山西省家庭内夫妻间HIV性传播及影响因素的研究  

An epidemiological study of HIV sexual transmission in married couples in Shanxi Province

作　　者：乔晓春[1] 申俊萍[1] 卫军[2] 郭晓黎[1] 王晋生[2] 梁正虎[1] 宁少萍 贾少贤 阮玉华[3] 邢辉[3] 邵一鸣 

机构地区：[1]山西省疾病预防控制中心,太原030012 [2]山西省运城市疾病预防控制中心 [3]中国疾病预防控制中心性病艾滋病预防控制中心,北京100050

出　　处：《中国预防医学杂志》2009年第11期976-979,共4页Chinese Preventive Medicine

基　　金：国家十五科技攻关项目(2004BA719A01);山西省科技攻关项目(051101)

摘　　要：目的了解山西省家庭内夫妻间HIV性传播状况及影响因素。为政府制定有效的防控政策和策略提供科学依据。方法选择一方HIV阳性;另一方没有静脉吸毒、多性伴、有偿供血和输血等HIV感染的危险行为史,有稳定婚姻的夫妻,采用回顾性方法进行调查。结果①夫妻性传播HIV感染率30.4%(28/92);②丈夫(男性)传妻子(女性)的HIV传播率为31.1%(14/45),妻子(女性)传丈夫(男性)的HIV传播率29.8%(14/47),X^2=0.019,P>0.05,两者差异无统计学意义;③夫妻感染的流行株均为HIV-1B′亚型;④CD4细胞计数平均值,双阳组(133个/ml)低于单阳组(227个/ml),t=-2.166,P<0.05,差异有统计学意义;⑤病毒载量≥10~5拷贝/ml的比例,双阳组为78.5%,单阳组为54.6%,X^2=5.211,P=0.024,OR=1.629,OR95%CI=[1.326,2.001],差异有统计学意义;⑥机会性感染发生情况,双阳组35.7%(10/28),单阳组17.2%(11/64),X^2=0.53,P<0.05,两组差异有统计学意义。结论山西省夫妻间HIV性传播率较高,男传女与女传男无明显差异。影响山西省家庭内夫妻HIV性传播的主要因素与感染者体内CD4细胞计数低、病毒载量高、机会性感染的发生有关。Objective To study the status and risk factors of the HIV sexual transmission in married couples and to provide scientific evidence for HIV prevention and control stragety. Methods Ninety-two couples aged 20 - 65 years with stable marriages were selected. In each couple, one was HIV positive and the other had no known risk behavior such as drug injection, multi-sexual partners, history of paid blood donation, blood transfusion and so on. All of the participants were investigated on suspected risk factors and laboratory tests for HIV antibody, CD4 lymphoeytes, viral load and HIV subtypes. They were followed-up 1 or 2 years later. All of the data were analyzed with SPSS 11.5 statistical software. Results The HIV infection rate of sexual transmission was 30. 4% in married couples. The HIV transmission rates of male-to-female and female-to-male were 31.1% and 29. 8% respectively. The HIV subtype of all the positive participants was HIV-1 B＇. The average CIM cell count in the case group （133/ml） was significandy lower than that in tile control group （227/ml） （t =2. 166, P 〈0. 05 ）. The HIV viral load more than 105 copies/ml reached 78.5% in the case group and 54. 6% in the control group, and the difference was significant （Χ^2 = 5. 211, P 〈 0. 05 ）. Opportunistic infection occurred in 35.7% of the couples of the case group and 17.2% of the control group. The difference was significant （ Χ^2 = 0. 53, P 〈 0. 05）. Conclusion Low CD4 cell count, high HIV viral load and opportunistic infection are the main risk factors that affected HIV transmission in couples.

关 键 词：艾滋病 夫妻 性传播 影响因素 

分 类 号：R512.91[医药卫生—内科学]