杭州市2015-2016年艾滋病综合防治成果

Effect analysis on prevention and control of AIDS in Hangzhou from 2015 to 2016

目的探讨由疾控机构、定点医院、社区卫生服务中心和社会组织组成的“多位一体”艾滋病综合防治模式的成效，为政府决策提供依据。方法收集2015-2016年期间HIV，AIDS检测、抗病毒治疗和随访管理数据，分析不同组织在重点人群HIV检测发现中作用，比较不同医疗机构HIV／AIDS治疗随访管理质量。结果杭州市西湖区2015-2016年重点人群HIV抗体累计检测42171人，初筛阳性率1．11％（468例），确证阳性率0．75％（317例）。医院性病门诊动员就诊者占总数的42．47％，初筛阳性送确证率仅68．25％，确证阳性率O．96％（172例）。疾控中心检测人数占总数的36．11％，初筛阳性送确证率达90．09％，确证阳性率0．61％（93例）。社区卫生服务中心检测人数占16．90％，初筛阳性送确证率88．87％，确诊阳性7例。社会组织动员男男性行为者1906例，初筛阳性送确诊率46．88％，确诊阳性率2．36％（45例）。2632参与检测的男男性行为者中，由社会组织动员检测者占72．42％；由疾控中心确证阳性率达到11．70％（82例）。随访检测项目如CD4细胞和病毒载量检测、抗病毒治疗、结核病检测等的实施率方面，疾控机构显著低于医院和社区卫生服务中心（P〈0．01）。结论有必要加强对医院性病门诊及社会组织初筛阳性人群的追踪随访，提高该人群的送确诊率；疾控机构在随访项目实施方面无优势，相关工作更适宜在社区卫生服务中心及定点医院开展。

Objective To explore the achievements for the ＂all-in-one＂ comprehensive prevention and control of AIDS set up by disease control agency, fixed-point hospital, community healthcare center and social organizations, and provide the basis for government decision-making. Methods We collected data of HIV/AIDS detection, antiviral therapy and follow-up management during 2015-2016, analyzed roles of different organizations in key crowd by HIV testing, and compared qualities of HIV/AIDS treatment follow-up management of different medical institutions. Results The key cluster HIV antibody were tested among 42 171 people during 2015 to 2016 in Xihu District of Hangzhou. The positive rate on preliminary screening was 1.11% （468 cases）, and the positive rate on a definite diagnosis was 0.75% （317 cases）. STD clinic attendants were 42.47%, of which the positive rate on preliminary screening was 68.25% and the positive rate on a definite diagnosis was 0.96% （172 cases）. The people tested by center for disease control and prevention were 36.11%, of which the positive rate on preliminary screening was 90.09% and the positive rate on a definite diagnosis was 0.61% （93 cases ）. The people tested by the community health service centers was 16.90%, of which the positive rate on preliminary screening was 88.87% and the 7 cases were definitely diagnosed positive. A total of 1 906 men who have sex with men involved in the detection, of which the positive rate on preliminary screening was 46.88% and the positive rate on a definite diagnosis was 2.36% （45 cases）. Among 2 632 men who have sex with men had been tested, and 72.42% took testmotivated by social organizations, and the positive rate on a definite diagnosis by the center for disease control and prevention was 11.70% （82 cases）. HIV/AIDS virus detection rate, CD4 testing, antiviral treatment, tuberculosis detection percentage by disease control agency were significantly lower than the community health service center and the fixed-point hospital （P〈0.01）. Conclusions It is necessary to enhance the follow-up visit of positive people in STD clinic and social organization, and improve the confirmed rate of those people. CDC has no advance on follow-up programs, so community health center and fixed-point hospital should do the relative work.