2008-2013年我国医疗机构检测发现艾滋病病例情况分析

HIV/AIDS cases detection in medical institutions from 2008 to 2013 in China

目的分析2008--2013年我国医疗机构检测发现艾滋病病例的情况。方法医疗机构医务人员按照“知情不拒绝”的原则，对术前检测、受血（制品）前检测、性病门诊检测、其他就诊者检测和孕产期检查的5类就诊者动员进行HIV抗体检测。结果2008-2013年我国医疗机构开展HIV抗体检测人次数从2494万增加到7654万，增加了206．8％；检测发现病例数从18241例增加到45560例，增加了149．8％；粗检出率略有下降，从2008年的7．3／万下降至2013年的6．0历，其中，性病门诊和其他就诊者检测发现阳性率在2009年出现上升后逐渐稳定于一个较高水平状态，术前检测、受血（制品）前检测和孕产期检查发现阳性率稳定在较低水平。医疗机构检测发现病例的比例逐年上升，分别为32．4％、36．O％、40．2％、45．3％、47．9％和50．6％。其他就诊者检测发现病例的比例维持在50％以上，术前检测维持在20％以上。结论医疗机构扩大检测后，性病门诊和其他就诊者检测发现了较多艾滋病病例。应进一步推动医疗机构重点科室的常规艾滋病检测。

Objective To assess the detection of HIV/AIDS cases in medical institutions in China from 2008 to 2013. Methods ＇Provider-initiated Opt-out HIV testing and counseling＇ method was offered to patients who met the needs for preoperation, perinatal examination, at the sexually transmitted disease （STD） clinic or other types of testing services. Results From 2008 to 2013, the number of HIV screening tests offered in medical institutions increased by 206.8%, from 24.94 million to 76.54 million. The number of diagnosed HIV cases increased by 149.8%, from 18 241 to 45 560. HIV positive coarse rate showed a slight decrease, from 7.3 per ten thousand in 2008 dropped to 6.0 per ten thousand in 2013. The HIV positive rate detected at the STD clinics or from other attendants showed a gradual decrease in 2009 and remained relatively stable. HIV positive rates showed at the programs as preoperative testing, regular screening programs on blood products, on pretreatmentregular-blood-testing or through perinatal examination, maintained at low levels. Proportions of case detection at medical institutions increased annually from 2008 to 2013 （32.4%, 36.0%, 40.2%, 45.3%, 47.9% and 50.6% respectively） in China. Among them, the proportion of case detection via other types of testing services appeared over 50%. Over 20% of the HIV cases were identified via preoperative testing. Conclusion Significant effects were seen through programs as offering Provider-initiated HIV testing and counseling to patients that receiving testing at the STD clinics or through other types of testing services. Opt-out HIV testing and counseling should be routinized in all the HIV related divisions in medical institutions.