The associations of voluntary counseling and testing acceptance and the perceived likelihood of being HIV-infected among men with multiple sex partners in a South African township

This paper examines the socio-demographic factors and sexual risk behaviors (condom use, number of sexual partners, STI symptoms) associated with voluntary counselling and testing (VCT) acceptance and self-perceived risk of being HIV-infected among black men with multiple and younger sex partners in a South African township outside of Cape Town. Using respondent driven sampling, we interviewed 421 men, of whom 409 (97.3%) consented to provide a dried blood spot, 12.3% were HIVinfected (95% confidence intervals [CI.] 8.3, 16.9) and 47.2% (CI. 41.1, 53.6) accepted on site VCT. Twenty six percent (CI. 20.2, 30.7) reported having an HIV test in the past year. Few men perceived themselves as very likely to be infected with HIV (15.6%; CI. 10.4, 20.5). VCT acceptance was significantly associated with being older, married or living with a partner, having higher education, having four to six partners in the past three months and testing HIV positive. Self-perceived likelihood of being HIV infected was significantly associated with low condom use and having seven or more partners in the past three months, and testing HIV positive. These findings indicate that men correctly understand that engaging in certain HIV risk behaviors increases the likelihood of HIV-infection. However, those who perceive themselves at high risk of having HIV do not seek testing. Further investigation into the psychological and cultural barriers to reducing risky sexual behaviors and accessing VCT and other HIV services is recommended.     

High Rates and Positive Outcomes of HIV-Serostatus Disclosure to Sexual Partners: Reasons for Cautious Optimism from a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania

The rates, barriers, and outcomes of HIV serostatus disclosure to sexual partners are described for 245 female voluntary counseling and testing (VCT) clients in Dar es Salaam, Tanzania. VCT clients were surveyed 3 months after HIV testing to describe their HIV-serostatus disclosure experiences. Sixty-four percent of HIV-positive women and 79.5% of HIV-negative women (p = 0.028) reported that they had shared HIV test results with their partners. Among women who did not disclose, 52% reported the reason as fear of their partner's reaction. Both 81.9% of HIV-negative women and 48.9% of HIV-positive women reported that their partner reacted supportively to disclosure (p < 0.001). Less than 5% of women reported any negative reactions following disclosure. VCT should continue to be widely promoted. However, intervention approaches such as development of screening tools and new counseling approaches are important to ensure the safety of women who want to safely disclose HIV serostatus to their sexual partners.     

浙江省江山市献血者艾滋病自愿咨询检测情况

目的了解江山市献血者艾滋病自愿咨询检测（VCT）情况,降低输血感染艾滋病病毒（HIV）的风险,确保输血安全。方法通过采供血机构专业的健康征询技巧,将发现的高危献血者转介到VCT门诊,并对174例求询者情况进行统计分析。结果174例求询者中,男性占70．7％,23-40岁占67．8％,已婚占73．0％,高中以下占64．0％,无固定职业占86.2％,来自个人献血的占83．9％。有多个性伴侣者占85．1％,其余为有偿献血史者、职业暴露史者和外来婚嫁女。接受HIV抗体检测者97例,其中1例HIV抗体确认阳性。结论献血前征询体检与VCT门诊有机地结合,能使高危献血者得到情感和心理上的支持,主动退出献血,这不仅是预防艾滋病的需要,也能降低输血感染HIV的风险,保证血液安全。     

A Venue-Based Approach to Reaching MSM,IDUs and the General Population with VCT: A Three Study Site in Kenya

A venue-based HIV prevention study which included Voluntary Counseling and Testing (VCT) was conducted in three diverse areas of Kenya-Malindi, Nanyuki and Rachounyo. Aims of the study were to: (1) assess the acceptability of VCT for the general population, men who have sex with men (MSM), and injecting drug users (IDUs) within the context of a venue-based approach; (2) determine if there were differences between those agreeing and not agreeing to testing; and (3) study factors associated with being HIV positive. Approximately 98% of IDUs and 97% of MSM agreed to VCT, providing evidence that populations with little access to services and whose behaviors are stigmatized and often considered illegal in their countries can be reached with needed HIV prevention services. Acceptability of VCT in the general population ranged from 60% in Malindi to 48% in Nanyuki. There were a few significant differences between those accepting and declining testing. Notably in Rachuonyo and Malindi those reporting multiple partners were more likely to accept testing. There was also evidence that riskier sexual behavior was associated with being HIV positive for both men in Rachounyo and women in Malindi. Overall HIV prevalence was higher among the individuals in this study compared to individuals sampled in the 2008-2009 Kenya Demographic and Health Survey, indicating the method is an appropriate means to reach the highest risk individuals including stigmatized populations.     

HIV Risk Among Patients Attending Sexually Transmitted Disease Clinics in China

HIV and other sexually transmitted diseases (STDs) are spreading rapidly in China. However, little is known about HIV risk among STD patients. In October–November 1997, we recruited a consecutive sample of 1,371 STD clinic patients from 16 different provinces and municipalities across the country and examined their sexual practices and condom use. We found that the median age for sexual initiation was 22 years for men and 21 years for women, and only a small proportion of men (12%) and women (15%) had used a condom during this first sexual intercourse. Eighty-one percent of men and 53% of women had two or more sexual partners in the past year. During the same period, 78% of men and 44% of women had both steady and nonsteady partners; of those with both types of partners, only 1% of men and 7% of women always used a condom with these partners. Multiple sexual partnerships in the past year were more common among men, older men (over 35 years), and those who had initiated sex at an earlier age. More frequent condom use was associated with being younger, having nonsteady partners, and having used a condom during a first sexual encounter. Our findings underline a need for patient education and condom promotion among STD clinic patients as a part of efforts to prevent the spread of HIV in China.     

Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort

OBJECTIVES: To examine the determinants of uptake of voluntary counselling and testing (VCT) services, to assess changes in sexual risk behaviour following VCT, and to compare HIV incidence amongst testers and non-testers. METHODS: Prospective population-based cohort study of adult men and women in the Manicaland province of eastern Zimbabwe. Demographic, socioeconomic, sexual behaviour and VCT utilization data were collected at baseline (1998-2000) and follow-up (3 years later). HIV status was determined by HIV-1 antibody detection. In addition to services provided by the government and non-governmental organizations, a mobile VCT clinic was available at study sites. RESULTS: Lifetime uptake of VCT increased from under 6% to 11% at follow-up. Age, increasing education and knowledge of HIV were associated with VCT uptake. Women who took a test were more likely to be HIV positive and to have greater HIV knowledge and fewer total lifetime partners. After controlling for demographic characteristics, sexual behaviour was not independently associated with VCT uptake. Women who tested positive reported increased consistent condom use in their regular partnerships. However, individuals who tested negative were more likely to adopt more risky behaviours in terms of numbers of partnerships in the last month, the last year and in concurrent partnerships. HIV incidence during follow-up did not differ between testers and non-testers. CONCLUSION: Motivation for VCT uptake was driven by knowledge and education rather than sexual risk. Increased sexual risk following receipt of a negative result may be a serious unintended consequence of VCT. It should be minimized with appropriate pre- and post-test counselling.     

Characteristics of Individuals and Couples Seeking HIV-1 Prevention Services in Dar Es Salaam, Tanzania: The Voluntary HIV-1 Counseling and Testing Efficacy Study

The objective of this paper is to describe the baseline characteristics, risk behavior, and HIV prevalence of individuals and couples who enrolled in the Voluntary HIV Counseling and Testing Efficacy Study at the study site in Dar es Salaam, Tanzania. Participants were recruited through flyers, radio, and outreach to schools and workplaces to participate in a randomized clinical trial testing the effectiveness of HIV voluntary counseling and testing (HIV VCT) for prevention of new HIV and STD infections. Recruitment was stratified to include men and women enrolling alone and as couples. Baseline data were collected in face-to-face interviews, then participants were randomized to receive HIV VCT or health information. A total of 1,427 participants were recruited, 708 women and 719 men; 444 participants enrolled as part of a couple. HIV seroprevalence for those who received VCT at baseline was 21% overall (12% men, 30% women). Those enrolled as couples reported less sexual risk behavior than those enrolled as individuals. Both couples and individuals reported high rates of unprotected sexual intercourse with commercial partners. Overall 45% of participants self-reported an STD symptom (54% of women and 36% of men), and men were more likely to have received treatment for their symptoms. A large number of individuals and couples responded to advertisements for VCT in Dar es Salaam, Tanzania. High rates of HIV seroprevalence and couple serodiscordance, self-reported STD symptoms, and sexual risk behavior indicate that at-risk participants were recruited. Implications for delivery of HIV VCT and related services are discussed.     

HIV Voluntary Counseling and Testing Service Preferences in a Rural Malawi Population

Voluntary counseling and testing (VCT) services have become an integral component of HIV prevention efforts in sub-Saharan Africa. This study of a rural Malawi district population examined variation in past and desired use of VCT services among 868 women aged 15 to 34 and 648 men aged 20 to 44 aware of HIV/AIDS. Only 11% of men and 7% of women had been tested, but of those untested, 76% of men and 61% of women desired testing. Ninety percent of respondents willing to know their results preferred to hear them from a test site counselor and on the same day of the test. However, 27% of women wanting to be tested did not want to know their test results, a finding significantly associated with knowing someone affected by AIDS and perceiving oneself at HIV infection risk. Knowledge of the behaviors of HIV prevention, knowing someone with AIDS, knowing the locations of a test site, and perceived risk of HIV infection all had a consistently significant association with past and future VCT use for men and women.     

Trends in the uptake of voluntary counselling and testing for HIV in rural Tanzania in the context of the scale up of antiretroviral therapy

Objectives To describe trends in voluntary counselling and testing (VCT) use and to assess whether high‐risk and infected individuals are receiving counselling and learning their HIV status in rural Tanzania. Methods During two rounds of linked serological surveys (2003–2004 and 2006–2007) with anonymous HIV testing among adults, VCT was offered to all participants. The crude and adjusted odds ratios for completing VCT in each survey were calculated to compare uptake by demographic, behavioural and clinical characteristics, stratified by sex. Repeat testing patterns were also investigated. Results The proportion of participants completing VCT increased from 10% in 2003–2004 to 17% in 2006–2007, and among HIV‐infected persons from 14% to 25%. A higher proportion of men than women completed VCT in both rounds, but the difference declined over time. Socio‐demographic and behavioural factors associated with VCT completion were similar across rounds, including higher adjusted odds of VCT with increasing numbers of sexual partners in the past 12 months. The proportion having ever‐completed VCT reached 26% among 2006–2007 attendees, with repeat testing rates highest among those aged 35–44 years. Among 3923 participants attending both rounds, VCT completion in 2006–2007 was 17% among 3702 who were HIV negative in both rounds, 19% among 124 who were HIV infected in both rounds and 22% among 96 who seroconverted between rounds. Conclusion VCT services are attracting HIV‐infected and high‐risk individuals. However, 2 years after the introduction of antiretroviral therapy, the overall uptake remains low. Intensive mobilisation efforts are needed to achieve regular and universal VCT use.     

Correlates of HIV Test Results Seeking and Utilization of Partner Counseling Services in a Cohort of Male Factory Workers in Zimbabwe

Correlates of individual HIV test results-seeking and utilization of partner counseling services were identified among male factory workers who participated in a longitudinal HIV prevention intervention study in Harare, Zimbabwe. Men working at participating factories were offered HIV voluntary counseling and testing (VCT) for themselves and their partners. While risk assessment counseling was offered in the workplace, result disclosure and partner counseling occurred at an off-workplace location. Of the 3,383 men undergoing risk assessment and testing, 1,903 (56%) chose to receive their test results and 230 (7%) brought their partners for VCT. Factors associated with receiving test results were history of STD and lower salary. Factors associated with bringing a partner for VCT were history of STD, being married, being employed at a factory with a peer educator, lower salary, and no prostitute contact. Incorporating VCT into STD treatment services is likely to reach a large number of men and their partners at highest risk for both types of infections. Because men are often the main decision-makers in sexual and reproductive matters, VCT must be easily accessible to urban, working African men.     

Lesbians' sexual history with men: implications for taking a sexual history

BACKGROUND: Health care providers may not solicit a comprehensive sexual history from lesbian patients because of provider assumptions that lesbians have not been sexually active with men. We performed this study to assess whether women who identify themselves as lesbians have a history of sexual activities with men that have implications for receipt of preventive health screening. OBJECTIVE: To convey the importance for health care providers to know their patients' sexual history when making appropriate recommendations for preventive health care. METHODS: A survey was printed in a national news magazine aimed at homosexual men, lesbians, and bisexual men and women. The sample included 6935 self-identified lesbians from all 50 US states. The outcomes we measured were respondents' number of lifetime male sexual partners and partners during the past year, their lifetime history of specific sexual activities (e.g., vaginal intercourse, anal intercourse), their lifetime condom use, and their lifetime history of sexually transmitted diseases. RESULTS: Of respondents, 77.3% had 1 or more lifetime male sexual partners, 70.5% had a lifetime history of vaginal intercourse, 17.2% had a lifetime history of anal intercourse, and 17.2% had a lifetime history of a sexually transmitted disease. Exactly 5.7% reported having had a male sexual partner during the past year. CONCLUSION: These findings reinforce the need for providers to know their patients' sexual history regardless of their reported sexual orientation, especially with regard to recommendations for Papanicolaou smears and screening for sexually transmitted diseases.     

Empowering HIV testing as a prevention tool: targeting interventions for high-risk men who have sex with men

In France, HIV testing can be easily performed in free and anonymous voluntary counselling testing (VCT) centres. The recent national study among French men who have sex with men (MSM) showed that 73% of those already tested for HIV had been tested in the previous two years. Nothing is known about the risk behaviours of MSM attending VCT centres. This study aimed to characterize sexual risk behaviours of MSM tested for HIV in such centres and identify factors associated with inconsistent condom use (ICU). A cross-sectional study was conducted from March to December 2009 in four VCT centres where a self-administered questionnaire was proposed to all MSM about to have a HIV test. ICU was defined as reporting non-systematic condom use during anal intercourse with casual male partners. Among the 287 MSM who fully completed their questionnaire, 44% reported ICU in the previous six months. Among those who had been already tested, 63% had had their test in the previous two years. Factors independently associated with ICU included: never avoiding one-night stands, not having been recently HIV tested, experiencing difficulty in using condoms when with a HIV negative partner or when under the influence of drugs or alcohol and finally, reporting to have had a large number of casual male partners in the previous six months. The rate of recently tested MSM was high in our study. Nevertheless, this rate was lower than that found in the last national study. Furthermore those not recently tested were significantly more likely to report high risk behaviours. We therefore recommend that further efforts be made to adapt the offer of both HIV testing and counselling to meet the specific needs of hard-to-reach MSM. Accordingly, an additional community-based offer of HIV testing to reach most-at-risk MSM is forthcoming in France.     

High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China.

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). We investigated sexual risk, risk perception, HIV and condom knowledge, and utilization of prevention services in the first large sample of MSM recruited in Beijing. Four hundred eighty-two MSM were sampled from September 2001 to January 2002. Forty-nine percent of participants reported unprotected anal intercourse with men during the previous 6 months. However, only 15% perceived they are at risk for HIV and many had misconceptions about HIV transmission routes and limited knowledge about condoms. Less than one quarter obtained free condoms (24%) and condom lubricants (19%) in the past 2 years. Multiple logistic regression analysis showed that unprotected insertive anal intercourse was associated with not having a Beijing residence card, having six or more male sexual partners, not having sex with women, having a lifetime history of sexually transmitted diseases (STDs), and having never tested for HIV. Unprotected receptive anal intercourse was independently associated with having six or more male sexual partners, not having sex with women, having a lifetime history of STDs, having never tested for HIV, and having less exposure to HIV prevention services. In addition, 28% reported having sex with both men and women during the previous 6 months, and 11% had unprotected intercourse with both men and women. This finding suggests that MSM are a potential bridge of HIV transmission to heterosexual women (or vice versa) and that addressing the HIV prevention needs of MSM may benefit the wider population.     

Patterns of Self-reported Behaviour Change Associated with Receiving Voluntary Counselling and Testing in a Longitudinal Study from Manicaland, Zimbabwe

Voluntary counselling and testing (VCT) is promoted as a potential HIV prevention measure. We describe trends in uptake of VCT for HIV, and patterns of subsequent behaviour change associated with receiving VCT in a population-based open cohort in Manicaland, Zimbabwe. The relationship between receipt of VCT and subsequent reported behaviour was analysed using generalized linear models with random effects. At the third survey, 8.6% of participants (1,079/12,533), had previously received VCT. Women who received VCT, both those positive and negative, reduced their reported number of new partners. Among those testing positive, this risk reduction was enhanced with time since testing. Among men, no behavioural risk reduction associated with VCT was observed. Significant increases in consistent condom use, with regular or non-regular partners, following VCT, were not observed. This study suggests that, among women, particularly those who are infected, behavioural risk reduction does occur following VCT.     

2010-2012年武汉市某艾滋病VCT门诊数据分析

目的对近3年来武汉市某艾滋病自愿咨询检测（VCT）门诊的数据进行分析,为完善VCT服务,为求询者提供更好的健康教育提供依据。方法收集武汉市某VCT示范门诊2010-2012年的数据,对求询者的一般人口学资料、高危因素及HIV和梅毒抗体初筛结果进行统计分析。结果 3年总求询者为3148人,进行艾滋病病毒（HIV）检测3048人,检测率为96.8%,HIV阳性124人,阳性率为4.1%;梅毒检测2529人,梅毒阳性142人,阳性率为5.6%。结论 VCT门诊求询者HIV、梅毒检测率较高,但还应提高VCT服务质量和水平,加大对全人群的艾滋病防治知识宣传力度,控制性传播疾病向普通人群蔓延。     

Voluntary counselling and testing sites as a source of sentinel information on HIV prevalence in a concentrated epidemic: a pilot project from Indonesia

A new system for monitoring HIV voluntary counselling and testing (VCT) outcomes was established in 2007 at seven VCT clinics in Jakarta and Bali, Indonesia. Counsellors collected demographic and risk information from VCT clients. Logistic regression was used to determine factors associated with HIV infection. In 15 months, HIV prevalence in 5569 new clients without HIV symptoms was 63.3% in injecting drug users (IDUs) (n = 783), 7.7% in female sex workers (n = 1437), 31.6% among transgender people (n = 395), 9.3% in men who have sex with men (n = 268), 13.5% in clients of sex workers (n = 643), 21.1% in people with high-risk partners (n = 569) and 3.2% in other VCT clients (n = 822). Among IDUs, being older, tested though outreach, tested due to being 'at risk' and having injected for one or more years were independently associated with HIV infection. This network confirmed high HIV prevalence among IDUs and transgender people. HIV prevalence estimates were consistent with serosurveys.     

Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs

This study aimed to describe the prevalence and predictors for male partner participation in HIV voluntary counselling and testing (VCT) at two primary healthcare clinics in Moshi urban, Tanzania as well as the effect of partner participation on uptake of HIV perinatal interventions. Pregnant women (n = 2654) in their third trimester, participating in a prevention of mother to child tranmission (PMTCT) program between June 2002 and March 2004 were encouraged to inform and invite their partners for HIV-VCT. Trained nurses conducted pre-test counselling, interviews, clinical examinations and blood sampling from the participating women and their partners. Test results were presented and post-test counselling was conducted individually or in couples, depending on the wishes of the participants. Three-hundred-and-thirty-two male partners (12.5%) came for HIV-VCT. A high proportion (131; 40%) came after the woman had delivered. HIV-seropositive women whose partners attended were three times more likely to use Nevirapine prophylaxis, four times more likely to avoid breastfeeding and six times more likely to adhere to the infant feeding method selected than those whose partners didn't attend. Women were more likely to bring their partner for VCT if they collected their own test results, were living with their partner, had a high monthly income and had expressed at enrolment the intention to share HIV results with their partner. Although PMTCT programs are presumably a good entry point for male involvement in prevention of sexual and perinatal HIV transmission, this traditional clinic-based approach reaches few men. Given the positive influence male participation has on the acceptance of perinatal interventions, a different approach for promoting male participation in VCT is urgently required. Within PMTCT programs, counseling should emphasize the advantages of partner participation to encourage women to inform and convince male partners to come for VCT. Also, promotion of couple VCT outside antenatal settings in male friendly and accessible settings should be given priority.     

Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment

Objective To describe the associations between socio‐demographic, behavioural and clinical characteristics and the use of HIV voluntary counselling and testing (VCT) services among residents in a rural ward in Tanzania. Methods Eight thousand nine hundred and seventy participants from a community‐based cohort were interviewed, provided blood for research HIV testing, and were offered VCT. Univariate and multivariate logistic regression was used to identify socio‐demographic, clinical and behavioural factors associated with VCT use. Results Although 31% (1246/3980) of men and 24% (1195/4990) of women expressed an interest in the service, only 12% of men and 7% of women subsequently completed VCT. Socio‐demographic factors, such as marital status, area of residence, religion and ethnicity influenced VCT completion among males and females in different ways, while self‐perceived risk of HIV, prior knowledge of VCT, and sex with a high‐risk partner emerged as important predictors of VCT completion among both sexes. Among males only, those infected with HIV for 5 years or less tended to self‐select for VCT compared to HIV‐negatives (adjusted odds ratio = 1.43; 95% CI: 0.99–2.14). This contributed to a higher proportion of HIV‐positive males knowing their status compared to HIV‐positive females. Conclusions In this setting, a disproportionate number of HIV‐positive women are failing to learn their status, which has implications for equitable access to onward referral for care and treatment services. Evidence that some high‐risk behaviours may prompt VCT use is encouraging, although further interventions are required to improve knowledge about HIV risk and the benefits of VCT. Targeted interventions are also needed to promote VCT uptake among married women and rural residents.     

Characteristics of Individuals and Couples Seeking HIV-1 Prevention Services in Nairobi, Kenya: The Voluntary HIV-1 Counseling and Testing Efficacy Study

This paper describes the recruitment and baseline characteristics of men, women, and couples who enrolled in the Voluntary Counseling and Testing Efficacy Study at the study site in Nairobi, Kenya. The purpose of this study was to test the effectiveness of Voluntary HIV Counseling and Testing (HIV VCT) to reduce sexual risk behavior. Between June 1995 and March 1996, 500 individual men, 500 individual women, and 515 couple members were recruited for a total sample of 1,515 participants. Participants were young (average age 29 years) and of low income. High levels of risk behavior and self-reported STD symptoms and a high rate of HIV seropositivity among those tested at baseline (15% of men and 27% of women) indicate that an at-risk sample was recruited. Women and participants reporting symptoms of a sexually transmitted infected were significantly more likely to be infected with HIV. Findings suggest that HIV VCT services combined with STD diagnosis and treatment and economic development services could motivate more at-risk individuals and couples to receive counseling and testing.     

2008-2011年上海市长宁区VCT情况分析

目的分析上海市长宁区艾滋病自愿咨询检测（VCT）人群相关情况,以及艾滋病病毒（HIV）抗体检测和部分人群梅毒检测结果,为今后艾滋病性病防治干预工作提供科学的依据。方法搜集2008-2011年上海市长宁区疾病预防控制中心VCT门诊求询者的基本信息,以及HIV抗体及部分求询者梅毒检测结果等资料进行统计学分析。结果 2008-2011年,长宁区疾病预防控制中心VCT门诊接受咨询检测服务共计3 382人,求询者男女性别比为11.6∶1;求询者以25～44岁的青壮年人群为主,占66.74%（2 257/3 382）。求询者均有性接触史（非婚异性性行为、男男性行为、配偶/固定性伴阳性）,且男男性行为人群（MSM）比例呈逐年上升趋势。求询者中曾经接受过HIV抗体检测所占比例总体呈上升趋势（z=18.854,P〈0.000 1）;2008-2011年,96.24%（3 255/3 382）的求询者接受了HIV抗体检测,且阳性率呈逐年升高的趋势（z=5.680 5,P〈0.000 1）。HIV抗体阳性人群中,配偶/固定性伴阳性者及MSM人群阳性率较高,分别为10.53%（8/76）、7.45%（89/1 195）,其中MSM人群HIV抗体阳性率总体呈上升趋势。同时接受HIV和梅毒抗体检测的1 713名求询者中,梅毒抗体阳性人群的HIV阳性率为24.62%（16/65）,梅毒抗体阴性人群的HIV抗体阳性率为4.49%（74/1 648）,两者之间的差异有统计学意义（χ2=50.88,P〈0.000 1）。结论今后的工作重点在于加强对配偶/固定性伴阳性者的知识宣传和行为干预,尽早发现感染者,减少二代传播;MSM人群的干预以及其阳性感染者获得很好的后续服务及管理,也是今后干预工作的一项重要内容。