低流行地区HIV/AIDS发现及管理的策略研究

Study on strategies to find and manage the new-found HIV/AIDS in low-epidemic areas

目的通过分析天津市2009-2010年艾滋病病毒(human immunodeficiency virus,HIV)感染者和艾滋病(acquired immunodeficiency syndrome,AIDS)病人相关的监测数据,探索低流行地区HIV/AIDS发现及管理的策略。方法收集天津市2009-2010年相关监测数据,对不同检出途径的HIV/AIDS检出率、报告的HIV/AIDS在规定期限内开展首次CD4+T淋巴细胞检测的比例、首次CD4+T淋巴细胞的均值和发现1例HIV/AIDS的成本进行分析。结果艾滋病自愿咨询检测(voluntary counseling and testing,VCT)、性病门诊就诊者和男男性接触人群(menwho have sex with men,MSM)专项调查HIV/AIDS检出率、首次CD4+T淋巴细胞均值均较高,同时这3个途径每发现1例HIV/AIDS的成本相对较低;其中MSM人群专项调查,在规定期限内开展首次CD4+T淋巴细胞的比例较高,对新发现HIV/AIDS的管理比例也较高。结论加强性病门诊就诊者、VCT以及MSM人群专项调查相关的工作,在经费投入有限的情况下加大这3类人群的投入,进一步提高阳性发现率,及时管理新发现的HIV/AIDS病例,有效降低二代传播。

Objective To analyse the human immunodeficiency virus（HIV）and acquired immunodeficiency syndrome（AIDS） survelliance data in 2009 and 2010,and to explore the strategy for finding and managing the new-found HIV/AIDS in low-epidemic areas.Methods The survelliance data in 2009 and 2010 were collected to calculate the rate of HIV-positive and the rate of testing primary CD＋4 T lymphocytes before limited time and the mean number of primary CD＋4 T lymphocytes,and to analyse the unit cost of HIV/AIDS reported in 2009 and 2010.Results The survelliance data showed that among different detection channels,clients of sexually transmitted disease,voluntary counseling testing（VCT）,investigation of men who have sex with men（MSM） have the higher detection rates and the mean of primary CD＋4 T lymphocytes than others.Besides,the unit cost were lower than other detections.At the same time,the rate of testing primaryCD＋4 T lymphocytes was higher and the rate of management of HIV/AIDS new-found was higher.Conclusions The work on STD,VCT and investigation of MSM should be strengthened,and the fund for the three sureillances under the limited investment should be increased,so as to further improve the rate of HIV-positive,manage the new-found HIV/AIDS as early as possible,and effectively reduce the second-generation transmission.