南京市2008-2012年报告HIV/AIDS流行特征分析

Analysis on epidemiological characteristics of reported HIV/AIDS infected people in Nanjing City,2008-2012

目的了解南京市2008-2012年报告的HIV/AIDS感染者流行病学特征,计算病例晚发现率并分析其相关因素。方法对南京市2008-2012年在国家艾滋病防治信息系统中报告的1 833例HIV/AIDS病例资料进行整理和分析,主要包括一般人口学特征、既往感染性病情况、感染途径和样本来源。结果 1 833例研究对象中,男性占88.0%,平均年龄(35.6±12.0)岁,南京市籍占59.8%,50岁以上病例占12.5%。感染途径以性传播途径为主,占83.9%。报告当年为学生的病例占5.5%。样本来源以医疗机构、自愿咨询检测门诊(voluntary counseling and testing,VCT)和男男性接触人群(men who have sex with men,MSM)专题调查为主。1 833例病例中,当年发展至艾滋病(acquired immunodeficiency syndrome,AIDS)病程的病例562例,晚发现率30.7%。多因素Logistic回归分析显示,50岁以上年龄组、异性性传播途径感染和医疗机构发现来源是晚发现病例的独立相关因素。结论今后南京市应进一步加大MSM、学生和50岁以上等重点人群的艾滋病控制力度;在继续实施VCT、MSM专题调查和羁押场所体检等检测策略的同时,全面推进医疗机构主动提供艾滋病检测咨询(provider initiated HIV testing and counseling,PITC)服务,扩大检测覆盖面,提高病例早发现能力。

Objective To examine epidemiological characteristics of people who were reported as HIV infection from 2008 to 2012 in Nanjing, and to analyse the prevalence and correlation of delayed diagnosis. Methods All reported HIV infected people were analyzed during 2008 to 2012 in Nanjing City were collected through the National Information System for Comprehensive AIDS Prevention and Control, including their general demographic characteristics, their conditions of venereal disease, routes of intection and sources of sample. Results Of 1 833 reported HIV infected people, 88. 0% were male. The average age was 35.6 ± 12. 0 years old and 59. 8% were the residents in Nanjing. 12. 5% were above 50 years old. The sexual transmission accounted for 83.9%. Students accounted for 5.5%. The cases were mainly found from medical institutions, VCT and investigation of MSM. Of 1 833 reported HIV cases, 562 （30. 7% ） developed into the stage of AIDS patients in the reported year, which were belong to delayed diagnosis. The multiple Logistic regression analysis indicated that people over 50 years, via heterosexual transmission, and found from medical institutions were the independent correlated with delayed diagnosis. Conclusions It is necessary to devote greater efforts to control transmission of HIV among MSM, old people and students. The current measures on VCT, investigation of MSM and testing at detention centers should be kept. Moreover, all medical institutions should carry out PITC in order to strengthen the ability of earlier finding of HIV infections.