HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda
HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda
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DOI：
10.1097/00002030-200111090-00013
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发表时间：
2001-11-09
期刊：
影响因子：
3.8
通讯作者：
Gray, R
中科院分区：
文献类型：
--
作者：
Ahmed, S;Lutalo, T;Gray, R
目的：安全套预防艾滋病毒和性传播疾病(STD)有效的证据主要基于高危人群。我们检查了在非洲农村艾滋病毒高流行的普通人群中避孕套的有效性。方法：数据来自乌干达拉凯的一个随机社区试验。在30个月的时间里，从17264名15-59岁的性活跃人群中前瞻性地获得了避孕套的使用信息。与不使用避孕套的人相比，持续使用避孕套和不使用避孕套的人的艾滋病毒发病率和性传播疾病患病率被确定。用Poisson多元回归估计HIV感染的调整比率(RR)，用Logistic回归估计性病的优势比。结果：仅有4.4%的人报告在上一年中坚持使用避孕套，16.5LO报告不一致使用安全套。避孕套的使用率在男性、年轻、未婚和受过较好教育的人中较高，以及那些报告有多个性伴侣或婚外关系的人。在调整了社会人口学和行为特征后，持续使用安全套显著降低了HIV发病率[RR，0.37；95%可信区间(CI)，0.15~0.88]、梅毒[优势比(OR)，0.71；95%CI，0.53~0.94]和淋病/衣原体(OR，0.50；95%CI，0.25~0.97)。不规律使用避孕套对HIV或STD没有保护作用，并与淋病/衣原体感染风险增加相关(OR，1.44；95%CI，1.06-1.99)。持续使用安全套预防HIV的人群归因分数为-4.5%(95%CI，-8.3~0.0)，这是因为持续使用安全套的人群中持续使用安全套的患病率较低。结论：持续使用避孕套可以预防HIV和STD，而不一致使用则不具有保护作用。项目必须强调持续使用安全套，以预防艾滋病毒和性传播疾病。(C)2001年，Lippincott Williams&Wilkins。
Objective: Evidence of condom effectiveness for HIV and sexually transmitted disease (STD) prevention is based primarily on high-risk populations. We examined condom effectiveness in a general population with high HIV prevalence in rural Africa.Methods: Data were from a randomized community trial in Rakai, Uganda. Condom usage information was obtained prospectively from 17 264 sexually active individuals aged 15-59 years over a period of 30 months. HIV incidence and STD prevalence was determined for consistent and irregular condom users, compared to non-users. Adjusted rate ratios (RR) of HIV acquisition were estimated by Poisson multivariate regression, and odds ratios of STDs estimated by logistic regression.Results: Only 4.4% reported consistent condom use and 16.5 lo reported inconsistent use during the prior year. Condom use was higher among males, and younger, unmarried and better educated individuals, and those reporting multiple sex partners or extramarital relationships. Consistent condom use significantly reduced HIV incidence [RR, 0.37; 95% confidence interval (CI), 0.15-0.88], syphilis [odds ratio (OR), 0.71; 95% CI, 0.53-0.94] and gonorrhea/Chlamydia (OR, 0.50; 95% CI, 0.25-0.97) after adjustment for socio-demographic and behavioral characteristics. Irregular condom use was not protective against HIV or STD and was associated with increased gonorrhea/Chlamydia risk (OR, 1.44; 95% CI, 1.06-1.99). The population attributable fraction of consistent use for prevention of HIV was -4.5% (95% CI, -8.3 to 0.0), due to the low prevalence of consistent use in the population.Conclusions: Consistent condom use provides protection from HIV and STDs, whereas inconsistent use is not protective. Programs must emphasize consistent condom use for HIV and STD prevention. (C) 2001 Lippincott Williams & Wilkins.