告知与随访对降低HIV/AIDS病人相关危险行为的影响  

Impact of notification and case management on HIV/AIDS related risk behaviors among people living with HIV/AIDS

作　　者：曾亚莉[1] 赖文红[1] 廖强[2] 杨薇[1] 鲁友生 鹿茸[4] 喻航[1] 刘青恋[1] 张灵麟[1] 

机构地区：[1]四川省疾病预防控制中心性病艾滋病防治所,成都610041 [2]凉山州疾病预防控制中心艾滋病防治所,四川西昌615000 [3]盐源县疾病预防控制中心,四川盐源615700 [4]成都市疾病预防控制中心艾滋病防治科,成都610000

出　　处：《中国艾滋病性病》2016年第3期180-184,共5页Chinese Journal of Aids & STD

摘　　要：目的了解告知与随访对降低艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)相关危险行为的影响,为随访管理提供建议。方法分别采用分层抽样和随机抽样法,对四川省5个重点县(区)能随访到的HIV/AIDS病人进行面对面问卷调查,分析既往获得告知、随访服务情况,艾滋病相关危险行为变化及其影响因素等。结果共调查424例HIV/AIDS病人,分别有26.89%(114例)和41.75%(177例)报告对告知、随访服务"非常满意"。通过告知与随访,HIV/AIDS病人最近一个月与配偶/固定性伴安全套坚持使用率从17.41%(51/293)提高至47.91%(103/215)。其中女性、彝族、注射吸毒传播感染、未开展抗病毒治疗以及对随访未达到"非常满意",是与配偶/固定性伴不坚持使用安全套的危险因素;告知与随访后,发生商业性行为、临时性行为的比例分别降低到6.86%(29/423)和18.68%(79/423),最近一次安全套使用率分别升高到75.86%(22/29)和74.68%(59/79);其中同性性传播或注射吸毒传播感染、得知感染HIV的时间较短以及对随访未达到"非常满意",是与临时性伴不使用安全套的危险因素。结论告知与随访能有效降低HIV/AIDS病人的HIV相关危险行为,且令HIV/AIDS病人满意的随访服务能有效地降低其长期传播艾滋病风险。建议因地制宜,探索适宜于当地HIV/AIDS病人需求的随访管理模式。Objective To understand the impact of HIV positive status notification and the case management on HIV/AIDS related risk behaviors among people living with HIV/AIDS（PLWHA）and to provide suggestions on HIV case management services.Methods Stratified sampling and convenient sampling were adopted,and a face-toface questionnaire survey was conducted to know the satisfaction of the notification and case management.HIV/AIDS related risk behaviors change and the influencing factors were analyzed.Results Of 424 PLWHA,26.89%（114）and 41.75%（177）were very satisfactory with the notification and case management services respectively.The consistent condom use with the spouse or the fixed partners increased to 47.91%（103/215）.The potential risk factors of the inconsistent condom use were female,Yi minority,infected HIV by injection drug use,antiretroviralnaive and unsatisfied with case management services.Also the occurrence of the commercial and causal sexual behaviors was reduced to 6.86%（29/423）and 18.68%（79/423）respectively,and the rate of condom use in the last time rose to 75.86%（22/29）and 74.68%（59/79）respectively.The potential risk factors of the condom use with the causal sexual partner included those infected with HIV by homosexual transmission or injection drug use,shorter time of being notified of HIV positive status and being unsatisfied with case management services.Conclusion Notification and case management services can reduce PLWHA＇s HIV/AIDS related risk behaviors,and quality case management services can decrease the long-term risk behaviors effectively.It＇s recommended that case management services should be based on PLWHA＇s demands.

关 键 词：艾滋病病毒感染者/艾滋病病人 告知 随访 危险行为 

分 类 号：R512.91[医药卫生—内科学]