广西壮族自治区来宾市艾滋病母婴阻断项目效果评价

Effectiveness evaluation of project of mother-to-child transmission block of HIV/AIDS in Laibin,Guangxi Zhuang Autonomous Region

目的对艾滋病母婴阻断项目在广西来宾市的实施进行效果评估,为全市预防艾滋病母婴传播提供科学依据。方法在全市实施艾滋病母婴阻断技术,对凡参加孕检的孕产妇免费进行艾滋病咨询检测,对检出阳性者进行艾滋病母婴阻断(感染母亲及所生婴儿按艾滋病母婴阻断技术方案服用抗逆转录病毒药物、实行安全助产和人工喂养指导等)。结果 2010—2015年全市共有207 861例孕产妇参加艾滋病咨询检测,检测率99.17%(207 861/209 600),检出艾滋病抗体阳性325例,检出阳性率0.16%(325/207 861);对检出艾滋病抗体阳性的孕妇纳入艾滋病母婴阻断系统管理,通过卫生咨询指导,告知患者艾滋病的传播方式及其危害性、预防措施和伦理等知情选择,最后自愿选择终止妊娠87例,选择生育的238例;238例艾滋病抗体阳性者中有227例按艾滋病母婴阻断技术方案全程足量服用抗逆转录病毒药物,服药率95.38%(227/238);活产婴儿232例,按艾滋病母婴阻断技术方案全程足量服用抗逆转录病毒药物221例,服药率95.26%(221/232);而后按艾滋病母婴阻断技术方案对出生婴儿满42天和3个月进行艾滋病早期诊断,检出阳性1例,检出阳性率0.45%;最后对198例出生满18个月婴儿,进行艾滋病抗体检测,未捡出艾滋病抗体阳性者。结论孕产妇在进行正常孕产检时同时进行艾滋病咨询检测,对艾滋病的早期发现,可以取得事半功倍的效果;对检出艾滋病阳性孕妇及所生婴儿采取艾滋病母婴阻断综合性预防措施,是预防艾滋病母婴传播的有效方法。

Objective To evaluate the effectiveness of the project of mother-to-child transmission block of HIV/AIDS in Laibin City, Guangxi Zhuang Autonomous Region, so as to provide the evidence for improving the prevention of mother-to- child transmission of HIV/AIDS in the city. Methods The mother-to-child transmission block of HIV/AIDS technology was implemented in the whole city. The HIV/AIDS counseling and detection were conducted in pregnant women in free of charge, and the HIV positive detection women were treated according to the mother-to-child transmission block of HIV/AIDS technology （the infected mothers and babies receiving antiretroviral drugs according to the mother-to-child transmission block of HIV/AIDS technology, implementation of safe deliver, and artificial feeding, etc.）. Results A totel of 207 861 pregnant women received the maternal counseling and HIV tests in the city during 2010 and 2015. The detection rate was 99.17% （207 861/209 600）, and 325 cases were HIV antibody positive with the positive rate of 0.16% （325/207 861）. The HIV antibody positive pregnant women were brought into the mother-to-child transmission block of HIV/AIDS system management. Through the health advisory guidance, including informing the knowledge of the spread of HIV/AIDS and its harmfulness, the prevention measures and ethical informed choices, 87 women selected the termination of pregnancy, and 238 cases chose birth. Among 238 HIV antibody positive cases, 227 received the enough antiretroviral drugs according to the mother-to-child transmission block of HIV/AIDS technology during the whole course, and the medication rate was 95.38% （227/238）. The live births were 232 cases and 221 received the enough antiretroviral drugs according to the mother-to-child transmission block of HIV/AIDS technology during the whole course, and the medication rate was 95.26% （221/232）. Then according to the mother-to-child transmission block of HIV/AIDS technology, the infants of 42 days and 3 months received the HIV antibody tests, and one case was positive （0.45%）. Finally, 198 infants of 18 months received the HIV antibody tests and none was positive. Conclusion While the pregnant women receive the antenatal care, they also receive the counseling and detection of HIV/ AIDS, which can get well effects, such as early diagnosis of AIDS, and therefore, the measures of mother-to-child transmission block of HIV/AIDS can be implemented as early as possible. It is an effective method to prevent mother-to-child transmission of HIV/AIDS.