中国2014年新报告HIV感染者与配偶离异或分居情况及其相关因素分析

Factors associated with marital status among spouse after diagnosed in newly reported HIV cases in China, 2014

目的 分析HIV感染者与配偶离异或分居情况及相关因素。方法 收集国家艾滋病综合防治信息系统2014年新报告、年满18周岁且已婚有配偶的HIV感染者的信息，根据确证阳性后1年内配偶变化情况分为“离异或分居”和“已婚有配偶”。应用logistic回归分析感染者与配偶离异或分居的相关因素。结果 共有31 708个已婚有配偶HIV感染者纳入分析，有22.5%（7 134/31 708）确证阳性后1年内离异或分居。81.6%（25 864/31 708）感染者的配偶1年内进行了HIV抗体检测，其中10.0%（2 599/25 864）离异或分居；18.4%（5 844/31 708）感染者的配偶1年内未进行HIV抗体检测，其中有77.6%（4 535/5 844）离异或分居。多因素logistic回归分析显示，配偶未检测的感染者中，≥46岁（46~岁：OR=1.28，95%CI：1.03~1.58；61~岁：OR=1.83，95%CI： 1.41~2.37）、汉族（OR=1.56，95%CI：1.34~1.83）、高中及以上文化程度（OR=1.55，95%CI：1.27~1.90）、非农民或民工（OR=1.34，95%CI：1.17~1.54）、注射吸毒（OR=1.33，95%CI：1.03~1.71）和同性传播途径感染（OR=1.49，95%CI：1.20~1.86）、无子女（OR=2.35，95%CI：1.78~3.09），离异或分居的比例较高。配偶已检测的感染者中，≥61岁（OR=1.32，95%CI：1.12~1.56）、汉族（OR=1.27，95%CI：1.13~1.44）、高中及以上文化程度（OR=1.26，95%CI：1.11~1.43）、非农民或民工（OR=1.37，95%CI：1.25~1.51）、同性传播途径感染（OR=1.38，95%CI：1.25~1.54）、无子女（OR=1.48，95%CI：1.27~1.71），离异或分居的比例较高。结论 我国已婚有配偶HIV感染者确证阳性后存在一定比例的离异或分居，不同特征的感染者确证阳性后离异或分居的比例不同，为减少已发现感染者的传播，需要采取针对性的干预措施。

Objective To analyze the factors associated with divorce or separation when one of the spouse diagnosed and newly reported as HIV positive, in China. Methods Data from the Chinese HIV/AIDS Comprehensive Response Information Management System, by December 31, 2015 were used for collection on newly reported HIV cases regarding their baseline information in 2014 and follow-up within one year, among couples and above 18 year olds. HIV cases were divided into divorce/separation group and married group according to their marriage dynamics in one year after being diagnosed as HIV positive. Multivariate logistic regressions were used to analyze potential factors associated with divorce or separation after the diagnoses made. Results A total of 31 708 HIV cases were included in this study. 22.5% （7 134/31 708） of them got divorced or separated in one year after diagnose being made. 81.6%（25 864/31 708） of them had couples tested in one year after diagnose made and 10.0% （2 599/25 864） of them got divorced or separated. Among 18.4% （5 844/31 708） of the HIV cases who did not have their couples tested in one year after the diagnoses, 77.6% （4 535/5 844） got divorced or separated. For those who did not have their couples tested in one year after the diagnose. Data from the multivariate logistic regression analysis showed that factors as those who were older than 45 （46-60 yr.：OR=1.28, 95%CI：1.03-1.58; ≥61 yr.：OR=1.83, 95%CI：1.41-2.37）, with Han ethnicity （OR=1.56, 95%CI：1.34-1.83）, with high school education or above （OR=1.55, 95%CI：1.27-1.90）, non-farmers or non-rural laborers （OR=1.34, 95%CI：1.17-1.54）, infected through injecting drug use （OR=1.33, 95%CI：1.03-1.71）, men who had sex with men （OR=1.49, 95%CI：1.20-1.86）, or with childless （OR=2.35, 95%CI：1.78-3.09） etc. were more likely to be divorced or separated after the diagnoses being made, among those who had their couples tested in one year after the diagnoses. Results from the multivariate logistic regression analysis showed that factors as those who were above 60 year olds （OR=1.32, 95%CI：1.12-1.56）, with Han ethnicity （OR=1.27, 95%CI：1.13-1.44）, with high school education or above （OR=1.26, 95%CI：1.11-1.43）, non-farmers or non-rural labors （OR=1.37, 95%CI：1.25-1.51）, infected through having sex with men （OR=1.38, 95%CI：1.25-1.54）, or without a child （OR=1.48, 95%CI：1.27-1.71）, were more likely to be divorced or separated after the diagnoses. Conclusion A certain proportion of HIV cases got divorced or separated in one year after the diagnosis was made. The proportions of divorce or separation were different among populations. Interventions targeting reducing divorce or separation in certain populations should be integrated into routine care system to reduce the HIV transmission.