Objective  To systematically evaluate the risk factors for spousal transmission of human immunodeficiency virus (HIV) among single-positive families in China and provide theoretical basis for early intervention.

Methods  Databases including CNKI, WanFang Data, CBM, VIP, PubMed, Web of Science, Embase and The Cochrane Library were searched for studies on the risk factors for spousal transmission of HIV in Chinese single-positive families. The search time limit was from the establishment of the databases to January 15, 2024. Two researchers independently completed the literature search and screening, quality assessment and data extraction process, and RevMan 5.3 software was used for Meta-analysis.

Results  A total of 18 articles were included. The results of Meta-analysis showed that age ≥40 years[OR=0.73, 95%CI (0.54, 0.99), P=0.047], education level [OR=0.49, 95%CI (0.38, 0.63), P<0.001], consistent condom use [OR=0.17, 95%CI (0.09, 0.31), P<0.001], receiving antiretroviral therapy [OR=0.27, 95%CI (0.17, 0.42), P<0.001] and baseline CD4 cell count [OR=0.43, 95%CI (0.31, 0.58), P<0.001] were protective factors for spousal transmission of HIV in single-positive families. The frequency of sexual behavior in the past 6 months [OR=2.31, 95%CI (1.19, 4.50), P=0.014] and transmission route [OR=3.68, 95%CI (1.28, 10.59), P=0.016] were the risk factors for spousal transmission of HIV in single-positive families.

Conclusion  The spousal transmission of HIV in single-positive families is affected by many factors in China. Prevention and control of intervention risk factors can help to reduce the risk of spousal transmission of HIV in single-positive families, reduce the burden on society and family, and promote human health.

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