农村地区HIV检测结果阳性者告知现状及影响因素调查

Self-disclosure of HIV serostatus and influencing factors in rural areas in China

目的了解我国农村地区HIV检测结果阳性者告知现状及影响因素。方法采取方便抽样,以云南省德宏州两县(市)于2006年1月至2008年6月期间检测并确认HIV血清抗体阳性的497名来自农村地区的HIV感染者为调查对象,利用自行编制的匿名问卷调查一般社会人口学特征,HIV检测咨询和HIV检测阳性结果告知他人情况等。结果农村地区HIV感染者的阳性结果固定性伴告知率为78.9%,非固定性伴、家人和朋友的告知率分别为6.3%,78.9%和21.1%。影响HIV检测阳性结果告知固定性伴的主要因素有性伴类型为配偶(OR=16.97,95%CI:1.57～183.65),检测前获得咨询服务(OR=5.18,95%CI:1.69～15.82)和告知后获得心理支持(OR=8.64,95%CI:1.13～66.32)等。结论固定性伴和家人是农村地区HIV感染者阳性结果告知的主要对象,在提供HIV检测咨询服务时应加强性伴告知方面的探讨并给予告知后心理支持和安抚,提高性伴就诊率,减少感染者的危险性行为。

Objective To understand self-disclosure of HIV serostatus and influencing factors in rural areas in China. Methods A total of 497 rural residents who were tested with HIV from Jan 2006 to Jun 2008 were conveniently selected in two rural counties in Dehong Prefecture, Yunnan province. A self- administered anonymous questionnaire was used to collect information about demographic characteristics, HIV counseling and testing and self-disclosure. Results 78.9 % of respondents disclosed their HIV sta- tus to regular sexual partner （s）, 6.3 % , 78.9 % and 21.1% told to their casual sexual partners, family members and friends respectively. Type of sexual partnership （ OR = 16.97,95 % CI ： 1.57 - 183.65）, pre-test counseling service （ OR = 5.18,95 % CI ： 1.69-15.82） and psychological support after disclosure （ OR - 8.64,95% CI ： 1.13 - 66.32） were associated with partner notification. Conclusions Spouse/regular sexual partner（s） and family members were the main subjects of disclosure in rural areas. To increase rate of partner notification and to reduce risk sexual behaviors among HIV positive people, discussion on partner notification must be included during HIV testing and counseling and psychological support is needed to provide care and support for HIV-infeeted rural residents.