贵港市非在治HIV/AIDS患者流行病学特征及未治疗原因分析  

Epidemiological characteristics and reasons for HIV/AIDS patients not receiving antiviral therapy in Guigang City

作　　者：徐月香[1] 覃凤翔 梁贤君 黄运轩[1] 覃春伟[1] 徐志良[1] 邓本本 梁浩 Xu Yuexiang;Qin Fengxiang;Liang Xianjun;Huang Yunxuan;Qin Chunwei;Xu Zhiliang;Deng Benben;Liang Hao(Guigang Center for Disease Control and Prevention,Guigang 537100,China;School of Public Health&Guangxi Key Laboratory of AIDS Prevention and Control,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]贵港市疾病预防控制中心,贵港537100 [2]广西医科大学公共卫生学院广西艾滋病防治研究重点实验室,南宁530021

出　　处：《广西医科大学学报》2021年第9期1806-1812,共7页Journal of Guangxi Medical University

基　　金：贵港市科学研究与技术开发计划项目-科技创新能力建设(No.1903004);广西重点研发计划(No.桂科AB18050022)。

摘　　要：目的:了解贵港市非在治人类免疫缺陷缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者流行病学特征及其未开展治疗原因,为提高抗病毒治疗覆盖率及治疗依从性等提供理论依据。方法:由经过培训的调查人员使用自行制定的《健康调查问卷》,对贵港市1996年5月10日至2019年12月31日未进行抗病毒治疗的HIV/AIDS患者进行健康调查。结果:2012~2020年贵港市HIV/AIDS患者未治疗率呈波动现象,2020年的未治疗率为9.09%。1 315例非在治患者,以汉族中老年男性为主。未治疗的主要原因以社会因素居多(48.4%),其次为心理因素(35.1%)和生物因素(16.5%)。与因生物因素为主要未治疗原因的患者相比,年龄在30~49岁(以≥50岁为参照,OR=3.082,95%CI:1.962~4.841)、未婚(以已婚/同居为参照,OR=1.970,95%CI:1.128~3.411)的患者更可能因为社会因素影响而不治疗;现居住于桂平市(OR=2.896,95%CI:1.789~4.688)和平南县(OR=1.901,95%CI:1.094~3.302)(以居住于贵港市辖三区为参照)、疾病阶段处于HIV阶段(以AIDS阶段为参照,OR=1.833,95%CI:1.084~3.099)的患者更可能因为心理因素影响而不治疗。结论:贵港市HIV/AIDS患者未治疗的主要原因为社会因素。可根据未治疗人群的特征,构建提高患者治疗率的生物—心理—社会因素综合干预模型,以全面提高贵港市治疗覆盖率,降低病死率。Objective: To investigate the epidemiological characteristics and the reasons for not receiving antiretroviral treatment(ART) of human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS) patients in Guigang city, and to provide theoretical basis for improving the coverage rate of antiviral treatment and treatment compliance. Methods: Face to face interviews were conducted among untreated HIV/AIDS patients in Guigang city from May 10, 1996 to December 31, 2019 by trained investigators using self-developed health questionnaire. Results: The untreated rate of HIV/AIDS patients in Guigang city fluctuated from 2012 to2020, and the untreated rate was 9.09% in 2020. A total of 1,315 untreated HIV/AIDS patients were investigated in this study. The subjects were identified as mainly Han nationality, medium-elderly male. Social factors were the main reasons(48.4%), followed by psychological factors(35.1%) and biological factors(16.5%) for not receiving ART. When compared with the subjects who not receiving ART due to biological factors, subjects age 30-49 year-old(referring to ≥50 year-old, OR=3.08, 95% CI: 1.96-4.84), unmarried(referring to married/cohabiting,OR=1.97, 95%CI: 1.14-3.41) were more likely to not be treated due to social factors. However, subjects living in Guiping city(OR=2.90, 95% CI:1.79-4.69) and Pingnan County(OR=1.90,95% CI: 1.09-3.30)(referring to the three districts of Guigang City), in HIV disease stage(referring to AIDS disease stage, OR=1.83,95%CI:1.08-3.10) were more likely to not be treated due to psychological factors. Conclusion: Social factors were the main reasons for HIV/AIDS patients not receiving ART in Guigang. According to the characteristics of the untreated population, a comprehensive intervention model of biological-psychological-social factors can be constructed to improve the ART rate of HIV/AIDS patients, so as to comprehensively improve the treatment coverage rate and reduce the case fatality rate in Guigang city.

关 键 词：HIV AIDS 艾滋病 抗病毒治疗 非在治 

分 类 号：R181.81[医药卫生—流行病学]