我国2016-2018年报告HIV/AIDS首次随访后的跨省流动情况和抗病毒治疗效果分析  

Analysis of inter-provincial movement and the effect of antiretroviral therapy of HIV/AIDS cases after first follow up in China,2016-2018

作　　者：韩晶[1] 李健[1] 臧春鹏[1] 刘玉芬[1] Han Jing;Li Jian;Zang Chunpeng;Liu Yufen(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

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：《中华流行病学杂志》2021年第1期126-130,共5页Chinese Journal of Epidemiology

摘　　要：目的分析2016年7月国家免费抗病毒治疗纳入标准调整后报告的HIV/AIDS首次随访后的跨省流动及其抗病毒治疗和病毒抑制情况,了解其流动特征及对抗病毒治疗效果的影响。方法利用艾滋病防治基本信息系统的HIV/AIDS报告及治疗数据,采用描述性分析和χ^(2)检验探讨HIV/AIDS流动与治疗和病毒抑制的关系。结果首次随访后跨省流动HIV/AIDS占7.8%(22426/289218)。男性(8.3%,18557/223713)、高中(9.6%,4317/44877)和大专及以上文化程度(9.5%,4792/45858)、未婚(11.5%,10538/91572)、发现方式为羁押人员检测(16.0%,1268/7927)、通过同性性传播感染(11.4%,9069/79735)的HIV/AIDS跨省流动的比例较高。发生跨省流动的HIV/AIDS诊断1年内接受抗病毒治疗的比例(77.1%,17296/22426)和达到病毒抑制的比例(70.7%,15858/22426)均低于未发生跨省流动的HIV/AIDS(分别为86.7%,231293/266792和78.6%,209760/266792)。首次随访为非户籍省份的HIV/AIDS有41.4%(18887/45570)发生了跨省流动,其中,流动返回户籍省的占92.9%(17538/18887)。首次随访后发生病例流出人数在前5位的省份分别是广东、浙江、上海、北京和四川,病例流入人数在前5位的省份分别是四川、贵州、广东、安徽和湖南。结论HIV/AIDS跨省流动影响其接受抗病毒治疗及病毒抑制。需要进一步关注户籍地与现住址分离的流动人口中HIV/AIDS的发现和管理,消除政策壁垒,确保抗病毒治疗的及时性和有效性。Objective To analyze the interprovincial movement of newly reported HIV/AIDS cases after the first follow up in China and understand their movement characteristics and the effect of antiretroviral therapy(ART)after adjustment of ART inclusion criteria.Methods The data of HIV/AIDS cases,including the effects of ART,were extracted from the information system for HIV/AIDS prevention and control.Descriptive analysis andχ^(2)test was used to explore the characteristics of the movement of HIV/AIDS cases and its relationship with ART effect and viral suppression.Results In 289218 HIV/AIDS cases,22426(7.8%)cases experienced inter-provincial movement after the first follow up.Higher prevalence of inter-provincial movement was found in males(8.3%,18557/223713),those with education level of senior high school(9.6%,4317/44877)and college degree and above(9.5%,4792/45858),the unmarried(11.5%,10538/91572),those diagnosed in detention center(16.0%,1268/7927)and those infected by homosexual behavior(11.4%,9069/79735).The rates of ART initiation within 1 year of diagnosis and viral suppression were lower in HIV/AIDS cases with inter-provincial movement(77.1%,17296/22426 and 70.7%,15858/22426)than in those without inter-provincial movement(86.7%,231293/266792 and 78.6%,209760/266792).After the first follow-up,41.4%(18887/45570)of HIV/AIDS cases diagnosed in non-native provinces experienced inter-provincial movement,of which 92.9%(17538/18887)went back to native province.The top five provinces(municipalities)with outflows of HIV/AIDS cases were Guangdong,Zhejiang,Shanghai,Beijing and Sichuan.The top five provinces with inflows of HIV/AIDS cases were Sichuan,Guizhou,Guangdong,Anhui and Hunan.Conclusions The inter-provincial movement affects ART effect and viral suppression of HIV/AIDS cases.It is necessary to pay more attention to the discovery and management of HIV/AIDS in floating population and eliminate policy barriers to ensure the timeliness and effectiveness of ART.

关 键 词：艾滋病病毒/艾滋病 抗病毒治疗 病毒抑制 随访 跨省流动 

分 类 号：R512.91[医药卫生—内科学]