盐城市HIV/AIDS流行特征和晚发现影响因素

Analysis of epidemiological characteristics of HIV/AIDS and influencing factors of late diagnosis in Yancheng

目的了解盐城市近3年新发现HIV/AIDS的流行病学特征,探讨HIV/AIDS早期发现的对策与措施。方法对2011年1月-2014年6月新报告的现住址为盐城市的411例HIV/AIDS病例进行流行病学分析,并对其中存活的92例晚发现病例开展调查访谈。结果411例HIV/AIDS中,男性占84.67%,平均年龄（39.34±12.98）岁,≥50岁病例占21.41%。感染途径均为性途径,同性传播占37.23%。样本来源以医疗机构为主,占51.10%。晚发现比例为36.01%,多因素逐步logistic回归发现,25~49岁组、≥50岁龄组患者晚发现的风险较高,样本来源于＂VCT、其他检测＂的患者晚发现的风险较低。92例存活的晚发现病例中有非固定异性性行为史比例较高,主动检测比例较低,CD4＋计数〈50/μL的占43.48%。结论盐城市应关注≥50岁人群的宣传干预,开展针对性专题调查,全力推进VCT和PITC工作,扩大检测面,及早发现HIV感染者并有效管理。

Objective To study the epidemiological characteristics of newly diagnosed HIV/AIDS patients in past 3 years;to discuss measures and strategies to diagnose HIV/AIDS in early stage.Methods A total of 411 newly diagnosed patients with current residency in Yancheng from Jan 2011 to Jun 2014 were selected and subjected to epidemiological analysis.The questionnaire survey was conducted among 92 survival late diagnosed patients.Results The average age of 411HIV/AIDS patients was（39.34 ±12.98）years.Male accounted for 84.67% and patients over 50 years accounted for 21.41%.All patients were infected via sexual transmission route,in which 37.23% were infected via homosexual transmission route.Samples were mainly collected in medical institutions,accounting for 51.10%.The late diagnosis rate was 36.01%.Multivariate logistic regression analysis showed that age of 25~49or≥50had higher risk of late diagnosis,samples collected from ＂ VCT,other test service＂ had lower risk of late diagnosis.92 survival patient of late diagnosis had high ratio of irregular heterosexual history with low ratio of active test,43.48% had less than 50CD4＋cells/μL in blood.Conclusion More advocacy and interventions should be focused on people≥50 in Yancheng.In order to expand HIV test coverage and identify HIV-infected patient at early stage with following effective management,targeted special investigation should be carried out to promote VCT and PITC services.