甘肃省2010-2019年新报告HIV/AIDS中晚发现病例的生存状况及影响因素分析  

Influencing Factors of Late HIV Diagnosis and Survival Status of HIV/AIDS Patients in Gansu Province from 2010 to 2019

作　　者：时欣培 李健[1] 余爱玲[1] 王斌[1] 苟伟斌[1] 李彬 SHI Xinpei;LI Jian;YU Ailing;WANG Bin;GOU Weibin;LI Bin(Center for Disease Control and Prevention of Gansu,Lanzhou 730050,China)

机构地区：[1]甘肃省疾病预防控制中心,甘肃兰州730050

出　　处：《中国皮肤性病学杂志》2021年第12期1384-1389,共6页The Chinese Journal of Dermatovenereology

基　　金：2019年甘肃省卫生行业科研计划项目(GSWSKY-2019-95)。

摘　　要：目的分析甘肃省2010-2019年HIV/AIDS新报告病例中晚发现者的生存状况并探究导致晚发现的可能风险因素。方法利用艾滋病综合防治信息系统数据,晚发现病例的生存分析结合Kaplan-Meier法和寿命表法,并通过Log-Rank检验比较不同地区间的生存时间;用二分类非条件Logistic回归探究导致甘肃省HIV/AIDS晚发现的相关影响因素。结果 2010-2019年甘肃省新报告7 365例HIV/AIDS,其中晚发现病例有2 327例,晚发现率为31.60%。2010-2019年甘肃省贫困地区和非贫困地区新报告HIV/AIDS晚发现者的平均生存时间分别是5.77年(95%CI:5.17~6.37)和6.80年(95%CI:6.57~7.05);生存时间差异具有统计学意义(P=0.006)。多因素分析显示,男性、年幼阶段感染(诊断时年龄为0~15岁)、无多种高危行为史、非检测咨询样本来源、贫困地区报告及地区类别非本市是影响甘肃省HIV/AIDS新报告病例晚发现的危险因素。结论减少甘肃省HIV/AIDS晚发现的发生应从加强宣传教育、完善HIV检测手段、促进贫困地区医疗资源可及等方面入手,采取综合性、针对性的措施。Objective To analyze the survival status of newly reported HIV/AIDS patients diagnosed late in Gansu Province from 2010 to 2019 and explore the possible risk factors associated with late HIV/AIDS diagnosis.Methods Based on the AIDS Comprehensive Prevention and Control Information System data, the survival status of late detected cases was analyzed by combining the Kaplan-Meier method and the life table method.The Log-Rank test was used to compare survival time between different regions.The binary unconditional logistic regression was used to explore the factors leading to the late detection of HIV/AIDS in Gansu Province.Results From 2010 to 2019, 7 365 cases of HIV/AIDS were newly reported, of which 2 327 cases were detected late, and the late detection rate was 31.6%.The average survival time of patients with late diagnosis in poor and non-poor areas was 5.8 years(95%CI:5.17~6.37) and 6.8 years(95%CI:6.57~7.05), respectively.There was a statistical difference in survival time between different regions(P=0.006).Multivariate analysis showed that male gender, young age(0~15 years old when diagnosed), no history of multiple high-risk behaviors, lack of testing, living in poor areas, and non-local cities were risk factors for the late diagnosis of HIV/AIDS.Conclusion Comprehensive and targeted measures should be taken to reduce the incidence of late HIV/AIDS detection in Gansu Province, such as strengthening publicity and education, improving HIV testing methods and increasing the access to medical resources in poor areas.

关 键 词：艾滋病 晚发现 生存分析 影响因素 

分 类 号：R512.91[医药卫生—内科学]