南宁市HIV暴露儿童失访情况及相关因素分析  

Status and factors related to loss to follow-up among HIV-exposed children in Nanning

作　　者：毛良勤[1] 言京礼[1] 蒋武[1] 李江恒 MAO Liangqin;YAN Jingli;JIANG Wu;LI Jiangheng(Nanning Maternal and Child Health Hospital,Nanning 530000,Guangxi,China)

机构地区：[1]南宁市妇幼保健院,南宁530000

出　　处：《中国艾滋病性病》2024年第5期493-496,共4页Chinese Journal of Aids & STD

基　　金：广西卫生健康委员会自筹经费科研课题(Z20211420)。

摘　　要：目的探讨HIV感染产妇所生儿童(HIV暴露儿童)失访的发生情况及影响因素。方法收集2010-2021年南宁市上报的HIV暴露儿童及其父母个案资料,采用趋势χ^(2)检验和Logistic回归模型对儿童失访的变化趋势和影响因素进行分析。结果2010-2021年南宁市HIV暴露儿童1269例,发生失访127例,失访率为10.01%。失访率由2010年的30.10%下降至2021年的0,呈下降趋势(χ_(趋势)^(2)=70.52,P<0.001)。母亲文化程度小学及以下、未婚/同居、流动人口、新发感染、孕早期未检查、产前检查<5次、孕期未进行CD4细胞计数检测、孕期未进行病毒载量检测、母亲未cART、父亲未接受HIV抗体检测者的儿童失访率相对较高(P<0.05)。多因素分析显示,流动人口(a OR=1.87,95%CI:1.22~2.85)、新发现感染(a OR=1.83,95%CI:1.19~2.83)、产前检查<5次(a OR=2.30,95%CI:1.42~3.74)、母亲未抗病毒治疗(a OR=4.47,95%CI:2.62~7.64)、父亲未接受HIV抗体检测(a OR=1.92,95%CI:1.23~2.99)是HIV暴露儿童发生失访的独立危险因素。结论南宁市HIV暴露儿童失访率处于较低水平,但父母预防母婴传播服务利用不足时,其所生儿童失访率较高;充分利用失访的影响因素,采取针对性干预措施,尽可能较少失访。Objective This study aimed to explore the status of and factors related to loss to follow-up among children born to HIV-infected mothers(HIV-exposed children)in Nanning.Methods Data on HIV-exposed children and their parents reported during the period of 2010–2021 in Nanning were collected.The chi-square trend test and logistic regression analysis were conducted to investigate the trend and influencing factors of loss to follow-up among these children.Results Between 2010 and 2021,a total of 1269 HIV-exposed children were reported in Nanning,among whom 127 were lost to follow-up,resulting in an incidence rate of 10.01%.The incidence of loss to follow-up exhibited a decreasing trend,declining from 30.10%in 2010 to 0 in 2021(χ_(trend)^(2)=70.52,P<0.001).Factors associated with a higher incidence of loss to follow-up included mothers with primary school education or below,single or cohabiting status,unsettled residency,recent HIV infection,inadequate prenatal care(less than five visits),lack of CD4^(+)cell count or viral load testing during pregnancy,as well as absence of combination antiretroviral therapy(cART)for the mother and HIV antibody testing for the father(P<0.05).Multivariate analysis revealed that maternal unsettled residency(aOR=1.87,95%CI:1.22-2.85),new HIV infection(aOR=1.83,95%CI:1.19-2.83),fewer than five prenatal visits(aOR=2.30,95%CI:1.42-3.74),lack of antiviral therapy(for the mother aOR=4.47,95%CI:2.62-7.64),and absence of HIV antibody testing for the father(aOR=1.92,95%CI:1.23-2.99)were independent risk factors for loss to follow-up among HIV-exposed children.Conclusions Although the incidence of loss to follow-up among HIV-exposed children in Nanning is currently low,parental non-participation in prevention of mother-to-child transmission services increases the risk of loss to followup in their children.Targeted intervention measures based on these identified risk factors should be implemented to minimize loss to follow-up among HIV-exposed children.

关 键 词：艾滋病病毒暴露儿童 失访 影响因素 母婴传播 

分 类 号：R512.91[医药卫生—内科学]