百色市HIV/AIDS患者配偶HIV感染变化趋势及影响因素分析

Change trend and influencefactors of HIV infection among the spouses of HIV/AIDS patients in Baise

目的探讨HIV/AIDS患者配偶HIV感染变化趋势及相关影响因素,为预防配偶间经性传播HIV提供参考依据。方法采取回顾性调查和前瞻性监测相结合的方法,选择百色市2006-2015年1 658例HIV/AIDS患者及其配偶为研究对象,每6个月对HIV/AIDS患者进行一次随访,并对HIV阴性的配偶进行HIV检测,运用Joinpoint Regression Program软件计算配偶HIV阳转率年度变化百分比(APC)并进行趋势检验,Cox比例风险回归模型分析配偶间HIV传播相关影响因素。结果调查的1 658例HIV/AIDS患者中男性980例(59.11%),平均年龄(40.59±13.57)岁,以壮族、农民及农民工、初中及以下文化程度和异性性途径感染为主,配偶HIV阳性率为34.08%,阴性配偶HIV阳转率1.77/(100人·年),HIV/AIDS患者确诊后1～6年的阴性配偶HIV阳转率分别为1.53/(100人·年)、2.29/(100人·年)、2.19/(100人·年)、1.23/(100人·年)、1.73/(100人·年)和0.93/(100人·年),经Joinpoint回归分析,阴性配偶HIV阳转率年度变化百分比(APC)为-4.70,下降趋势经检验差异无统计学意义(t=-0.563,P=0.603)。经Cox比例风险回归模型分析结果显示,HIV/AIDS患者的性别、年龄、职业和安全性行为状况与配偶间HIV传播存在统计学关联。结论安全性教育和健康干预需贯穿HIV/AIDS患者及其配偶健康管理的始终,可减少配偶间HIV经性途径传播的风险。

Objective To explore the change trend and influence factors of HIV infection among the spouses of HIV/AIDS patients,so as to provide reference for the prevention of sexual transmission of HIV between spouses.Methods With retrospective investigation and prospective monitoring,we selected 1658 cases of HIV/AIDS patients and their spouses from 2006 to 2015 in Baise city as the research object.Medical follow-up of theHIV/AIDS patients and HIV testing for spouses with negative HIV test results were performed every 6 months.Joinpoint regression program software was used to calculate the annual percentage change in the HIV seroconver-sion rate of spouses and a trend test was conducted.We used Cox proportional hazards regression model to analyze the influencing factors of HIV transmission among spouses.Results Among the 1 658 HIV/AIDS patients surveyed,males accounted for 59.11%(980)cases,with a mean age of(40.59±13.57)and they were mainly from Zhuang ethnic group,peasant and migrant workers,with education background of junior high school or below and infected by heterosexual behavior.The positive rate of HIV in spouses was 34.08%.The negative spouse HIV positive rate was 1.77/100 person-years.During the following 6 years from the diagnosis of HIV/AIDS patients,HIV positive rate of negative spouses was 1.53,2.29,2.19,1.23,1.73 and 0.93/100 person-year,respectively.Joinpoint regression analysis showed that the annual percentage change(APC)of HIV positive rate was-4.70,and there was no statistical difference in the downward trend(t=-0.563,P=0.603).The Cox proportional hazards regression model showed that gender,age,occupation and safe sexual behavior of HIV/AIDS patients were statisti-cally related to HIV transmission among spouses.Conclusion Safety education and health intervention needs should be performed throughout the health management of HIV/AIDS patients and their spouses,which can reduce the risk of sexual transmission of HIV between spouses.