上海市某区医疗机构开展HIV检测结果分析

Evaluation on Provider-initiated HIV Test and Counseling(PITC) in a District of Shanghai

目的评估上海市静安区开展医务人员主动提供HIV检测咨询服务(PITC)工作的效果。方法收集静安区2008—2014年HIV检测数以及HIV感染者和艾滋病人数,分别计算总体HIV阳性率、PITC阳性率和非PITC阳性率的时间变化趋势,分析PITC发现的感染者人口学特征和临床特征。结果 98.00%的检测数来自PITC,64.62%的感染者通过PITC发现,检出率为57.95/10万。2008—2014年总体HIV报告阳性率(P<0.001)、PITC(P<0.001)与非PITC(P<0.001)的报告阳性率均呈上升趋势。三级医疗机构为开展PITC的主要场所,且性病门诊的阳性检出率最高。与非PITC发现的感染者相比,PITC发现的HIV感染者中,50岁及以上(P=0.011)、女性(P=0.002)及非同性传播(P<0.001)者比例更高。结论 PITC是静安区HIV检测数和阳性数的主要来源。为达到尽可能多发现、早发现HIV感染者的目的,静安区应长期坚持开展PITC。

OBJECTIVETo evaluate the effect of Provider-Initiated HIV Test and Counseling（PITC） in Jing＇an District, Shanghai.METHODS It collected the numbers of people who received HIV test and who were diagnosed as HIV-positive from 2008 to 2014 inJing＇an District,to calculate temporal trends of HIV positive rates among all people,people detected through PITC and non-PITC,separately. In addition, it explored demographic and clinical characteristics of HIV-positive people detected through PITC. RESULTS 98.00% of people receiving HIV test in Jing＇an District were from PITC and 64.62% of HIV-positive people were detectedthrough PITC with the positive rate 57.95/100 000. From 2008 to 2014,the temporal trends of HIV positive rates among all people（χ~2=47.176, P〈0.001）, people detected through PITC（χ~2=22.373, P〈0.001）and non-PITC（χ~2=13.852, P〈0.001）were on therise. PITC was offered mainly in third-grade medical institutions,and the highest HIV positive rate was detected at Sexually Trans-mitted Disease（STD） clinic. Compared with HIV-positive people detected through non-PITC,there were higher proportions of peo-ple who were above 50（χ~2=6.432,P=0.011）,female（χ~2=9.557,P=0.002） and infected by non-homosexual route（χ~2=58.399,P〈0.001） among people detected through PITC. CONCLUSION Most of people who received HIV test and who were diagnosed asHIV-positive were from PITC in Jing＇an District. It should persist in long-term PITC to detect more HIV-positive people as early aspossible.