厦门市集美区2010-2019新报告HIV/AIDS病例晚发现状况及其影响因素

Influencing factors of late diagnosis of new HIV/AIDS cases in Jimei District of Xiamen City,2010-2019

目的了解2010-2019年厦门市集美区新报告的人类免疫缺陷病毒(HIV)/艾滋病(AIDS)病例晚发现率及其影响因素,为制定针对性的措施提供理论依据。方法按照现住址浏览,审核日期选择2010-01-01-2019-12-31,从《艾滋病综合信息管理系统》导出病例信息,剔除重卡、外籍及港澳台病例,描述晚发现率的变化趋势,采用单因素及多因素分析HIV/AIDS晚发现率的危险因素。结果368例病例中,符合晚发现病例定义159例,晚发现率达43.2%。2010-2019年来源为AIDS自愿咨询检测门诊和专题调查等主动筛查人群的晚发现率为31.1%(50/161),各年间无明显下降趋势,差异无统计学意义,趋势χ^(2)=0.3,P>0.05。来源于医疗机构和常规体检等非主动检测人群的晚发现率为52.7%(109/207),晚发现率呈逐年下降趋势,趋势χ^(2)=6.1,P<0.05。相较于商业服务,职业为学生是晚发现率的保护因素(OR=0.27,95%CI:0.10~0.71,P=0.01);相较于<20岁年龄组,40~<50岁(OR=3.86,95%CI:1.25~11.86,P=0.02)和≥50岁(OR=4.05,95%CI:1.26~12.99,P=0.02)为晚发现率的危险因素;非主动检测晚发现率是主动检测的2.43倍(OR=2.43,95%CI:1.52~3.90,P<0.001)。结论在AIDS宣传中应加强对中老年及非学生职业人群的宣教,提高人群主动检测意识,强化检测结果告知、转介和随访等环节,减少失访率,降低晚发现率。

Objective To understand the late detection rate of newly reported HIV/AIDS cases in Jimei District,Xiamen City from 2010 to 2019 and their influencing factors,and provided a theoretical basis for formulating targeted measures.Methods Browsed by current address,selected the review date from January 1,2010 to December 31,2019,exported case information,excluded heavy trucks and foreign cases,Hong Kong,Macao and Taiwan cases,described the trend of late detection rate,using single factor and multiple factors analyzed and explored the risk factors of late detection rate.Results Among the 368 cases,159 met the definition of late detection cases,the late detection rate reached 43.2%.The late detection rate that the source was the active screening population such as AIDS counseling&testing clinics and special surveys from 2010 to 2019 was 31.1%(50/161),and the overall trend did not show a downward trend.The trendχ^(2)=0.3,P>0.05.The late detection rate from non-active tests such as medical institutions and routine physical examinations was 52.7%(109/207),showed a downward trend,with a trendχ^(2)=6.1,P<0.05.Compared with business services,occupation for students was a protective factor for the late detection rate(OR=0.27,95%CI:0.10-0.71,P=0.01).Compared to the age group under 20,40-<50 years old(OR=3.86,95%CI:1.25-11.86,P=0.02)and≥50 years old(OR=4.05,95%CI:1.26-12.99,P=0.02)were the risk factors for late detection rate.The late detection rate of nonactive detection was 2.43 times that of active detection(OR=2.43,95%CI:1.52-3.90,P<0.001).Conclusions In AIDS propaganda,it is necessary to strengthen the publicity and education of the middle-aged and non-student occupational population,increase the population’s active detection awareness,strengthen the test result notification,referral and follow-up links,reduce the loss of follow-up rate,and reduce the late detection rate.