广西部分艾滋病高流行区人类免疫缺陷病毒母婴阻断效果及及时性、依从性研究  

Interventions for prevention of mother-to-child HIV transmission in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region: success rate,timeliness and patient compliance

作　　者：覃寿学 谭健坤 施容光 吴宏燕 农燕丽 程玉清 卢炳炎 QIN Shouxue;TAN Jiankun;SHI Rongguang;WU Hongyan;NONG Yanli;CHENG Yuqing;LU Bingyan(Health Care Department,Guigang Maternal and Children＇s Healthcare Hospital,Guigang,Guangxi Zhuang Autonomous Region,537100;Department of Obstetrics and Gynecology,Guiping Maternal and Children＇s Healthcare Hospital,Guiping,Guangxi Zhuang Autonomous Region,537200;Health Care Department,Pingnan County Maternal and Children＇s Healthcare Hospital,Pingnan,Guangxi Zhuang Autonomous Region,537300;Department of Infectious Diseases,Pingnan People＇s Hospital,Pingnan,Guangxi Zhuang Autonomous Region,537300,China)

机构地区：[1]贵港市妇幼保健院保健部,广西贵港537100 [2]桂平市妇幼保健院妇产科,广西桂平537200 [3]平南县妇幼保健院保健部,广西平南537300 [4]平南县人民医院感染科,广西平南537300

出　　处：《第三军医大学学报》2018年第18期1704-1710,F0003,共8页Journal of Third Military Medical University

基　　金：广西贵港市科学研究与技术开发计划项目(GKC1504041)~~

摘　　要：目的系统评价广西部分高流行区人类免疫缺陷病毒(human immunodeficiency virus,HIV)母婴阻断效果及及时性、依从性,探讨相关影响因素。方法 2011年1月至2017年9月,采取非概率整群抽样和随访观察研究,对广西部分艾滋病高流行区内319例调查对象进行母婴阻断干预,从传播率、及时性和依从性等方面了解HIV母婴阻断效果,采用Logistic回归模型分析接受干预及时性和依从性的相关影响因素。结果继续妊娠HIV感染孕产妇用药率为95.92%(306/319);安全分娩率70.51%(225/319),呈逐年升高趋势(Z=2.03,P=0.042),累计分娩活婴295例;儿童用药率98.31%(290/295),人工喂养率98.64%(291/295),早期诊断率96.20%(152/158),18月龄抗体检测率93.90%(277/295),随访率97.97%(289/295),死亡率1.69%(5/295),失访率4.1%(12/295)。HIV母婴传播率1.06%(校正1.92%)。HIV母婴阻断及时性好率54.86%(175/319),其影响因素包括稳定住址、妊娠意愿、确认时间、艾滋病认知、配偶支持和焦虑情绪。HIV母婴阻断依从性好率52.04%(162/319),其影响因素包括文化程度、稳定住址、产前保健次数、病毒载量、CD4水平、艾滋病认知、配偶支持和焦虑情绪。结论广西贵港市等部分艾滋病高流行区HIV母婴阻断成功率比较高,但母婴阻断及时性及依从性差,服务利用质量有待提高。Objective To systematically evaluate the effect of the interventions for preventing motherto-child HIV transmission and explore the factors affecting the timeliness of these interventions and the patient compliance in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region. Methods Between January,2011 and September,2017,using a non-probability cluster sampling method with follow-up observation,we conducted interventions for preventing mother-to-child HIV transmission in 319 HIV-infected pregnant women in some regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region.The transmission rate,timeliness of administration and compliance with the interventions were assessed to evaluate the effect of these interventions,and a logistic regression model was used to analyze the factors influencing the timeliness of the interventions and the patient compliance. Results The rate of antiviral drug administration was 95. 92%（306/319） in these HIV-infected pregnant women who chose to continue pregnancy. The overall safe delivery rate was 70. 51%（225/319）,and the annual safe delivery rate tended to increase with time（Z = 2. 03,P = 0. 042）. A total of 295 live births were recorded,and 98. 31%（290/295） of the children were given antiviral drugs; the artificial feeding rate was 98. 64%（291/295） in these children; 96. 20%（152/158） of the children received services for early diagnosis and 93. 90%（277/295）were detected for HIV antibody at 18 month. The follow-up rate of the children was 97. 97%（289/295）,with a mortality rate of 1. 69%（5/295） and a loss to follow-up rate of 4. 1%（12/295）. The mother-to-child HIV transmission rate was 1. 06%（1. 92% after correction） in these cases. The rate of optimal timing of the transmission-preventing interventions was 54. 86%（175/319）,and the factors influencing the timeliness of the interventions included stability of address,pregnancy intention,confirmation time,AIDS awareness,spouse support and anxiety. The goo

关 键 词：人类免疫缺陷病毒 孕产妇 母婴阻断 及时性 依从性 

分 类 号：R373.9[医药卫生—病原生物学] R725.129.1[医药卫生—基础医学]