2016年中国孕产妇艾滋病病毒感染空间分布特征  

HIV epidemic among pregnant women in China, 2016： trend and spatial analysis

作　　者：姜金茹 周玉博[1] 李宏田[1] 高燕秋[2] 张亚黎[1] 罗树生[2] 康楚云[2] 刘建蒙[1] Jiang Jinru;Zhou Yubo;Li Hongtian;Gao Yanqiu;Zhang Yali;Luo Shusheng;Kang Chuyun;Liu Jianmeng(Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health~Office for National Maternal and Child Health Statistics of Chin;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学生育健康研究所/国家卫生健康委员会生育健康重点实验室刊北京大学公共卫生学院全国妇幼卫生年报办公室/北京大学公共卫生学院流行病与卫生统计学系,100191 [2]北京大学公共卫生学院全国妇幼卫生年报办公室/北京大学公共卫生学院妇女与儿童青少年卫生学系

出　　处：《中华医学杂志》2018年第41期3360-3364,共5页National Medical Journal of China

基　　金：全国妇幼卫生年报项目（2017和2018年度）

摘　　要：目的描述2016年中国孕产妇艾滋病病毒（HIV）感染的空间分布特征，为预防艾滋病母婴传播工作提供科学依据。方法产妇数和孕产妇HIV感染资料来自全国妇幼卫生年报；纳入县（区）2964个，形成包括344个地市的数据集。计算地市别孕产妇HIV感染率，采用空间自相关和趋势分析揭示空间分布特征。结果2016年研究地区分娩产妇14879082人，HIV感染者5051人，HIV感染率34．0／10万。HIV感染率呈南高北低，由西（93．5／10万）向东（8．6／10万）递减，西部是东部的11倍（χ^2趋势=68．61，P〈0．01）。从省份来看，云南、新疆、四川、广西、贵州和重庆6个西部省份的感染率〉50．0／10万，其产妇占比为2l％，感染人数占比却高达76％。从地市来看，感染率〉100．0／10万的地市有30个，其中28个分布在上述西部省份。HIV感染率的全局莫兰指数（Moran’s，）为0．5（P〈0．01），提示存在较强的空间聚集性；热点分析进一步揭示，新疆中西部地区、云南及其毗邻省份（四川、贵州、广西和重庆）的部分区域是高发聚集的“热点区域”（183．6／10万），东部省份以及中部偏东的部分区域属于低发的“冷点区域”（8．1／10万），热点区域的感染率是冷点区域的23倍。结论2016年中国孕产妇HIV感染率处于国际较低水平，但地区差异显著、有明显的空间聚集性，新疆中西部、云南和毗邻的川黔桂渝的部分区域是预防艾滋病母婴传播工作的重点地区，宜分析成因制定有针对性的综合防控措施。Objective To describe the spatial distribution characteristics of the HIV prevalence among pregnant women in China's Mainland in 2016, providing scientific evidence for the prevention of mother-to-child transmission of HIV. Methods Data on pregnant women and those living with HIV in 2016 for all counties in China's Mainland is from the National Maternal ＆ Child Health Statistics dataset. To obtain robust estimates, 2 964 counties were merged into 344 cities. Spatial autocorrelation analysis and trend analysis were performed based on the city-level dataset to detailedly describe the characteristics of the spatial distribution. Results A total of 14 879 082 pregnant women were ineluded in the analysis, among whom 5 051 were diagnosed to be infected with HIV, giving an overall prevalence of 34. 0 per 100 000 pregnant women. The prevalence was higher in the south than in the north, and decreased from the west （93.5/100 000） to the east（8. 6/100 000 ） , more specifically, the prevalence in the West region was 11 2 times as high as that in the East region（ χ^2tread = 68.61, P 〈 0. 01 ）. Stratified analysis by provinces showed that there were 6 provinces whose prevalence was 〉 50. 0 per 100 000, and they （ Yunnan, Xinjiang, Sichuan, Guangxi, Guizhou and Chongqing） were all located in the West Region; pregnant women in these provinces accounted for 21% of all pregnant women, but the HIV cases accounted for 76% of all cases diagnosed in China's Mainland. Stratified analysis by cities showed that there were 30 cities whose prevalence was 〉 100. 0 per 100 000, and 28 of these cities were also located in the western provinces above. Furthermore, the global Moran＇s I （0. 5, P 〈 0. 01 ） indeed indicated a strong clustered distribution across China's Mainland; 2 hot spots were observed in the Midwest of Xinjiang, and Yunnan and its bordering areas （Sichuan, Guizhou, Guangxi and Chongqing）, while 1 cold spot in the central and east China. The HIV prevalence in the hot spots （183.6/100 000�

关 键 词：HIV 孕产妇 空间分析 

分 类 号：R714.251[医药卫生—妇产科学]