南宁市基层艾滋病综合防控工作模式可推广性和可持续性研究  

Study on popularization and sustainability of comprehensive prevention and control mode of AIDS at grass-roots level in Nanning City

作　　者：农丽萍[1] 何波[1] 汤洪洋[1] 黎火佳 林倩[1] 姚敏[1] 李斯斯[1] 吴敬兰 农梦妮 许秀东[1] 覃威翱 NONG Li-ping;HE Bo;TANG Hong-yang;LI Huo-jia;LIN Qian;YAO Min;LI Si-si;WU Jing-lan;NONG Meng-ni;XU Xiu-dong;QIN Wei-ao(Department of STD and AIDS Prevention and Control,Nanning City Center for Disease Control and Prevention,Nanning Guangxi,530021,China;Institute Office,Health Supervision Institute of Guangxi Zhuang Autonomous Region)

机构地区：[1]南宁市疾病预防控制中心性病与艾滋病防制科,广西南宁530023 [2]广西壮族自治区卫生监督所办公室,广西南宁530021

出　　处：《职业与健康》2021年第15期2089-2095,共7页Occupation and Health

基　　金：广西卫生健康委员会科研课题(Z20190631,Z20200419)。

摘　　要：目的评价南宁市基层艾滋病(acquired immune deficiency syndro,AIDS)综合防控(艾防)工作模式的效果及可推广性和可持续性,探讨影响该工作模式可推广性和可持续性的因素,为更好地指导开展基层艾防工作提供参考。方法定量研究比较南宁市基层艾防工作模式推广前、中和后3个时期新报告人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者和AIDS患者(HIV感染/AIDS患者)一定时间段内随访CD4检测(随访检测)率、抗病毒治疗(antiviral therapy,ART)比例、死亡率和暗娼人群干预与阳性暗娼接受ART情况。采用面对面小组访谈的方法对相关工作人员进行调查,并对收集到的资料进行归纳总结。结果南宁市实施基层艾防工作模式后新发现病例及时随访检测率和及时ART率分别由2017年推广前的97.6%和77.8%提升到2019年推广后的99.2%和86.5%,均呈现逐期逐年上升的趋势,差异均有统计学意义(均P<0.01);病例在确证后1个月内死亡率由2017年推广前的2.4%下降到2018年推广期的1.6%,再提升到2019年推广后的3.2%,出现波动现象,差异有统计学意义(P<0.05)。病例报告当年内随访检测率始终保持在较高的水平(≥99%),ART比例由2017年推广前的74.2%提升到2019年推广后的84.6%,呈现逐期逐年上升的趋势(P<0.01);死亡率由2017年推广前的5.4%下降到2018年推广期的5.2%,再提升到2019年推广后的7.2%,出现波动现象,差异有统计学意义(P<0.01)。暗娼人群HIV检测率由2017年推广前的92.95%提升到2018年推广期的98.97%,再下降到2019年推广后的95.48%,出现波动现象,差异有统计学意义(P<0.01);暗娼人群HIV阳性率由2017年推广前的1.06%下降到2019年推广后的0.87%,但差异无统计学意义(P>0.05);HIV阳性暗娼发现当年接受ART和商业性行为每次坚持使用安全套的比例分别由2017年推广前的45.83%和90.11%提升到2019年推广后的88.24%和92.88%,均呈现逐期逐年上升的趋势,�Objective To evaluate the effectiveness,popularization and sustainability of the comprehensive prevention and control of Acquired Immune Deficiency Syndrome(AIDS)(hereinafter referred to as "AIDS prevention") work mode at the grass-roots level in Nanning City,explore the factors influencing the popularization and sustainability of the work mode,so as to provide reference for better guiding the grass-roots AIDS prevention and control work. Methods The rate of CD4 detection in follow-up(hereinafter referred to as "follow-up detection"),the rate of antiviral therapy(ART),the mortality rate,and the intervention of female sex workers and the acceptance of ART by positive female sex workers among human immunodeficiency virus(HIV) and and AIDS patients(HIV/AIDS patients) before,during and after the promotion of Nanning grassroots AIDS prevention work mode were analyzed by the quantitative research and comparison. Using face-to-face group interviews,the relevant staff were investigated,and the collected data were summarized. Results After the implementation of grassroots AIDS prevention mode in Nanning City,the timely follow-up detection rate and the timely ART rate of newly found cases increased from 97.6% and 77.8%before the promotion in 2017 to 99.2% and 86.5% after the promotion in 2019,respectively,showing an increasing trend year by year(all P<0.01),and the differences were statistically significant(all P<0.01). The mortality rate of the cases within one month after confirmation decreased from 2.4% before promotion in 2017 to 1.6% during promotion in 2018,and then increased to 3.2%after promotion in 2019,with fluctuations,and the difference was statistically significant(P<0.05). The follow-up detection rate of the cases in the current year has always remained at a high level (≥99%). The proportion of ART increased from 74.2% before promotion in 2017 to 84.6% after promotion in 2019,showing a trend of increasing year by year(P<0.01),and the difference was statistically significant(P<0.01). The mortality rate decre

关 键 词：基层 艾滋病防控模式 效果评价 

分 类 号：R183[医药卫生—流行病学]