HIV单阳家庭先证者不安全性行为致配偶阳转危险因素主成分分析  

Principal component analysis of the risk factors of seroconversion due to unsafe sex among HIV discordant couples

作　　者：刘慧[1] 龚茁 颜星[1] 段丹 李秋 唐美秀[1] 曾灿 杨双波 LIU Hui;GONG Zhuo;YAN Xing;DUAN Dan;LI Qiu;TANG Meixiu;ZENG Can;YANG Shuangbo(Changsha Medical University,Changsha,Hunan 410219,China;不详)

机构地区：[1]长沙医学院,湖南长沙410219 [2]郴州市第一人民医院 [3]长沙市岳麓区疾病预防控制中心 [4]黔南民族医学高等专科学校

出　　处：《中国预防医学杂志》2024年第3期357-361,共5页Chinese Preventive Medicine

基　　金：湖南省教育厅重点项目(22A0657);湖南省教育厅一般项目(21C0898);湖南省卫生健康委项目(202212055151)。

摘　　要：目的 分析影响人类免疫缺陷病毒(human immunodificidncy virus,HIV)单阳家庭先证者通过不安全性行为导致阴性配偶发生阳转的主要危险因素。方法 对湖南省3个地区(长沙市、邵阳市和郴州市)HIV单阳家庭进行24个月的随访观察,以单因素χ2检验、主成分分析、回归分析等方法,分析先证者层面、阴性配偶层面、配偶双方层面各影响因素对阴性配偶阳转情况的影响。结果 随访HIV单阳家庭352对先证者层面,世界卫生组织临床分期、全程抗反转录病毒治疗(antiretroviral therapy,ART)治疗规范情况、末次HIV病毒载量、末次CD4+T淋巴细胞、末次淋巴细胞对阴性配偶阳转的影响差异有统计学意义(χ^(2)=6.283、4.415、19.720、12.965,P<0.05);阴性配偶层面,定期体检、行为和饮食习惯自评2项因素对阴性配偶阳转的影响差异有统计学意义(χ^(2)=3.736、11.866,P<0.05);配偶双方层面,结婚年限、性行为频率、性行为保护措施和合并性病情况对阴性配偶阳转的影响差异有统计学意义(χ^(2)=4.520、20.694、31.801、13.597,P<0.05)。10项影响显著的单项因素主成分分析可归纳到4个主成分(艾滋病病情严重程度、安全性行为自我保护、健康关注和规范治疗以及夫妻双方的融洽关系),累积贡献率97.99%。分别以主成分或影响因素为自变量,拟合的主成分线性回归模型和多因素线性回归模型差异有统计学意义(χ^(2)=82.26、53.47,P<0.05),主成分线性回归模型更为可靠、不存在共线性,自变量解释因变量程度相对更高(VIF=87.25)。结论 艾滋病病情严重程度是影响HIV单阳家庭阴性配偶发生阳转的核心因素,安全性行为自我保护和健康关注和规范治疗是影响阴性配偶发生阳转的主要因素。Objective To analyze the main risk factors of HIV single positive family proband leading to negative partner's positive conversion through unsafe sex.Methods HIV-positive families in three regions of Hunan(Changsha,Shaoyang and Chenzhou)were followed up for 24 months.The effects of the proband level,negative spouse level and both spouses level on the positive transfer of negative spouses were analyzed by single factor chi-square test,principal component analysis and regression analysis.Results A total of 352 HIV-positive families were followed up,At the proband level,WHO clinical stage,standard status of total ART treatment,last HIV viral load,last CD4+T,the last lymphocyte had statistically significant effects on the negative partner's positive turn(χ^(2)=6.283,4.415,19.720,12.965,P<0.05);At the level of negative spouses,regular physical examination,self-evaluation of behavior and eating habits had statistically significant effects on positive rotation in negative spouse(χ^(2)=3.736,11.866,P<0.05);At the level of both spouses,marriage years,sexual frequency,sexual protection measures、morbidity of sexually transmitted diseases,The four factors had statistical significance on the positive turn of the negative spouse(χ^(2)=4.520,20.694,31.801,13.597,P<0.05);The principal component analysis of 10 single factors with significant influence can be concluded into 4 principal components(AIDS severity,safe sex self-protection,health attention and standardized treatment,harmonious relationship between husband and wife),with the cumulative contribution rate of 97.99%.With principal component or influencing factors as independent variables,the fitted principal component linear regression model and multi-factor linear regression model were statistically significant(χ^(2)=82.26,53.47,P<0.05).The principal component linear regression model is more reliable and has no collinearity,and the independent variable explains the dependent variable to a higher degree(VIF=87.25).Conclusions The severity of AIDS disease is the core

关 键 词：单阳家庭 抗病毒治疗 先证者 不安全性行为 抗体阳转 危险因素 主成分分析 回归分析 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]