广东省2010―2016年晚发现HIV/AIDS病例特征及影响因素分析

Characteristics and influencing factors for late diagnosed HIV/AIDS cases in Guangdong Province,2010-2016

目的了解广东省2010―2016年新报告的艾滋病病毒(HIV)感染者和艾滋病(AIDS)患者中晚发现病例的比例、相关特征以及影响因素。方法通过全国艾滋病防治信息系统收集广东省2010―2016年新报告的HIV/AIDS病例数据,对其中晚发现的HIV/AIDS病例特征进行描述流行病学分析,并运用多因素logistic回归分析探索晚发现的相关影响因素。结果 2010―2016年广东省新报告HIV/AIDS病例47 343例,其中19 624例为晚发现病例(占41.5%),7年间晚发现比例呈下降趋势(P<0.01)。多因素logistic回归分析结果显示,女性病例相比男性病例晚发现的风险较低(OR=0.820);≥20岁的各年龄组病例晚发现的风险高于<20岁年龄组病例(OR=1.720~5.265);已婚(OR=1.255)、离异/丧偶(OR=1.199)病例晚发现的风险高于未婚病例;文化程度为大专及以上的病例晚发现的风险低于文盲者(OR=0.823);来自医疗机构(OR=3.110)、检测咨询(OR=1.687)和性病门诊(OR=1.569)的病例晚发现的风险均高于专题调查来源的病例;异性传播(OR=0.580)、同性传播(OR=0.404)、注射吸毒(OR=0.588)的病例均比经血液途径感染的病例晚发现的风险低。结论广东省2010―2016年新报告HIV/AIDS病例晚发现比例呈下降趋势,性别、年龄、婚姻状况、文化程度、发现途径和感染途径均为HIV/AIDS病例晚发现的影响因素。

Objective To understand the proportion, epidemic characteristics and influencing fac- tors of late diagnosed HIV/AIDS among the new cases reported between 2010 and 2016 in Guangdong Prov- ince. Methods The data of the newly reported HIV/AIDS cases from 2010 through 2016 in Guangdong were collected from the National AIDS Prevention and Information System. Descriptive analysis was conduc- ted on the late diagnosed HIV/AIDS cases, and multivariate logistic regression was performed to analyze the related influencing factors, lleslllts A toal of 47 343 HIV/AIDS eases were reported in Guangdong Province from 2010 to 2016, including 19 624 late diagnosed cases （41.5% of the total cases）. The pro- portion of late diagnosed cases decreased in the past 7 years （ P 〈 0.01 ）. Multivariate logistic regression analysis showed that female patients had lower risk of late diagnosed than male ones （ OR = 0. 820 ） ; the risk of late diagnosed cases in group aged over 20 years was higher than that in group 〈 20 years （ OR = I. 720 - 5. 265 ） ; compared with unmarried patients, the married （ OR = 1. 255 ）, divorced or widowed （ OR = 1. 199 ） had higher risk of late diagnoses ; those with college degree or above had lower risk of late diagnoses than illiterates（ OR =0. 823）. Compared with the cases derived from special investigation, cases from medical institutions （ OR = 3.110 ）, VCT （ OR = 1. 687 ） and STD chuics （ OR = 1. 569 ） tended to have a greater risk; and the cases who had blood transfusion experience had higher risk of late diagnoses com- pared with the cases who had experienced heterosex（ OR =0.580）, homosex （OR =-0.404）or drug injec- tion（ OR = 0. 588 ）. Conclusion The proportion of late diagnosed cases showed a downtrend among the newly reported HIV/AIDS cases in Guangdong Province from 2010 to 2016. Gender, age, marital status, educational level, discovery approach and route of infection were influencing factors for late diagnoses.