An Epidemiological Study Of HIV Sexual Transmission In Married Spouses In Yunnan Province

ObjectiveYunnan is one of the serious epidemic area which suffered from AIDS in China, To contain the spread of AIDS between spouses has became the emergency need in Yunnan. Therefore, we studied the current status of the spread of AIDS between spouses, understand the main infection factors of spouses AIDS epidemic by comparing different types of People Who Live With HIV/AIDS(PLWHA),with the attitude and behaviors. In order to provide a scientific basis of HIV/AIDS further control strategy and some advices on intervention of spouses.MethodsSectional study was used to analysis the AIDS epidemic.5serious epidemic areas and3moderate epidemic areas of AIDS were selected randomly. By the sequence of time, with investigators who were trained first, the couples which were included in the research were investigated face to face and one to one. The data was from people who were HIV infected and their spouse from the300families(600person) which were able to follow-up,informed consent, correctly understand and answer the questionnaire. Epidata3.1was used, the data was detected based on logic and parallel double-entry. After verification application SPSS11.5statistical analysis software were used for analysis. Meanwhile, data of qualitative interview were arranged by investigators, during the interview and after it, investigators should accomplish the note immediately and the analyze were used the method of Theme framework lawResults(1)300PLWHA spouses have investigated in our survey. According to the infectious status in spouses, we collected178spouses (59.3%) which had single positive and122spouses(40.7%) who are both HIV antibody positive. According to the HIV epidemic level, we collected182spouses in serious epidemic areas of AIDS(both HIV antibody positive spouses71, single positive spouses111),and118spouses in serious epidemic areas of AIDS (both HIV antibody positive spouses51, single positive spouses67).(2) In300first infectious persons, male accounted for62%and female accounted for38%, there were significant differences in gender. The average age was34.5±9.0;the people who were first infected are mainly Han nationality and Dai nationality;93.7%of the investigated people were educated less than9years; the object were mainly farmers(69.7%) About the spouse of the300people, the average age was33.9±8.1, the following HIV and negative ones are mainly Han nationality and Dai nationality too, the percentage were52.0%and24.3%respectively;89.5%of them are educated less than9years; most of them are faers (69.7%).(3)The average rate of knowledge about AIDS was96.7%among the600objects.(4)In300first infected person between couples,205persons who infected HIV by sexual transmission occupying68.3%(including106persons by business sexual transmission and99persons by temporary sexual behavior).59persons(19.7%)living with HIV were intravenous drug users,and we never found the spouses who were both intravenous drug users which share needles.(5) In the600objects, there are71has the history of STD; the rate of infection is11.83%. Among the300first infected persons, there are49has the history of STD; The rate of infection is16.3%; After statistics analyze, the rate of STD history is higher in both positive spouses who was infected first; the rate of STD history is higher in double positive families the people who is lately infected than those who were negative in single positive families.(6)In the survey of300families living with HIV, all spouses of the family have been informed their spouses'positive test results. The methods that the spouses were informed were mainly by the infected persons and CDC/hospital workers, the rate is33.67%,65.67%respectively, there were significant differences.(7) After informed,276couples choose to have sex even when they know one of them was infected; and24couples have not; the rate of sexual behavior decrease is higher in one positive spouses than in both positive ones.As the frequency of sexual activity, there were significant differences between one positive spouses and both positive ones. The usage rate of condom had a high increase after informed. Before informed, the usage rate of condom increased from16.8%to95%in one positive spouses, and there were significant differences between these. The usage rate of condom also had a high increase after informed in both positive spouses. Before informed, the usage rate of condom increased from7.8%to60.9%, and there were significant differences between these.(8) According to the multiple Logistic regression analysis, condom use after informed, whether to suffer from STD in first infected persons,the changes after informed and whether male in first infected persons were influence factors of HIV transmission between couples.Conclusion The main transmission approach for the first one infected HIV in spouse is sexual transmission. factors influencing sexual transmission in spouses included condom use, times of sexual behaviors, STD of the first one infected HIV in spouse and he first one infected HIV is men. Disclosing t heir HIV test outcome to their spouses can make a significant changes in times of sexual behaviors and rate of condom use.