艾滋病高发区艾滋病病毒感染者及病人的健康状况与卫生服务需求调查

Investigation on Health Status and Health services Demand of People Living with HIV / AIDS in the High HIV Epidemic Area

目的:了解艾滋病疫情高发区艾滋病病毒感染者及病人的健康状况与卫生服务需要导向,明确无任何症状的HIV感染者与艾滋病病人之间的需求差异。方法:选择以吸毒传播和性传播为主的云南省大理州大理市作为艾滋病高发区样本地区,按照感染者及病人发现顺序,随机抽取感染者274例,病人187例,通过当地疾病预防控制中心及定点治疗医院的信息系统及回顾性随访展开调查。结果:PLWHA人群中艾滋病病人的两周患病率、严重程度(休工/学率)以及慢性病患病率分别为598.9‰、7.5%和508.0%,显著高于无症状的HIV感染者(489.1‰、4.4%和263.7%),均高于一般人群水平,PLWHA两周患病率较高的疾病多与艾滋病的毒副反应和机会性感染有关。结论:随病情发展,PLWHA卫生服务需要将急剧增加,尤其对慢性病卫生服务需求增加明显。除了针对其抗病毒治疗外,尚需针对不同病情阶段特征,完善保障政策,满足其卫生服务需要,缓解PLWHA人群的疾病负担。

Objective： To investigate the health service demands of people living with HIV and AIDS in the high HIV epidemic area for identifying the differences of needs between the HIV carriers and AIDS patients. Methods： Dali,Yunnan was selected as the sample area since most of the PLWHA there is infected through drug abuse and unprotected sex. Based on the registration time,274 HIV carriers and 187 AIDS patients were random selected for retrospective survey about their needs of health service and demographic information. Some information were also collected by HIS. Results： The two- week prevalence rate,the chronic diseases prevalence rate and the rate of quitting school or working of AIDS patients（ 598. 9‰、7. 5% 、508. 0%） are significantly higher than those of HIV carriers（ 489. 1‰、4. 4% 、263. 7%）,and all rates of both group are also higher than those of general population. Diseases with high two- week prevalence rate are associated with toxicity reaction of HAART and opportunistic infections. Conclusion： The health service requirements of AIDS patients are greater than those of HIV infected persons,related policies should be improved to meet the requirements especially the huge one of chronic disease,and reduce the patients＇ financial burden.