告支付性行为(HR，2.01；95%CI，1.06-3.77)。血清发病率也随着登记前一年报告的性伴数量的增加而增加(每个伙伴的HR，1.10；95%CI，1.01-1.21)。在多因素COX回归分析中，生殖器溃疡(调整后HR，3.55；95%CI，1.52-8.29)、性伴人数(调整后HR，1.10；95%CI，1.01-1.21)和已婚但与妻子分居(调整后HR，2.21；95%CI，1.00-4.89)与HIV血清转换有关。结论：在这一经济产出人群中，需要创新和持续的工作场所干预措施来应对HIV感染的高风险。这项研究中描述的艾滋病毒血清转换的预测因素强调，公共卫生努力需要同时处理继续使非洲普通人口中的个人面临艾滋病毒风险的生物、社会经济和行为因素。
Objectives: Given that health promotion messages on transmission of HIV and other sexually transmitted diseases (STD) have been widely publicized in Zimbabwe and elsewhere in the late 1980s, it is vital to analyse which risk events still expose individuals to infection. A cohort was established with the objectives of estimating HIV seroincidence, behavioural and biological determinants of infection, and ultimately, evaluating the impact of AIDS prevention interventions in the workplace.Methods: HIV seroincidence was estimated in a prospectively followed cohort of male factory workers recruited in Harare, Zimbabwe during the period prior to a workplace AIDS prevention intervention. Correlates of HIV seroconversion were identified using Cox regression analysis.Results: There were 51 seroconversions among 1607 HIV-negative participants following 1738 person-years (PY) of observation [seroincidence, 2.93 per 100 PY; 95% confidence interval (CI), 2.18-3.86]. The prevalence of HIV in the cohort was 19.1%. HIV seroincidence was significantly increased among men who were younger [hazard ratio (HR) per year, 0.96; 95% CI, 0.93-0.99], were single (HR, 3.29; 95% CI, 1.56-6.96), were married but resided separately from their wives (HR, 2.18; 95% CI, 0.99-4.80), reported having any STD (HR, 3.00; 95% CI, 1.53-5.86), reported having a genital ulcer (HR, 4.87; 95% CI, 2.18-10.91), and reported paying for sex (HR, 2.01; 95% CI, 1.06-3.77). Seroincidence also increased with the number of sex partners reported in the year preceding enrolment (HR per partner, 1.10; 95% CI, 1.01-1.21). In multiple Cox regression analysis, three independent associations with HIV seroconversion were reporting a genital ulcer (adjusted HR, 3.55; 95% CI, 1.52-8.29), number of sex partners (adjusted HR, 1.10; 95% Cl, 1.01-1.21:), and being married but residing separately from one's wife (adjusted HR, 2.21; 95% CI, 1.00-4.89).Conclusions: Innovative and sustained workplace-based interventions are needed to address the high risk of HIV infection in this economically productive population. The predictors of HIV seroconversion described in this study underscore the need for public health efforts to simultaneously address the biological, socioeconomic and behavioural factors that continue to place individuals at risk of HIV in general populations of Africa.