结核病人拒绝HIV检测的原因及人口学特征分析

Reasons of tuberculosis patients refusing HIV testing and their demography characteristic

目的分析拒绝HIV抗体检测的结核病人特征,揭示拒绝检测的原因,判断感染HIV的风险大小。方法采用分层整群抽样方法,在31省(自治区、直辖市)333个县对结核病防治机构新登记结核病人开展HIV感染状况调查,在确诊结核病后用知情不拒绝的方式提供HIV检测,用开放式问题收集病人拒绝HIV检测的原因。结果结核病人拒绝HIV抗体检测率为3.3%(1525/45 523)。1232例说明了拒绝原因的病人中,5.7%的病人因为"近期做过HIV检测",14.3%的病人"认为没有必要,无不良行为",8.4%的病人"健康状况不宜采血",8.7%的病人"未能到结防机构采血",4.8%的病人"年纪太小或太大",54.9%的病人或家属"不同意"或病人"拒绝采血"。拒绝检测者与本次调查发现的HIV阳性者在性别、年龄、职业、民族、文化程度、婚姻状况、居住地、户籍等特征上差异有统计学意义(P<0.05)。结论拒绝HIV检测的结核病人与HIV阳性病人在各项特征上有较大差别,近半数的病人有合理的拒绝原因、感染HIV风险较低,其余病人拒绝检测的原因和感染风险需要进一步研究。

Objective To analysis the reasons of tuberculosis （TB） patients who refuse HIV testing and their risk of HIV infection. Methods A cross-sectional survey on HIV infection among TB patients was conducted in 333 counties u- sing stratified cluster sampling method. Patients were offered HIV testing using PITC after diagnosed TB. An open question- nair was used to collect the reason why they refused HIV testing. Results 3.3% （ 1525/45 523 ） of TB patients refused HIV testing. In 1232 cases who gave the reasons, 5.7% of them said they had gotten a HIV testing recently, 14. 3% of them believed there was no need for HIV testing due to mine high risk behavior, 8.4% of them can＇ t take blood due to their health problem, 8.7% of them didn＇t come to TB clinic to take blood after diagnosed TB, 4. 8% of them were too young or too old, 54. 9% of them said they or their family members disagreed or refused taking blood. There were significantly differ- ence between patients refusing HIV testing and HIV-positive patients on sex, age, career, minority, education, marriage status and inhabitant in this survey （ P 〈 0. 05 ）. Conclusion There is great difference between patients who refused HIV testing and who were HIV positive. Half of patients had reasonable excuse for not taking HIV testing and had low risk of HIV infection. The risk of other patients should be further studied in future.