2016—2022年云南省不同途径发现HIV感染者/艾滋病患者特征分析  

Analysis of characteristics among people living with HIV discovered through different approaches in Yunnan Province,2016-2022

作　　者：霍俊丽[1] 杨志敏[1] 安晓静[1] 韩瑜[1] 张小波[1] 徐诺雅[1] 黎萍 廖若冰 施玉华[1] HUO Junli;YANG Zhimin;AN Xiaojing;HAN Yu;ZHANG Xiaobo;XU Nuoya;LI Ping;LIAO Ruobing;SHI Yuhua(Yunnan Center for Disease Control and Prevention,Kunming,Yunnan 650022,China)

机构地区：[1]云南省疾病预防控制中心,昆明云南650022

出　　处：《中国预防医学杂志》2025年第3期289-296,共8页Chinese Preventive Medicine

基　　金：国家科技重大专项项目(2018ZX10715006)。

摘　　要：目的分析2016—2022年云南省艾滋病自愿咨询检测(voluntary counselling and testing,VCT)和医疗机构医务人员主动提供人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测咨询(provider initiated HIV testing and counselling,PITC)发现的HIV感染者和艾滋病患者(HIV感染者/艾滋病患者)特征的差异,为制定艾滋病检测策略提供依据。方法收集“中国疾病预防控制信息系统”中2016年1月1日—2022年12月31日通过VCT和PITC发现的新报告HIV感染者/艾滋病患者。利用非条件logistic回归分析比较不同途径发现的HIV感染者/艾滋病患者的特征、晚发现以及抗病毒治疗情况。结果2016—2022年云南省累计新报告VCT和PITC发现HIV感染者/艾滋病患者56378例,其中,VCT发现11750例(20.84%),PITC发现44628例(79.16%)。多因素logistic回归分析显示,女性(OR=0.84,95%CI:0.80~0.88)、配偶HIV阴性(OR=0.38,95%CI:0.35~0.41)及不清楚配偶HIV感染情况(OR=0.74,95%CI:0.61~0.89)者,通过PITC检测发现的可能性高。初中(OR=1.17,95%CI:1.11~1.24)、高中或中专(OR=1.31,95%CI:1.21~1.43)和大专及以上文化程度(OR=1.43,95%CI:1.30~1.57),通过男男同性性行为感染(OR=3.59,95%CI:3.29~3.92)、注射毒品感染(OR=1.63,95%CI:1.42~1.87)及配偶HIV阳性(OR=3.56,95%CI:3.38~3.75)者通过VCT门诊发现感染HIV的可能性高。与VCT相比,PITC中的其他就诊者检测(OR=1.41,95%CI:1.34~1.48)和术前/受血前检测(OR=1.20,95%CI:1.12~1.28)发现的HIV感染者/艾滋病患者晚发现的比例高,孕产期检测晚发现的比例低(OR=0.70,95%CI:0.60~0.81);与VCT相比,术前/受血(制品)前检测(OR=0.63,95%CI:0.57~0.70)、其他就诊者检测(OR=0.64,95%CI:0.59~0.69)发现的HIV感染者/艾滋病患者抗病毒治疗比例更低。结论VCT在早期发现病例、男男同性性行为筛查及抗病毒治疗促进方面有优势;PITC的推广有助于扩大普通人群的检测比例;可针对不同人群制定HIV感染者发现策略,促进早检测、早发�Objective To analyze the differences in the characteristics of HIV-infected individuals and AIDS patients(HIV infected individuals/AIDS patients)discovered through HIV voluntary counseling and testing(VCT)and provider-initiated HIV testing and counseling(PITC)in Yunnan Province from 2016 to 2022,providing a basis for formulating AIDS testing strategies.Methods Data on newly reported HIV-infected individuals/AIDS patients from January 1,2016,to December 31,2022,identified through VCT and PITC,were collected from the Chinese Disease Prevention and Control Information System.Unconditional logistic regression analysis was applied to compare the differences in characteristics,late diagnosis,and antiviral treatment status of HIV-infected individuals/AIDS patients identified through different approaches.Results A total of 56378 HIV/AIDS cases were reported by VCT and PITC in Yunnan Province from2016 to 2022,including 11750 cases(20.84%)identified through VCT and 44628 cases(79.16%)identified through PITC.Multivariable logistic regression showed that females(OR=0.84,95%CI:0.80-0.88),having HIV negative spouse(OR=0.38,95%CI:0.35-0.41),and those unsure of their spouse's HIV infection status(OR=0.74,95%CI:0.61-0.89)were more likely to be tested through PITC.Individuals with a junior high school education(OR=1.17,95%CI:1.11-1.24),high school or vocational school education(OR=1.31,95%CI:1.21-1.43),and college degree or above(OR=1.43,95%CI:1.30-1.57),as well as those infected through same-sex behavior(OR=3.59,95%CI:3.29-3.92),injecting drug users(OR=1.63,95%CI:1.42-1.87)were more likely to be identified through VCT.Compared to VCT,the proportion of late discovery among HIV-infected individuals/AIDS patients detected through other consultations in PITC(OR=1.41,95%CI:1.34-1.48)and pre-operative/blood transfusion testing(OR=1.20,95%CI:1.12-1.28)was higher,while the proportion of late discovery during pregnancy and childbirth testing was lower(OR=0.70,95%CI:0.60-0.81).Compared to VCT,the proportion of HIV-infected individuals/AIDS

关 键 词：人类免疫缺陷病毒 艾滋病 自愿咨询检测 主动提供 HIV检测咨询 

分 类 号：R512.91[医药卫生—内科学]