2013—2018年杭州市HIV/AIDS病例检测发现与晚发现影响因素研究  

HIV/AIDS case detection and influencing factors for late diagnosis in Hangzhou from 2013 to 2018

作　　者：罗艳[1] 赵刚[1] 黄思超 罗文杰[1] 李西婷[1] 丁建明[1] LUO Yan;ZHAO Gang;HUANG Sichao;LUO Wenjie;LI Xiting;DING Jianming(Department of AIDS and STDs Prevention and Control,Hangzhou Center for Disease Control and Prevention,Hangzhou,Zhejiang 310021,China)

机构地区：[1]杭州市疾病预防控制中心艾滋病性病防治所,浙江杭州310021

出　　处：《预防医学》2020年第8期757-761,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省医药卫生科技计划项目(2020KY777,2018KY638,2015KYA189);杭州市科技局社会发展项目(20160533B51,20191203B140);杭州市卫生计生科技计划A类项目(2018A81)。

摘　　要：目的了解2013—2018年杭州市艾滋病病毒感染者和艾滋病患者(HIV/AIDS)检测发现与晚发现情况,并分析影响因素,为提高HIV抗体检测发现能力提供依据。方法通过中国疾病预防控制信息系统艾滋病综合防治信息系统收集2013—2018年杭州市HIV抗体检测和新确证HIV/AIDS病例资料,分析不同地区、检测途径、检测机构和重点人群的HIV抗体检测人数和确证阳性情况;采用多因素Logistic回归模型分析新确证HIV/AIDS病例晚发现的影响因素。结果 2013—2018年杭州市HIV抗体检测率、阳性率和晚发现比例均呈上升趋势,年均检测率为24.99%,阳性率为6.95/万,晚发现比例为30.07%。多因素Logistic回归分析结果显示,年龄≥20岁(OR:1.912~5.117,95%CI:1.250~7.904)和男性(OR=1.656,95%CI:1.351~2.030)的晚发现风险较高;受血(制品)前检测(OR=4.429,95%CI:2.217~9.225)、其他就诊者检测(OR=2.137, 95%CI:1.615~2.826)、术前检测(OR=2.137, 95%CI:1.615~2.826)、性病门诊检测(OR=1.359,95%CI:1.007~1.834)较自愿咨询检测的晚发现风险高;疾控中心(OR=0.714,95%CI:0.558~0.915)和社区卫生服务中心(OR=0.645,95%CI:0.441~0.943)较医疗机构检测的晚发现风险低;经异性性接触感染者较经同性性接触感染者的晚发现风险高(OR=1.299,95%CI:1.130~1.493);有性病史者较无性病史者的晚发现风险低(OR=0.818,95%CI:0.706~0.948)。结论 2013—2018年杭州市HIV抗体检测发现力度扩大,但HIV/AIDS病例晚发现比例呈上升趋势;年龄、性别、检测途径和机构、感染途径及性病史是HIV/AIDS病例晚发现的影响因素。Objective To analyze current situation of HIV/AIDS case detection and factors associated with late diagnosis among the newly diagnosed cases from 2013 to 2018 in Hangzhou, so as to provide basis for improving the detection capacity of HIV.Methods The data of HIV testing and newly diagnosed HIV/AIDS cases in Hangzhou from 2013 to2018 were collected through the China AIDS Prevention and Control Information System. The proportion of HIV antibody detection and positive cases in different regions, detection ways and high-risk groups were analyzed. The influencing factors for late diagnosis were analyzed by multivariate logistic regression model.Results The proportions of cases with HIV detected, HIV positive and late diagnosis increased from 2013 to 2018, and the annual ones were24.99%, 6.95 per ten thousand and 30.07%, respectively. The results of the multivariate logistic regression analysis showed that people who were male( OR=1.656, 95%CI: 1.351-2.030) and aged older( OR: 1.912-5.117, 95%CI: 1.250-7.904) had higher risks of late diagnosis;who detected HIV through pre-test of receiving blood( OR=4.429, 95%CI:2.217-9.225), other inpatient detection(OR=2.137, 95%CI: 1.615-2.826), preoperative testing( OR=2.137, 95%CI: 1.615-2.826) and testing of STD clinic attendants( OR=1.359, 95%CI: 1.007-1.834) had higher risks of late diagnosis compared to those diagnosed at VCT clinics;who diagnosed at CDCs( OR=0.714,95%CI: 0.558-0.915) and community health centers( OR=0.645, 95%CI: 0.441-0.943) had lower risks of late diagnosis than those diagnosed in hospitals;who were infected by heterosexual contact( OR=1.299, 95%CI: 1.130-1.493) had a higher risk of late diagnosis than MSM;who had history of STD( OR=0.818, 95%CI: 0.706-0.948) had a lower risk of late diagnosis than who did not.Conclusion sHIV testing and case detection had been expanded, but late diagnosis had not been improved in Hangzhou from 2013 to 2018. Age, sex, route and institution of diagnosis, transmission route and history of STD were influencing factors of late

关 键 词：艾滋病 HIV抗体 检测 晚发现 

分 类 号：R512.91[医药卫生—内科学]