| BackgroundHIV sero-discordant couple, which means one couple HIV sero-positive and another HIV sero-negative in a stable marriage, has been highlighted for its bridge effect between high-risk population and general population. Understanding conversion rate and factors contribute to sero-conversion are essential in China where sexual transmission has become the major HIV transmission route. Study based on large scale and long-time follow-up discordant couple cohort has advantages when it comes to addressing these questions. Unlike abroad, unfortunately, large scale and long-time following cohort are limited in our country.ObjectiveThis study aimed to1) understand the overall sero-conversion rate and rate trend of HIV sero-discordant couple in Zhumadian city.2) to explore risk factors of sero-conversion of discordant couples in local city.3) to give reasonable suggestions for the administration and intervention of local discordant couples.MethodStudy population were sero-discordant couples choose from local HIV-infected Family Follow-up Management and Analysis System, who had been followed in July1,2006, at the same time, the positive partner should be infected via former plasma donation or blood transfusion. Follow-up with the family were conducted twice in one year to give negative partners HIV testing until December31,2010. Sero-conversion rate were calculated per100person year. Life table was used to output conversion rate in each following-period and cumulative rate as well. Cross-sectional study was performed from October,2010to march,2011, to retrospectively collect information include on socio-demographic characteristics, sexual-related activities, and medical history, etc. Cox regression model was implied to analyze the factors associated with sero-conversion.ResultA total of3088discordant couples were enrolled in our study and the4.5years retention rate was79.0%. There were132sero-conversion occurred in11237.6person years, which outcome the sero-conversion rate of1.17/100person years (95%CI:0.99-1.39). Field survey collected2672(86.5%) available questionnaires, multivariable analysis found that primary school education, sexual intercourse>4times per month, inconsistent using of condom were independent risky factor of sero-conversion. Besides that, Cox regression with2130couples whose positive partners under treatment also found that positive partners switching regimes could limit the risk of conversion (RR=0.261,95%CI:0.149～0.456), and negative partners conversion risk in viral load of400-10000copes/ml and≥10000copes/ml were2.49(RR=2.490,95%CI:1.416～4.379)and3.48(RR=3.482,95%CI:2.024-5.988) times of that viral load in <400copes/ml respectively.ConclusionIn Zhumadian city, HIV sero-discordant couples, whose positive partner infected via former plasma donation or blood transfusion, outcome a relative low conversion rate and the conversion rate in each following behaved a downward trend. The result proved positive effects of local discordant couple management style. High frequency of unprotected intercourse and low education would definitely higher the risk of conversion. In couples under treatment, high viral load and never changing regime were also risky factors of conversion as well. |
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