云南省孕产妇孕早期艾滋病病毒检测状况及影响因素分析  

HIV detection status and its influencing factors among pregnant women in early trimester in Yunnan Province

作　　者：李新毅[1] 郭光萍[1] 李燕[2] 张燕[1] 郑佳瑞[1] 周德 郑敏[1] LI Xin-yi;GUO Guang-ping;LI Yan;ZHANG Yan;ZHENG Jia-rui;ZHOU De;ZHENG Min(Yunnan Maternal and Child Health Care Hospital,Kunming 650021,China)

机构地区：[1]云南省妇幼保健院,云南昆明650021 [2]昆明医科大学,云南昆明650504

出　　处：《中国健康教育》2022年第3期228-232,268,共6页Chinese Journal of Health Education

基　　金：国家“十三五”科技重大专项:多民族边境地区消除艾滋病母婴传播策略研究与卫生经济学分析(2018ZX10715006-004);云南省母婴阻断研究中心课题(2014NS370);云南省卫生健康委学科带头人培养项目(D-2019005)。

摘　　要：目的 了解云南省艾滋病病毒(HIV)感染产妇孕早期HIV抗体检测情况及影响因素,为制定消除艾滋病母婴传播政策提供科学依据。方法 2012年1月至2016年6月,云南省所有孕期保健及助产医疗机构常规为首次到院产检的孕产妇提供HIV检测,并对发现HIV感染的孕产妇使用《艾滋病感染孕产妇个案卡》收集相关信息。使用描述性研究方法分析孕产妇HIV首次检测的孕期分布情况,趋势χ^(2)检验比较HIV感染孕产妇与全孕产妇人群的孕早期检测率,χ^(2)检验和多因素Logistic回归分析影响HIV感染孕产妇孕早期HIV检测的因素。结果 共有5086例HIV感染孕产妇纳入研究,HIV感染孕产妇孕早期HIV抗体检测率为40.1%(2041例),HIV感染孕产妇孕早期HIV抗体检测率呈逐年升高趋势(χ^(2)=81.787,P<0.001),多因素Logistic回归分析结果显示:产妇年龄21~岁组(aOR=1.503,95%CI:1.236~1.937)和≥35岁组(aOR=1.313,95%CI:0.820~2.101)、产妇彝族(aOR=1.271,95%CI:1.082~1.492)及其他少数民族(aOR=1.651,95%CI:1.225~2.225)、产妇文化程度为小学(aOR=0.504,95%CI:0.385~0.661)、配偶民族为彝族(aOR=1.381,95%CI:1.163~1.639)、配偶文化程度小学(aOR=0.711,95%CI:0.513~0.987)、初中(aOR=0.739,95%CI:0.601~0.909)、高中及以上(aOR=0.798,95%CI:0.664~0.960)、配偶职业为在家及待业(aOR=1.360,95%CI:1.178~1.569)、产妇本次妊娠前感染知晓情况(aOR=0.326,95%CI:0.272~0.391)是HIV感染孕产妇早期检测的影响因素。云南省16市(州)间HIV感染产妇孕早期检测率差异有统计学意义(χ^(2)=200.503,P<0.001)。结论 2012—2016年间云南省HIV感染孕产妇孕早期检测率呈逐年升高趋势,但仍存在地区、人群差异,在贫困地区、少数民族地区开展针对性健康教育,可进一步提高孕产妇早期检测率。Objective To investigate the status of HIV detection in pregnant women in early trimester and its influencing factors in Yunnan province. Methods The duration of study was from January 2012 to June 2016.Pregnant women who first came to visit hospital were routinely provided HIV test at all health and midwifery facilities in Yunnan Province.Among them, information on pregnant women tested positive for HIV were collected using the HIV-infected Maternal Case Card.Descriptive analyses were used to analyze the distribution of pregnancy in the first prenatal examination.Trend χ^(2) analyses were used to compare the detection rate of early trimester pregnancy of HIV-infected women with the total pregnant women.χ^(2) analyses and multivariate logistic regression were used to analyze the factors affecting detection rate of early trimester pregnancy. Results A total of 5086 HIV-infected women were investigated.The detection rate of early trimester pregnancy of HIV-infected women was 40.1%(2041 cases). The detection rate of early trimester pregnancy of HIV infected pregnant women was increasing year by year significantly(χ^(2)=81.787,P<0.001). The results of multivariate logistic regression showed that influencing factors were HIV infected women′s age 21-group(aOR=1.503,95%CI:1.236-1.937)and ≥35 group(aOR=1.313,95%CI:0.820-2.101),Yi nationality(aOR=1.271,95%CI:1.082-1.492),other ethnic minorities(aOR=1.651,95%CI:1.225-2.225),education level is elementary school(aOR=0.504,95%CI:0.385-0.661),spouse of HIV infected women is Yi nationality(aOR=1.381,95%CI:1.163-1.639),education level elementary school(aOR=0.711,95%CI:0.513-0.987),junior high school(aOR=0.739,95%CI:0.601-0.909),high school and above(aOR=0.798,95%CI:0.664-0.960),spouse′s occupation is at home and unemployed(aOR=1.360,95%CI:1.178-1.569),and HIV infected women awareness of infection before pregnancy(aOR=0.326,95%CI:0.272-0.391). The detection rate of early trimester pregnancy in 16 states(cities)of Yunnan province was statistically significant(χ^(2)=200.5

关 键 词：HIV感染产妇 孕早期 HIV检测 

分 类 号：R193[医药卫生—卫生事业管理]