顺德区新报告艾滋病病例晚发现情况及影响因素分析

Late diagnosis and the influence factors of HIV/AIDS cases new reported in Shunde district

目的分析顺德区新报告艾滋病病例晚发现情况及影响因素,为今后艾滋病防控工作措施制定提供科学依据。方法采用设计问卷对2017-2018年顺德区新报告艾滋病病例进行调查,对问卷内容进行有效性整理后进行卡方检验、非条件Logistics等统计学分析。结果共有385例HIV/AIDS纳入调查对象,其中男330例,女55例,男女比例为6:1;发现感染时年龄最小16岁,最大88岁,平均发现感染年龄(39.26±13.67)岁;民族以汉族为主,占88.8%;婚姻状况以已婚为主,占51.7%;初中文化为主,占40%;外地户籍为主,占77.7%;传播途径以异性传播为主,占56.1%。单因素分析显示,不同年龄、不同婚姻状况、不同户籍、是否主动检测意识、既往有无艾滋病相关临床症状和是否知晓艾滋病相关信息间晚发现率差异有统计学意义(P<0.05),且晚发现率存在随发现年龄增长而增大的趋势(P<0.001)。多因素Logistics回归分析显示,既往曾经有过艾滋病相关症状要比没有艾滋病相关症状的HIV/AIDS晚发现风险高(OR=2.363);知晓检测机构相比不知晓晚发现风险要低(OR=0.621);相比未婚或同居HIV/AIDS,已婚和离异或丧偶的HIV/AIDS晚发现风险要高(OR=2.257、2.314),差异均有统计学意义(P<0.05)。结论顺德区今后要加强高年龄、已婚和离异或丧偶、本地户籍HIV/AIDS的随访管理,强化检测宣传,特别是本地检测机构的宣传,同时加强医疗机构主动提供HIV咨询检测工作。

Objective To understand the situation of late dignosis and the influence factors of HIV/AIDS new report in Shunde district and provide scientific basis for the future development of AIDS prevention and control measures.Method The design questionnaire was used to investigate the newly reported AIDS cases in Shunde district in 2017-2018,and the content of the questionnaire were collated and analyzed,such as chi-square analysis and unconditional logistic analysis.Results A total of 385 HIV/AIDS patients were included in the survey,including 330 males and 55 females,with a male to female ratio of 6∶1;the youngest was found to be 16 years old and the oldest was 88 years old,with an average age of infection(39.26±13.67)years old;the majority of the Han people accounted for 88.8%;the marital status was mainly married,accounting for 51.7%;the junior high school culture was the main,accounting for 40%;The foreign household registration was the main,accounting for 77.7%;the transmission route was mainly heterosexual transmission,accounting for 56.1%.Late dignosis univariate analysis revealed factors such as discover age,marital status,household registration,active detection awareness,previous AIDS-related clinical symptoms and AIDS awareness had statistical significance(P<0.05),and the late dignosis rate increased with the discovery age(P<0.001).The multivariate logistic regression analysis of late dignosis showed the HIV/AIDS who have previous AIDS-related symptoms were higher late dignosis risky than that of the HIV/AIDS without AIDS-related symptoms(OR=2.363).The HIV/AIDS patients who knew the detection institutions had lower late dignosis risk than that of who did not know(OR=0.621).The HIV/AIDS who were married and divorced or widowed had higher late dignosis risk than that of unmarried or cohabiting(OR=2.257,2.314),and the difference was statistically significant(P<0.05).Conclusions In the future,Shunde district should strengthen the management of HIV/AIDS for elder age,married,divorced or widowed,and local household,and strengthen the publicity of testing,especially for local testing institutions.At the same time,it is necessary to strengthen the provider-initiated HIV testing and counseling work in medical institutions.