ABSTRACT
@#Objective To analyze the positive conversion rate of negative spouse and the survival analysis on HIV sero－discordant couples． Methods Data were collected from the case report database of the integrated AIDS prevention and control data and information system． HIV sero－discordant couples diagnosed between September 1，1997 and September 1，2018 were recruited into the cohort． The participants were divided into three groups as untreated subgroup，routine treatment subgroup and early treatment subgroup according to the situation when they started HIV treatment． The positive conversion rate of negative spouse and the survival were compared among the three subgroups． Ｒesults 598 HIV sero－discordant couples were recruited and the overall survival time of the three subgroups were 258. 92，4 987．17 and 862．25 person－year． The rate of positive conversion were 6. 18/100，0. 48/100 and 0. 23/100 person－year． Multivariate Cox regression model showed that the hazard ratio of routine treatment subgroup ( HＲ = 0. 052，95% CI: 0. 037－0. 074) and early treatment subgroup ( HＲ=0. 011，95% CI: 0. 003－0. 035) were lower than untreated subgroup． The risk of death of women was lower than that of men( HＲ=0. 667，95% CI: 0. 472－0. 944) ; the older the age，the higher the risk of death ( HＲ=1. 041，95% CI: 1. 026－1. 056) ; and the risk of death of the unemployed is higher than that of farmers ( HＲ=1. 571，95% CI: 1. 037－2. 381) ． Conclusion Targeted interventions methods and early antiviral therapy should be taken urgently for sero－discordant couples．
ABSTRACT
Objective To study the acceptability and associated factors of pre-exposure prophylaxis (PrEP) based on different sexual purpose among human immunodeficiency virus (HIV) male serodiscordant couples.Methods HIV-negative female spouses of HIV-positive male in Guigang,Guiping and Pingnan county in Guangxi Zhuang Autonomous Region were recruited by the existing epidemic database and the method of cluster random sampling.A face-to-face questionnaire survey was conducted during June 2013 to November 2016.Information including the general condition and acceptability of PrEP was surveyed.x2 test and Logistic regression were used to analyze the data.Results A total of 526 qualified questionnaires were collected.The intention rate of PrEP based on physiological sexual purpose was 66.9％ (352/526),the intention rate of PrEP based on fertility purpose was 93.3％ (491/526).The difference was statistically significant (x =139.48,P＜0.01).The reasons of refusal included worrying about its safety,effectiveness poor confidentiality and low self-assessment risk of infection.Logistic analysis showed that the associated factors of the intention rate of PrEP based on physiological sexual purpose included cognition of PrEP (OR=0.70,P=0.014),the number of lifetime partners (OR=0.55,P＜0.01),frequency of sexual behavior (OR=1.33,P=0.016),willingness of condom use (OR=0.16,P＜0.01),infection risk self-assessment (OR =0.22,P＜0.01),male viral load (OR=1.25,P=0.035),male CD4+ T lymphocyte count (OR=0.37,P＜0.01) and male usefulness of medication or not (OR=1.59,P＜0.01).The influencing factors of the intention rate of PrEP based on physiological sexual purpose included with or without children (OR =1.70,P＜0.01),cognition of PrEP (OR=0.72,P=0.026),willingness of using condom (OR=0.18,P＜0.01),infection risk self-assessment (OR=0.14,P＜0.01) and male CD4+ T lymphocyte count (OR=0.45,P＜0.01).Conclusions The acceptability of PrEP based on fertility purpose is significantly higher than that on the physiological purpose.It is more feasible to conducting clinical trials of PrEP in peri-conceptional period HIV serodiscordant couples.The main influencing factors include the uninfected individual behavior characteristics and infection features of HIV infected men,and have nothing to do with the general social demographic characteristics.