撒哈拉以南非洲的非伴侣艾滋病毒传播:对调查数据的数学建模研究
Steve E Bellan1, Kathryn J Fiorella, Dessalegn Y Melesse
1Department of Environmental Science, Policy and Management, University of California, Berkeley, CA, USA. steve.bellan@gmail.com
Lancet (London, England)
|February 9, 2013
概括
非情侣性关系对撒哈拉以南非洲地区的新艾滋病毒感染有很大影响,影响男性和女性. 预防工作应该超越夫妇范围,扩大到一般性活跃人口.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 数学建模的数学建模
背景情况:
- 在撒哈拉以南非洲的异性恋艾滋病毒传播途径受到争议.
- 了解传播对于有效的艾滋病毒预防策略至关重要,特别是在推进抗逆转录病毒疗法 (ART) 时.
研究的目的:
- 估计不同艾滋病毒传播途径在撒哈拉以南非洲的共同生活伙伴关系内外的比例贡献.
主要方法:
- 使用2003-2011年人口和健康调查 (DHS) 数据开发了一种机理性艾滋病毒传播模型.
- 该模型纳入了18个撒哈拉以南非洲国家的27,201对同居夫妇的数据,包括关系持续时间,性初恋年龄和艾滋病毒状况.
- 艾滋病毒存活率,流行率和ART覆盖率的估计被整合起来,以确定感染源 (前夫妇形成,夫妇内部或外夫妇).
主要成果:
- 非夫妇传播占艾滋病毒感染的很大一部分:在被调查的夫妇中,男性占27-61%,女性占21-51%.
- 在2011年,伴侣外的传播占男性新艾滋病毒感染的32-65%,女性在同居伴侣中占10-47%.
- 虽然夫妻间的传播主要是从男性传播给女性,但在结婚前,女性面临高风险.
结论:
- 非伴侣传播是新的艾滋病毒感染的主要驱动因素.
- 艾滋病毒预防干预措施应针对更广泛的性活跃人口,而不仅仅是血清异调夫妇.
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