天津市2011～2015年HIV/AIDS晚发现病例特征及影响因素分析

The characteristics of late diagnosed HIV/AIDS cases in Tianjin from 2011 to 2015 and its influencing factors

目的:了解天津市2011~2015年新报告HIV/AIDS病例的晚发现比例,分析晚发现的影响因素。方法:通过艾滋病综合防治信息系统收集天津市2011~2015年新报告HIV/AIDS病例的数据信息,对病例信息进行分析,计算晚发现的比例并分析其影响因素。结果:2011~2015年天津市累计新发现的HIV/AIDS病例数为2922例,晚发现比例为31.3%。多因素分析表明25~34岁病例(adjusted OR=1.722,95%CI:1.346~2.334)、35~49岁病例(adjusted OR=2.934,95%CI:2.125~4.051)、50岁及以上病例(adjusted OR=3.859,95%CI:2.625~5.673)晚发现比例高于25岁以下病例;STD就诊者发现病例(adjusted OR=0.293,95%CI:0.209~0.413)、VCT发现病例(adjusted OR=0.278,95%CI:0.213~0.364)、专题调查发现病例(adjusted OR=0.254,95%CI:0.198~0.326)晚发现比例低于医疗机构检测发现病例;本市户籍病例(adjusted OR=1.266,95%CI:1.043~1.538)晚发现比例高于非本市户籍病例。结论:天津市新发现HIV/AIDS病例存在一定比例的晚发现现象,年龄、户籍、病例来源为影响病例晚发现的主要因素,应采取有效措施及早发现病例。

Objectives： To understand the proportion of late diagnosis among newly reported HIV/AIDS cases in Tianjin from 2011 to 2015 and analyze its influencing factors. Methods： Related informations of newly reported HIV/AIDS cases from 2011 to 2015 were collected from national HIV/AIDS comprehensive information system,the rate of late diagnosis and its influencing factors were analyzed. Results： There were 2922 newly reported HIV/AIDS cases from 2011 to 2015 in total,with a proportion of late diagnosis of 31. 3%. Multivariate analysis indicated that the proportion of late diagnosis among 25 ~ 34 years old cases（ adjusted OR = 1. 722,95% CI： 1. 346 ~2. 334）,35 ~ 49 years old cases（ adjusted OR = 2. 934,95% CI： 2. 125 ~ 4. 051） and above 50 years old cases（ adjusted OR = 3. 859,95% CI： 2. 625 ~ 5. 673） was higher than that among under 25 years old cases. The proportion of late diagnosis among the cases from clients of sexually transmitted disease（ adjusted OR = 0. 293,95% CI：0. 209 ~ 0. 413）,from voluntary counseling testing（ VCT）（ adjusted OR = 0. 278,95% CI： 0. 213 ~ 0. 364）,from special investigation（ adjusted OR = 0. 254,95% CI： 0. 198 ~ 0. 326） was lower than that among the cases from medical institutions detections. The proportion of late diagnosis among the local cases was higher than that of migrant cases（ adjusted OR = 1. 266,95% CI： 1. 043 ~ 1. 538）. Conclusion： There is a certain proportion of late diagnosis among newly reported HIV/AIDS cases in Tianjin,while age,household registration and sources of detection channels are the influencing factors,so it is imperative to take effective countermeasures for early diagnosis.