2013—2017年四川省凉山彝族自治州入组治疗的HIV感染育龄妇女脱失情况及影响因素  

Antiretroviral therapy drop-out and its influencing factors among HIV-positive women of reproductive age who initiated ART from 2013 to 2017 in Liangshan Prefecture of Sichuan Province

作　　者：任建华 黄小青 黄玉玲 曾亚莉[1] 杨薇[1] 喻航[1] 向成戈 李菊梅 高鑫 刘安然 杨一挥[1] REN Jian-hua;HUANG Xiao-qing;HUANG Yu-ling;ZENG Ya-li;YANG Wei;YU Hang;LI Ju-mei;GAO Xin;LIU An-ran;YANG Yi-hui(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Pidu Center for Disease Control and Prevention,SCFETP-4,Pidu 611730,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041 [2]成都市郫都区疾病预防控制中心,成都611730

出　　处：《预防医学情报杂志》2022年第5期656-661,共6页Journal of Preventive Medicine Information

基　　金：四川省科技计划项目(项目编号:2020YJ0449);四川省疾病预防控制中心科研课题(项目编号:ZX201901)。

摘　　要：目的分析四川省凉山州2013—2017年入组治疗的HIV感染育龄妇女治疗脱失情况及影响因素,为针对性制定防控措施提供参考。方法利用国家艾滋病防治基本信息系统,收集并整理截至2020-12-31凉山州2013—2017年入组治疗的HIV感染育龄妇女的基本情况与治疗信息,采用χ^(2)检验和Logistic回归分析影响治疗脱失的因素。检验水准ɑ=0.05。结果5204例研究对象中,30~39岁占比45.41%,以彝族居多(92.77%),已婚或同居为主(82.42%),异性性传播占77.31%,脱失发生率32.13%(1672/5204),各年度入组治疗的研究对象脱失发生率呈下降趋势(χ_(t趋势)^(2)=343.038,P<0.001)。多因素Logistic回归分析结果显示:彝族(1.588,1.207~2.088)、样本来源为监管场所(2.209,1.658~2.944)、未婚更易发生脱失,初始治疗方案为二线、确证至入组治疗时间≤1月、2014年及以后入组治疗是发生脱失的保护因素。结论2013—2017年,凉山州每年新入组治疗的HIV感染育龄妇女脱失发生率逐年下降。应重点关注彝族、未婚、来源于监管场所等人群,同时,应优化检测发现至入组治疗流程,确保治疗及时性,持续强化依从性教育和关怀,减少脱失,提升治疗效果。Objective To analyze the status of antiretroviral therapy drop-out and its influencing factors among HIV-positive women of reproductive age who initiated ART from 2013 to 2017 in Liangshan Prefecture,Sichuan Province,so as to provide reference for the development of targeted prevention and control measures.Methods The baseline and ART information was collected from HIV/AIDS Comprehensive Response Information Management System by Dec31st.2020.Chi-square tests and logistic regression analysis were used to analyze the influencing factors of antiretroviral therapy drop-out.The significance test level was set asɑ=0.05.Results Among the total of 5204HIV individuals,45.41%of them were 30-39 years,92.77%of them were Yi nationality,and82.42%of them were married or living together,and 77.31%of them were heterosexual transmission.The drop-out rate was 32.13%(1672/5204).From 2013 to 2017,the drop-out rate showed an annual decreasing trend(χ^(2)_(trend)=343.038,P<0.001).The logistic regression analysis showed that Yi nationality(1.588,1.207~2.088),from supervised place(2.209,1.658~2.944),and unmarried were more likely to be drop-out.The protective factors for drop-out included initial second-line ART regiment,treatment time interval within 30 days,and initiate ART in 2014 and beyond.Conclusions In 2013-2017,the drop-out rate is decreasing yearly among HIV-positive women of reproductive.Attention should be paid to those who were Yi nationality,unmarried and from the supervised place.Meanwhile,the process of detection and treatment should be optimized to ensure the timeliness of treatment.Health education on treatment compliancy should be strengthened to decrease the drop-out rate and improve the effect of antiretroviral therapy.

关 键 词：艾滋病 育龄妇女 抗病毒治疗 脱失 影响因素 

分 类 号：R512.91[医药卫生—内科学]