成都市HIV/AIDS病例晚发现原因分析  

Analysis on the reasons of late diagnosis among HIV/AIDS cases,Chengdu

作　　者：何世娇 何勤英[1] 刘芳[1] 段振华[1] 代珍[1] 施雅莹[1] 王亮[1] HE Shi-jiao;HE Qin-ying;LIU Fang;DUAN Zhen-hua;DAI Zhen;SHI Ya-ying;WANG Liang(Department of Sexually Transmitted Diseases and HIV Prevention and Control,Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市疾病预防控制中心性病艾滋病防制科,四川成都610041

出　　处：《现代预防医学》2024年第24期4580-4584,共5页Modern Preventive Medicine

基　　金：成都市卫生健康委员会医学科研课题(项目编号:2021253)。

摘　　要：目的了解成都市HIV/AIDS病例晚发现原因,为降低晚发现水平,促进病例早期发现提供科学依据。方法采用横断面调查,对成都市9个区(市)县的HIV/AIDS病例进行问卷调查,收集其社会人口学资料、艾滋病知识知晓情况、医疗卫生服务利用情况、检测行为等信息,采用χ2检验和二分类非条件logistic回归模型对晚发现影响因素进行分析。根据“信息饱和”原则确定样本量,对晚发现病例开展深入访谈。结果共计调查757名HIV/AIDS病例,其中晚发现病例有258人(34.1%)。多因素logistic回归分析结果显示,相比于18~29岁年龄组,30~49岁(aOR=3.350,95%CI:1.725~6.506)和≥50岁(aOR=3.913,95%CI:1.876~8.161)年龄组晚发现风险更高;相比于怀疑自己有感染风险后主动检测发现者,被动检测发现者(aOR=2.002,95%CI:1.098~3.649)晚发现风险更高;相比于文化程度为初中及以下者,高中及以上者(aOR=0.472,95%CI:0.289~0.770)晚发现风险更低。258名晚发现感染者中,有218人(84.5%)在感染前从未有过去做HIV检测的想法,主要原因为没有听说过艾滋病(106人/48.6%)和觉得艾滋病离自己很遥远(82人/37.6%)。曾经有过去做HIV检测想法的40名晚发现感染者中,17人(42.5%)没有进行HIV检测,主要原因是担心隐私被暴露(12人/70.6%)、担心检测过程中他人的眼光(7人/41.2%)、担心检测阳性被歧视(7人/41.2%)。通过对16名晚发现感染者进行深入访谈,晚发现原因主要包括:从来没听说过艾滋病、对艾滋病认知存在严重误区、风险感知意识不足和存在侥幸心理。结论为有效降低HIV/AIDS病例晚发现水平,应高质量推进艾滋病宣传教育,提升艾滋病知识知晓水平和发生高危行为后的风险感知能力,促进有过高风险行为的人群尽快主动进行HIV检测。还应构建支持性的社会环境,避免出现发生高危行为后因担心歧视而放弃主动检测。Objective To analyze the reasons of late HIV diagnosis in Chengdu,and to provide scientific basis for promoting early detection.Methods A cross-sectional survey was used,and the questionnaires were conducted among HIV/AIDS cases in 9 districts in Chengdu.The socio-demographic data,AIDS knowledge awareness,health seeking habits,testing behavior and other information were collected.The chi-square test and binary Logistic regression model were used to analyze the influencing factors.In-depth interviews were conducted,and the sample size was determined according to the principle of"information saturation".Results A total of 757 HIV/AIDS cases were investigated,of which 258(34.1%)were found late diagnosis.Multivariate Logistic regression analysis showed that the risk of late diagnosis was higher in age group 30-49 years old(aOR=3.350,95%CI:1.725-6.506)and≥50 years old(aOR=3.913,95%CI:1.876-8.161)than 18-29 years old.Passive detection(aOR=2.002,95%CI:1.098-3.649)had a higher risk of late diagnosis than active detection.High school education or higher(aOR=0.472,95%CI:0.289-0.770)had a lower risk of late diagnosis than middle school education or lower.Among the 258 late diagnosis cases,218(84.5%)never had the idea of HIV testing in the past,mainly because they had not heard of AIDS(106 cases/48.6%)and felt that AIDS was far away from them(82 cases/37.6%).Among the 40 cases who had ever considering taking an HIV test,17(42.5%)did not take,mainly because they were worried about their privacy being exposed(12 cases/70.6%),worried about what others think during the test process(7 cases/41.2%),and worried about being discriminated against if they tested positive(7 cases/41.2%).In-depth interviews were conducted on 16 patients with late diagnosis.The reasons for late diagnosis mainly included:never heard of AIDS,serious misunderstanding of AIDS cognition,lack of risk perception awareness,and fluke mentality.Conclusion In order to effectively reduce the level of late HIV diagnosis,it is necessary to promote high-quality AIDS

关 键 词：HIV/AIDS 晚发现 原因调查 

分 类 号：R512.91[医药卫生—内科学]