Influencing Factors Of HIV Transmission Between Spouses In Lu'an,Anhui

Object To understand the transmission rate and influence factors of HIV between spouses in Lu'an,Anhui.Methods The HIV/AIDS cases who with a fixed partner,the current address was Lu'an,registered and followed up in CDC of Lu'an from January 2000 to August 2016,were observed follow-up observation,also their spouses.Following up began from the date of cases lived with negative spouse after been diagnosed with HIV,ended on December31,2016.The outcome variable was HIV antibody showed positive during following up period.HIV concordant positive couples in first testing,in addition to being reported to HIV information system,epidemiological investigation and following up being conducted to investigate the transmission direction between spouses to determine the index case.All cases and their negative spouses were followed up every 6 months.All information was entried double to the database using Epidata3.1.Statistical analysis was conducted using SPSS18.0 to known mean,standard deviation,and various rates.Chi square test and multivariate COX regression were used for the analysis,a=0.05 as a statistical inspection level.Results(1)the HIV transmission rate among HIV-discordant spouses before diagnosis of the index case was 19.48%(45/231).The HIV transmission rate of male-to-female and female-to-male were 21.56%(36/167)and 14.06%(9/64),respectively(?~2=1.420,P=0.233).(2)After diagnosis of the index case,the transmission rate between spouses was 0.39per 100 person year(2/507.7),the cumulative transmission rate was 1.08%(2/186),which was lower than rate before diagnosis(?~2=35.714,P<0.001)(3)Among 199 HIV/AIDS patients received ART,the transmission rate was 0(0/199),meanwhile,the transmission rate was 2.99%(2/67)among HIV/AIDS patients who were not received ART.The transmission rate of female-to-male was 0.95 per 100person year(2/209.5),the cumulative transmission rate was 3.64%(2/55),and the transmission rate of male-to-female was 0.(4)Univariate analysis showed that CD4 levels at the end of observation,the viral load level at the beginning and the end of observation,age at diagnosis,frequency of sexual activity before diagnosis were the risk factors of HIV infection between husband and wife.The COX regression analysis indicated that high frequency of sexual activity before diagnosis was the independent risk factors for HIV transmission between husband and wife,the higher the frequency,the greater the risk.(5)Among male index case,Univariate analysis showed that HIV transmission rate between spouseswere statistically associated with CD4 levels at the end of observation,the viral load level at the beginning and the end of observation,age at diagnosis,frequency of sexual activity before diagnosis.The COX regression analysis indicated that high frequency of sexual activity before diagnosis was the independent risk factors for HIV transmission between husband and wife,the viral load<300 copy/m L were protective factors.Among female index case,Univariate and multi-factor analysis showed that the viral load level at the end of observation was the risk factors of HIV infection between spouse.Conclusions(1)In recent years,HIV transmission rates between spouses was lower than in the past.(2)Before diagnosis of the index case,the cumulative transmission rate was high among couples.After diagnosis,due to the intervention,the rate is only 1/23 of the former.The above situation prompted that intervention has achieved remarkable results.(3)Early detection of HIV/AIDS cases was one of the most effective measures of prevention.(4)ART could reduce the risk of HIV transmission between spouses,which suggested that early ART should be carried out in HIV discordant couples.(5)The HIV transmission rate of male-to-female was higher than that of female-to-male before diagnosis of the index case;On the contrary,the rate of female-to-male is higher than that of male-to-female after diagnosis.(6)Influencing risk factors of HIV transmission between spouses was different in male index case and female index case:the CD4 level,the viral load level,age at diagnosis,frequency of sexual activity were influencing risk factors leading to HIV transmission between spouses inmale index case,the viral load level was influencing risk factors in female index case.The above suggested that these factors should be considered in making interventions.