利用多水平模型探讨HIV/AIDS报告现患率与宏观社会因素关系的研究  

Study on the relationship between HIV/AIDS prevalence and macro-social factors using multilevel statistical model

作　　者：钱莎莎[1] 郭巍[1] 邢健男[1] 王璐[1] 

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《实用预防医学》2014年第1期15-18,共4页Practical Preventive Medicine

基　　金：国家'十二五'科技重大专项(2012ZX10001001)

摘　　要：目的分析和探讨我国HIv／AIDS报告现患率与宏观社会因素的关联。方法收集各省份经济、人口和卫生等社会因素数据资料，利用主成分分析方法提取以上社会因素的综合指标；收集截至2011年底各县区分性别、年龄组的报告现存活HIV／AIDS病例数及人口数，利用两水平负二项分布模型分析县区HIV／AIDS报告现患率与省份宏观社会因素的关系。结果我国男性HIV／AIDS报告现患率（3．56／万人）显著高于女性（1．70／万人），男女问差异有统计学意义（P〈0．05）；20岁以下年龄组HIv／AIDS报告现患率最低（0．24／万人），而20～39岁年龄组最高（4．84／万人）。两水平负二项分布模型分析发现，水平2（省份）单位下各水平1（县区）单位的HIV／AIDS报告现患率存在聚集性，即调整性别和年龄因素后，各省份问HIV／AIIXS报告现患率差异亦有统计学：苣义（δu^2=2．612，P〈0．05）。纳入水平2宏观社会因素变量O进行单因素和多因素分析均发现，人H流动水平高或经济生活水平低（N3）、少数民族人口比例高（M4）、HIV筛检人次数多（M5）与HIV／AIDS报告现患率呈正相关（P〈0．05）。结论我国各地区艾滋病流行形势与其宏观社会因素密切相关，制定艾滋病防治政策时应综合考虑地区的社会背景，做到有的放矢。Objective To explore the relationship between HIV/AIDS prevalence and macroscopic scial factors. Methods The numbers of the reported surviving HIV/AIDS cases and population of different gender and age groups at county level, as well as the data of social economy, demography and health at province level till the end of 2011 were collected. Firstly, extract comprehensive variables of social factors were extracted by principal component analysis, and then their associations with HIV/ AIDS prevalence were explored by two - level negative binomial model. Results The HIV/AIDS prevalence in males （ 3.56 per 10,000 population） was significantly higher than that in females （1.70 per 10,000 population, P 〈 0.05）. The population younger than 20 years had the lowest HIV/AIDS prevalence （0.24 per 10,000 population）, while those aged 20- 39 years had the highest （4.84 per 10,000 population）. The fitted two level negative binomial model showed that HIV/AIDS prevalence da- ta at the county level were clustered in their higher level units or provinces, in other words, there was significant difference be- tween HIV/AIDS prevalence of different provinces after the adjustment of gender and age （δu^ 2= 2. 612, P 〈 0.05）. Univariate and multivariate analysis of macroscopic social factors showed that three comprehensive variables, high level of population mobility or low level of economic living standards（N3）, high proportion of minority population（M4） and large number of HIV screening population（MS）, were significantly positively associated with the HIV/AIIXS prevalence（ P 〈 0.05 ）. Conclusions The epi- demic of HIV is closely associated with macroscopic social factors in different regions in China, and these connections should be taken into account when HIV preventive strategies were planned.

关 键 词：HIV AIDS 宏观社会因素 多水平模型 负二项分布 主成分分析 

分 类 号：R512.91[医药卫生—内科学]