2021—2022年河南省非性行为HIV暴露后预防人群特征及预防用药及时性影响因素  

Characteristics and influencing factors of the timely medication of nonsexual HIV post-exposure prophylaxis in Henan Province,2021-2022

作　　者：徐亚珂 王奇[1] 梁妍[1] 施建春 张玮钰 张国龙 XU Yake;WANG Qi;LIANG Yan;SHI Jianchun;ZHANG Weiyu;ZHANG Guolong(Institute of STD/AIDS Prevention and Control,Henan Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心性病艾滋病防治研究所,河南郑州450016

出　　处：《现代疾病预防控制》2024年第10期732-735,749,共5页MODERN DISEASE CONTROL AND PREVENTION

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220167)。

摘　　要：目的了解河南省非性行为HIV暴露后预防人群特征,探究暴露后预防用药及时性影响因素。方法收集并分析2021—2022年河南省14家HIV暴露前后预防服务门诊接受艾滋病病毒暴露后预防(PEP)服务的职业人群和大众非性行为暴露人群个案,包括暴露者基本情况、暴露源类型、暴露损伤方式、暴露源HIV感染情况、暴露至用药时间及相关知识知晓情况等。结果2021—2022年,河南省HIV暴露前后预防门诊累计对169例暴露者开展了用药阻断服务,其中职业暴露人群56例(医务人员53例,警察3例),大众人群113例。暴露源为HIV阳性者119例,占70.41%(119/169);暴露源以血液为主,占88.76%;职业人群暴露方式以锐器损伤为主,占53.57%(30/56)。不同人群的暴露源HIV感染状况及暴露损伤方式均不同(χ^(2)值分别为14.640、15.723,P均<0.05)。职业人群在暴露后2 h内的用药比例为68.0%,高于大众人群的32.0%(χ^(2)=16.365,P<0.05)。暴露源为HIV阳性者在2 h内及2~24 h内服用阻断药的比例(84.0%、75.47%)均高于暴露源感染状况未知者(8.0%、20.76%)(χ^(2)值分别为7.791、6.100,P均<0.05)。职业人群在就诊前对PEP知识知晓率及服药期间依从性均高于大众人群(χ^(2)值分别为13.393、8.685,P均<0.05)。与暴露源感染状况未知相比,暴露源为HIV阳性的暴露者(OR=0.314,95%CI:0.131~0.752)更倾向于及早服药。结论进一步规范HIV职业暴露处置流程;扩大HIV检测,提高大众人群暴露源HIV检测率,缩短暴露至用药时间,有助于提升阻断效果。Objective To investigate the characteristics of non-sexual HIV post-exposure prophylaxis(PEP)and explore factors affecting the timeliness of PPEP initiation in Henan Province.Methods Data from 2021 to 2022 on non-sexual HIV exposure cases in 14 pre-and post-exposure prophylaxis service clinics in Henan Province were collected and analyzed.The analysis included information of exposed individuals,exposure sources,modes of exposure,HIV status of exposure sources,and timing and knowledge regarding PEP.Results From 2021 to 2022,a total of 169 patients accessed drug-blocking services,including56 occupational(53 medical workers,3 police officers)and 113 general population cases.HIV-positive exposure sources were reported in 119 cases(70.41%),with the blood being the primary source 88.76%.Occupational exposure primarily occurred via sharp instrument injury(53.57%,30/56).Significant differences were observed in HIV infection status(χ^(2)=14.640,P<0.05)and injury modes(χ^(2)=15.723,P<0.05)among populations.The occupational population(68.0%)had a higher rate of accessing drugblocking services within 2 hours post exposure compared to the general population(32.0%)(χ^(2)=16.365,P<0.05).Individuals exposed to HIV-positive sources were more likely to initiate PEP within 2 hours(84.0%)and 2-24 hours(75.47%)compared to those with unknown exposure status(8.0%,20.76%,respectively)(χ^(2)values were 7.791 and 6.100,respectively,and all P<0.05).Comparing with general population,occupational individuals had higher awareness of PEP prior to drug intake(χ^(2)=13.393,P<0.05)and better compliance during treatment(χ^(2)=8.685,P<0.05).HIV-positive exposed individuals were more likely to initiate early medication than those unknown exposure status(OR=0.314,95%CI:0.131-0.752).Conclusions Standardizing the treatment process of occupational HIV exposure and expanding HIV testing are critical to improve the public HIV detection rate,reduce the time from exposure to medication,and enhance efficacy of PEP.

关 键 词：艾滋病 职业人群 非性行为暴露 HIV暴露后预防 影响因素 

分 类 号：R512.91[医药卫生—内科学]