云南省陇川县新报告HIV感染者的高危行为接触者追踪调查

Tracing high risk contacts of newly reported HIV-infected cases in Longchuan county of Yunnan province

目的对新报告艾滋病病毒(HIV)感染者的高危行为接触者进行追踪调查并检测HIV,以最大程度地发现HIV感染者,探讨其作为新的艾滋病检测策略的费用效果。方法 2008年8月1日至10月31日,对云南省陇川县新发现的本地HIV感染者及其所提供的高危行为接触者,进行追踪调查和HIV检测(以下简称"溯源调查"),对高危行为接触者中原HIV阳性或通过本次检测新发现的HIV阳性者,同样作进一步的溯源调查。结果累计完成了4个层次的溯源调查,共调查109名HIV感染者。共提供高危行为接触者1 293人,其中1 102人(85.2%)因无姓名或详细地址而无法作进一步的追踪调查,62人(4.8%,其中死亡21人)在艾滋病疫情库中已记录为HIV感染者,另有129人(10.0%,其中死亡20人)有姓名和详细地址但HIV感染状况不清者中,65人接受了HIV检测,从中新发现18例HIV阳性,检测阳性率为27.7%。此次调查共耗资7 572元,平均每新发现1例HIV感染者耗资420.67元。结论溯源调查可以有效地发现高危行为接触者和HIV感染者,成本可接受。但未来的溯源调查需要解决严重的拒访和失访问题。

Objective To maximally identify HIV-infected individuals by tracing and testing high risk contacts of newly reported HIV cases,and to explore cost-effectiveness of risk contact tracing as a new supplemental HIV testing strategy.Methods All new HIV cases reported from August 1 to October 31 of 2008 in Longchuan county of Yunnan province and their high risk contacts were traced and tested for HIV infections.Meanwhile,all the high risk contacts,whether they had been infected with HIV previously or they were newly tested HIV positive during this survey would be also subject to further high risk contact tracing and HIV testing.Results Four rounds of tracing surveys were completed,in which a total of 109 HIV-infected cases were investigated.They reported a total of（1 293） high risk contacts,of whom 1 102（85.2%） were unable to be traced further for high risk contacts due to missing information on their names or detailed address,62（4.8%,including 21 deaths） as previously reported HIV cases had already been registered in the existing HIV/AIDS database and 129（10.0%,including 20 deaths） were unknown of their HIV status,though with clear contact information.Of these 129 contacts 65 were tested for HIV,of whom 18（27.7%） were HIV positive.The tracing survey spent totally RMB 7,572 Yuan,with an average of 420.67 Yuan per each newly detected case.Conclusions Tracing and testing high risk contacts of newly reported HIV cases is an effective way to identify high risk contacts and HIV-infected individuals,and the cost incurred is also acceptable.However,refusal and missing information among the contacts of newly reported HIV infected cases are problems to be solved in the future tracing survey.