湖州市HIV/AIDS患者抗病毒治疗及时性及影响因素分析

Analysis of Factors on Timeliness of Antiretroviral Treatment Among HIV/AIDS in Huzhou City

目的 分析湖州市2016-2020年艾滋病病毒(HIV)感染者/艾滋病患者(简称HIV/AIDS患者)抗病毒治疗及时性及其影响因素,为进一步推进抗病毒治疗工作提供依据。方法 利用国家艾滋病防治信息系统中2016-2020年现住址在湖州市的HIV/AIDS病例,确证报告至开始启动抗病毒治疗的时间在30 d以内记为及时治疗,分析病例抗病毒治疗及时性及其影响因素。结果 943例HIV/AIDS患者的治疗及时率为75.08%(708/943),治疗及时率呈现逐年上升的趋势,从2016年的61.49%上升至2020年的81.57%。多因素Logistic回归分析结果显示,已婚有配偶者(相较于离异丧偶者,OR=0.57,95%CI:0.36~0.88)、主动检测发现(相较于被动检测发现,OR=0.45,95%CI:0.27~0.75)、医疗机构报告(相较于疾控机构报告,OR=0.443,95%CI:0.269~0.729)的病例抗病毒治疗及时率较高;异性传播(相较于同性传播,OR=1.78,95%CI:1.21~2.62)、首次CD4细胞计数在400个/μL以上者(相较于<400个/μL,OR=1.57,95%CI:1.12~2.20)抗病毒治疗及时率相对较低。结论 婚姻状况、检测发现来源、传播途径和病例报告机构是影响HIV/AIDS患者抗病毒治疗及时性的因素。

Objective To analyse the influencing factors on timeliness of antiretroviral treatment among HIV/AIDS patients(HIV/AIDS patients) from 2016 to 2020 in Huzhou city, in order to provide evidence for promoting antiretroviral treatment.Methods The data of HIV/AIDS cases living in Huzhou city from January 1, 2016 to December 31, 2020 was collected from National HIV/AIDS Information System, an interval within 30 days between diagnosis of HIV infection and antiretroviral treatment initiation was defined as timely treatment.Results Among the 943 HIV/AIDS cases, 75.08%(708/943) had timely treatment. The timely treatment rate showed an upward trend year by year, from 61.49% in 2016 to 81.57% in 2020. Multivariate Logistic regression analysis showed that HIV/AIDS cases who had married(compared with divorced and widowed people, OR=0.57, 95%CI:0.36-0.88), diagnosed through active detection(compared with passive detection, OR=0.40, 95% CI:0.23-0.68), or reported by medical institutions(compared with that reported by CDCs, OR=0.45, 95% CI:0.27-0.75) were more likely to have timely antiretroviral treatment. Infected through homosexual behavior(compared with heterosexual behavior, OR=1.78, 95% CI:1.21-2.62), the first CD4 cell count above 400 cell/μL(compared with <400 cell/μL, OR=1.57,95% CI:1.12-2.20) had lower timely antiretroviral treatment.Conclusion The factors that affect the timely antiretroviral treatment are marital status, detection source, transmission route and reporting agencies.