Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States - Implications for HIV prevention programs
Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States - Implications for HIV prevention programs
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DOI：
10.1097/01.qai.0000151079.33935.79
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发表时间：
2005-08-01
影响因子：
3.6
通讯作者：
Janssen, RS
中科院分区：
文献类型：
--
作者：
Marks, G;Crepaz, N;Janssen, RS
目的：比较美国HIV感染者和HIV感染者的高危性行为发生率，并探讨其对HIV预防工作的影响。方法：对11项独立研究结果进行Meta分析。6项研究结果比较了艾滋病毒感染者与不了解艾滋病毒的独立人群(组间比较)，5项研究结果比较了血清转换者在被告知其艾滋病毒阳性状态前后的情况(受试者内比较)。结果：综合所有I I研究结果显示，与不知道自己状况的HIV+者相比，与任何伴侣发生UAV的发生率平均低53%(95%可信区间：45%~60%)。在调整了主要研究的数据以专注于与尚未感染HIV+的伴侣的无人机后，减少了68%(95%可信区间：59%-76%)。组间比较的减少幅度大于受试者内的比较。男性和女性的研究结果高度相似。结论：在人们意识到自己是HIV+后，高危性行为的流行率大幅下降。需要更加重视艾滋病毒检测和咨询，以减少不知道自己感染了艾滋病毒的人对艾滋病毒的暴露。需要为知道自己是艾滋病毒阳性并继续从事高危行为的人提供持续的预防服务。
Objectives: To compare the prevalence of high-risk sexual behaviors in HIV+ persons aware of their serostatus with that in HIV+ persons unaware of their status in the United States and to discuss implications for HIV prevention programs.Methods: A meta-analysis was conducted on 11 independent findings. Six findings compared HIV+ aware persons with independent groups of HIV+ unaware persons (between-group comparisons), and 5 findings compared seroconverting individuals before and after being notified of their HIV+ status (within-subject comparisons). Outcomes were self-reported unprotected anal or vaginal intercourse (UAV) during specified recall periods.Results: The analysis integrating all I I findings indicated that the prevalence of UAV with any partner was an average of 53% (95% confidence interval [CI]: 45%-60%) lower in HIV+ persons aware of their status relative to HIV+ persons unaware of their status. There was a 68% reduction (95% CI: 59%-76%) after adjusting the data of the primary studies to focus on UAV with partners who were not already HIV+. The reductions were larger in between-group comparisons than in within-subject comparisons. Findings for men and women were highly similar.Conclusions: The prevalence of high-risk sexual behavior is reduced substantially after people become aware they are HIV+. Increased emphasis on HIV testing and counseling is needed to reduce exposure to HIV from persons unaware they are infected. Ongoing prevention services are needed for persons who know they are HIV+ and continue to engage in high-risk behavior.