贵港市1996—2015年HIV/AIDS患者失访影响因素分析

Influence factors on losing follow-up of patients with HIV/AIDS during 1996-2015 in Guigang City.Guangxi

目的了解贵港市HIV/AIDS患者的失访率,并分析其失访的影响因素,为优化随访工作提供参考。方法收集1996年1月1日至2015年12月31日艾滋病综合防治信息系统的随访数据,建立数据库后,用SPSS17.0软件对数据进行描述性分析、卡方检验和非条件logistic回归统计分析,检验水准为0.05。结果共收集1996—2015年现住址为贵港市的HIV/AIDS患者9 425例,其中失访425例,失访率为4.51%。经卡方检验发现,报告单位、年龄、地区、职业、病程阶段、是否有密切接触者、婚姻状态、民族、文化程度、感染途径、样本来源以及诊断年龄均是失访的影响因素。非条件logistic回归分析发现,来自其他省,职业为民工,感染途径为注射毒品、性接触+注射毒品,样本来源为其他就诊者检测(性病门诊、术前/受血前/婚前/无偿献血/孕产期检测)、羁押人员检测、阳性者配偶、性伴、子女检测等病人更容易失访;病程为艾滋病,有密切接触者和诊断年龄>60岁的患者不容易失访。结论流动人群、羁押人员等高危人群易失访,他们更容易进一步传播艾滋病,应针对此类人群优化随访方案,以遏制艾滋病的蔓延和增加患者的寿命和生活质量。

Objective To explore the rate and influence factors of losing follow-up in HIV/AIDS patients in Guigang City. Methods The follow-up data was downloaded from China information system for AIDS control and prevention during 1996-2015. The database was established by Excel and SPSS for Windows Version 17.0 was used to analyze the data. Descriptive statistics, Chi-square test and Multivariate logistic regression analysis were performed to identify factors associated with the losing follow-up of HIV/AIDS patients. All statistical tests were two-sided with a significance level of P<0.05. Results There were 9 425 cases of the HIV/AIDS patients addressed in Guigang during 1996-2015 and 425 cases were losing follow-up accounting a rate of 4.51%. Chi-square test showed that the reporting unit, age, region, profession, the course of disease, close contact, marital status, nationality,education level, clinical stage, source of samples and age at diagnosis were associated with losing follow-up. The Binary multivariate logistic regression analysis showed that the persons coming from other provinces, migrant workers infected by injecting drugs and sexual contact+ injecting drugs, and other visitors(from STD clinic,preoperative/before accepting blood/premarital/free blood donation/pregnancy test), and the detainees testing as well as spouses, sexual partners and children of serum positive were more likely to lose follow-up,and the patients with AIDS, close contacts and the patients diagnosed at age over 60 were less likely to lose follow-up. Conclusion Migrant workers, detainees and other high-risk groups are more likely to lose follow-up, it's easier for them to spread AIDS. Above all, to curb the spread of AIDS, increase patients' life and quality of life, we need an optimized follow-up program for such groups.