我国自愿咨询检测门诊HIV感染阳性率meta分析  

The Prevalence of HIV at Voluntary Counseling and Testing Sites in China:A Systematic Review and Meta-analysis

作　　者：施露倩 何纳[1] 丁盈盈[1] Shi Luqian;He Na;Ding Yingying(Department of Epidemiology,School of Public Health,Key Laboratory of Public Health Safety/Ministry of Education,Fudan University,Shanghai,200032,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室,上海200032

出　　处：《中国初级卫生保健》2025年第2期57-62,共6页Chinese Primary Health Care

基　　金：国家重点研发计划(2022YFC2304901)。

摘　　要：目的:运用meta分析了解我国自愿咨询检测门诊HIV检测的阳性率,为提高艾滋病自愿咨询检测服务的覆盖面和有效性提供参考意见。方法:系统检索2013年1月1日—2024年1月23日中国知网、万方数据知识服务平台、维普数据库、PubMed、Web of Science、Embase中关于自愿咨询检测门诊HIV检测筛查的文献。采用随机效应模型对提取的数据进行meta分析,采用meta回归及亚组分析识别可能的异质性来源。结果:共筛选出59篇文献,其中中文文献58篇,英文文献1篇。HIV总检测例数为777186例,检出阳性19329例。meta随机效应模型显示,HIV合并阳性率为5.18%(95%CI为3.62%~7.42%,I^(2)=99.8%),因商业异性性行为而进行咨询检测的人群合并阳性率为2.66%(95%CI为1.64%~4.31%,I^(2)=99.4%),因非商业异性性行为而进行咨询检测的人群合并阳性率为2.73%(95%CI为1.71%~4.36%,I^(2)=99.3%),因男男性行为而进行咨询检测的人群合并阳性率为15.37%(95%CI为12.86%~18.38%,I^(2)=99.8%)。亚组分析和meta回归分析结果显示,接受检测人群中男性人员比例可能是不同研究间的异质性来源。结论:我国自愿咨询检测门诊确诊的HIV阳性率较高,但由于各研究中数据来源的可靠性及样本量差异等因素导致研究间存在较高的异质性。我国仍需扩大检测以发现更多的HIV潜在感染者。OBJECTIVE To systematically evaluate the prevalence of HIV among those who attending Voluntary Counseling and Testing(VCT)which wasan essential component of Chinese HIV prevention strategy.METHODS It conducted a comprehensive search of the CNKI,WanFang,VIP,PubMed,Web of Science,and EMBASE databases,using Meta terms and subheadings to identify observational studies reporting HIV diagnoses at VCT sites from January 1^(st) 2013 to January 23^(th) 2024.Random-effect meta-analysis was utilized and subgroup analysis,sensitivity analysis and meta-regression were employed to address heterogeneity.RESULTS A total of 59 articles were screened out,including 58 Chinese articles and 1 English article.The total number of tests was 777186 cases,with 19329 positive cases detected.Random-effect model showed that the overall prevalence was 5.18%(95%CI:3.62%~7.42%,I^(2)=99.8%).The pooled prevalence was 2.66%(95%CI:1.64%~4.31%,I^(2)=99.4%)for those who had commercial risk behaviors,2.73%(95%CI:1.71%~4.36%,I^(2)=99.3%)for those who had noncommercial risk behaviors,and 15.37%(95%CI:12.86%~18.38%,I^(2)=99.8%)for those who had MSM(men who have sex with men)behaviors.Meta regression indicated that the proportion of males might contribute to heterogeneity among studies.CONCLUSION The prevalence of HIV at VCT sites in China remains relatively high.However,significant heterogeneity exists due to variations in data reliability and sample sizes among included studies.Increased efforts are needed to expand testing and identify potentially infected individuals.

关 键 词：自愿咨询检测 人类免疫缺陷病毒 阳性率 荟萃分析 

分 类 号：R512.91[医药卫生—内科学]