不同样本来源的中老年HIV/AIDS死亡率及其影响因素分析

Death Rate and Correlates of Death of Different Sample Sources among the Elderly HIV /AIDS

目的了解云南省部分地区不同样本来源的〉150岁中老年艾滋病感染者／病人（HIV／AIDS）的病死率及其影响因素。方法收集来自云南省的临沧市、保山市、玉溪市、德宏州盈江县和瑞丽市、红河州开远市及昆明市五华区1989—2012年累计报告的≥50岁2244例中老年HIV／AIDS信息，计算病死率，并采用多因素非条件Logistic回归分析其影响因素。结果2244例I〉50岁中老年HIV／AIDS中，1989—2003年占5．40％，2004—2007年占30．20％，2008—2012年占64．40％；主要的样本来源为临床医疗机构，占36．30％，自愿咨询机构（VCT）占29．40％，其中2008—2012年占总数的构成比分别为81．90％和72．80％；以艾滋病死亡为结局的病死率为22．80％（95％CI：21．1％～24．6％），标准化后以来源于临床医疗机构的病死率最高（8．90％），后续依次分别为VCT（6．10％）、羁押场所（2．70％）、性病门诊（1．30％）、阳性配偶检测（0．60％）、专题调查（0．30％）。Logistic多因素回归分析显示，在控制潜在的多种混杂因素影响后，性别、年龄、职业、样本来源成为影响中老年HIV／AIDS死亡的主要因素。结论1989—2012年云南部分地区中老年HIV／AIDS主要来源于临床医疗机构和VCT点，且这两种来源的病死率较高。

Objective To determine the death rate and correlates of death by different sample sources among the elderly HIV/AIDS cases from 1989 to 2012 in the partial of Yunnan province. Methods Two thousands two hundreds and forty-four HIV/AIDS elderly cases were form the HIV/AIDS database in the partial of Yunnan province where were Lincang, Baoshan, Yuxi city, and so on, then we calculated the rate of death among them. Logistics regression analysis was conducted correlates of death rate. Results A total of 2 244 HIV/ AIDS cases were the elderly cases in 1989 through 2012, 5.40% of whom in 1989 - 2003,30.20% in 2004 -2007, and 64.40% in 2008 -2012. Among the main sample sources, 36.30% of whom were fond in the medical institutions, 29.40% in VCT sites. From 2008 to 2012, the proportion of elderly cases was 81.90% in the medical institutions, 72.80% in VCT sites. The rate of death due to AIDS was 22.80% （95% CI： 21.1% -24.6% ）. The standardization rate of death was the highest in the medical institutions which is 8.90% , the VCT sites, the places of detention, the medical institutions of sexually transmitted disease, the testing of spouse of HIV positive, and the special survey, respectively. Multiple logistic regression analysis indicated that the sex, age, occupation, and the sample sources were significantly. Conclusion From 1989 to 2012, the medical institutions and VCT sites were the mainly sample sources in the partial of Yunnan province, and had higher death rate.