Effect of Fertility Desire-Based Service on HIV Seroconversion Among Serodiscordant Partners: A 12-year Retrospective Cohort Study.

IF 2.9 3区医学 Q3 IMMUNOLOGY

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-05-01 DOI:10.1097/QAI.0000000000003607

Bin Yu, Chunnong Jike, Xiaomei Lan, Ju Wang, Gang Yu, Shujuan Yang

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引用次数: 0

Abstract

Background: Fertility desire-based service guided by behavioral theory is a potential strategy to mitigate the HIV transmission risk, while related evidence remains scarce. We examined the long-term effect of theory-guided fertility desire-based services on HIV seroconversion between seropositive and seronegative partners in areas with high HIV prevalence and a cultural emphasis on fertility in China.

Methods: We established a retrospective cohort by recruiting 8653 seropositive partners with seronegative partners between January 1, 2009, and December 31, 2020, in Liangshan, China. The differences in HIV seroconversion between partners who received fertility desire-based services guided by the extended Information-Motivation-Behavioral Skills model and those who did not were estimated, based on multivariable and inverse probability weighting adjusted multivariable Cox regression models. Subgroup analysis was conducted based on participants' demographic and HIV-related characteristics.

Results: Among the 8653 HIV-seropositive partners, 7958 (92.0%) and their seronegative partners received fertility desire-based services. At the end of the 12-year follow-up, 18 seronegative partners who did not receive fertility desire-based services experienced HIV seroconversion (incidence density: 7.4/1000 person-years), while 98 seronegative partners receiving such services exhibited HIV seroconversion (3.4/1000 person-years). Fertility desire-based services significantly reduced the risk of HIV seroconversion according to multivariable (HR = 0.32, 95% CI: 0.19 to 0.53) and inverse probability weighting-adjusted multivariable Cox regression models (HR = 0.48, 95% CI: 0.27 to 0.84). The effect of fertility desire-based services was more pronounced in men and those older than 40 years.

Conclusions: Fertility desire-based services based on the extended Information-Motivation-Behavioral Skills model may help reduce the HIV transmission risk between seropositive and seronegative partners in areas with high HIV prevalence.

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基于生育意愿的服务对血清不一致伴侣中HIV血清转化的影响：一项12年回顾性队列研究。

背景：行为理论指导下的基于生育意愿的服务是降低HIV传播风险的一种潜在策略，但相关证据尚缺乏。我们研究了理论指导的基于生育意愿的服务对中国HIV高流行地区血清阳性/血清阴性伴侣之间HIV血清转化的长期影响。方法：2009年1月1日至2020年12月31日，我们在中国凉山招募了8653名血清阳性伴侣和血清阴性伴侣，建立了一个回顾性队列。基于多变量和逆概率加权（IPW）调整的多变量Cox回归模型，估计了接受扩展信息-动机-行为技能（IMB）模型指导的基于生育愿望的服务的伴侣与未接受生育愿望服务的伴侣之间HIV血清转化的差异。根据参与者的人口统计学和hiv相关特征进行亚组分析。结果：8653例hiv血清阳性伴侣中，7958例（92.0%）及其血清阴性伴侣接受了基于愿望的生育服务。在12年随访结束时，18名未接受基于生育意愿服务的血清阴性伴侣发生了艾滋病毒血清转化（发病率密度：7.4/ 1000人年），而98名接受此类服务的血清阴性伴侣出现了艾滋病毒血清转化（3.4/ 1000人年）。根据多变量（HR=0.32, 95%CI: 0.19-0.53）和ipw调整的多变量Cox回归模型（HR=0.48, 95%CI: 0.27-0.84），基于生育意愿的服务显著降低了HIV血清转化的风险。基于生育意愿的服务在男性和40岁以上人群中效果更为明显。结论：在艾滋病毒高发地区，基于扩展IMB模型的基于生育意愿的服务可能有助于降低血清阳性/血清阴性伴侣之间的艾滋病毒传播风险。

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来源期刊

JAIDS Journal of Acquired Immune Deficiency Syndromes 医学-传染病学

CiteScore

5.80

自引率

5.60%

发文量

490

审稿时长

3-6 weeks

期刊介绍： JAIDS: Journal of Acquired Immune Deficiency Syndromes seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.