福建省2015—2018年新报告HIV/AIDS患者配偶检测情况及影响因素

HIV detection and its influencing factors among spouses of newly registered HIV/AIDS patients in Fujian province, 2015-2018

目的了解福建省2015-2018年新报告艾滋病病毒感染者/艾滋病(HIV/AIDS)患者配偶检测情况及影响因素。方法采用统一面访问卷调查福建省2015-2018年每年11月30日前新报告的存活、婚姻状况为已婚有配偶的确诊HIV/AIDS患者,收集人口学信息和疾病相关信息。对配偶检测情况的影响因素进行单因素和多因素非条件logistic回归分析。结果共调查2 937例新报告的HIV/AIDS病例,报告当年配偶检测率89.9%(2 641/2 937),其中配偶检测阳性率20.5%(541/2 641),不同年份间配偶检测率差异有统计学意义(χ^2=19.396,P <0.001),而配偶阳性率差异无统计学意义(χ^2=1.770,P=0.621);多因素非条件logistic回归分析显示,户籍为省外(OR=1.435,95%CI=1.050~1.960)在报告当年进行配偶检测的比例较低,进行CD4检测(OR=0.102,95%CI=0.072~0.144)、在当年进行治疗者(OR=0.488,95%CI=0.361~0.662)在报告当年进行配偶检测的比例较高,女性(OR=3.903,95%CI=3.095~4.922)、年龄≥60岁(OR=2.349,95%CI=1.493~3.693)、病程为AIDS患者(OR=1.750,95%CI=1.415~2.164)、样本来源为重点人群(OR=1.945,95%CI=1.093~3.462)在报告当年配偶检测阳性的比例较高,文化程度高中及以上(OR=0.418,95%CI=0.300~0.582)、感染途径为同性传播(OR=0.348,95%CI=0.139~0.868)在报告当年配偶检测阳性的比例较低。结论应加强对辖区内户籍为省外流动人员的配偶检测动员工作,同时与推动HIV/AIDS病例CD4检测与抗病毒治疗转介工作相结合,以完善新报告病例的随访管理工作;不同特征的病例在报告当年配偶检测阳性的比例不同,应采取针对性措施以减少配偶间传播,促进病例的早检测与早发现。

Objective To examine the status and influencing factors of human immunodeficiency virus(HIV) testing among spouses of newly registered HIV/AIDS patients in Fujian province. Methods We conducted face-to-face interviews during 2015 – 2018 among married HIV/AIDS patients newly diagnosed from January 1 st to November 30 th in a year.Information on demographics and HIV/AIDS of the patients and their spouses were collected using a questionnaire.Univariate and multivariate logistic regression analysis were adopted in analyses on status and impact factors of HIV detection among the patients′ spouses. Results For the 2 937 newly registered HIV/AIDS patients surveyed totally, 2 641(89.9%) reported HIV detections of their spouses in the year of themselves′ diagnosis. Among all the spouses being detected,541(20.5%) were HIV positive and there was a significant difference in yearly HIV detection rate among the spouses(χ^2 =19.396, P < 0.001) but the annual HIV positive rates for the spouses detected were not significantly different(χ^2 = 1.770, P =0.621). Multivariate logistic regression analysis indicated that the patients without local residence of Fujian province were less likely with a spouse having HIV detection in the year of the patients being diagnosed(odds ratio [OR] = 1.435, 95%confidence interval [95% CI]: 1.050 – 1.960);while, the patients having a CD4+ T cell detection(OR = 0.102, 95% CI:0.072 – 0.144) and receiving treatment in the year of diagnosis(OR = 0.488, 95% CI: 0.361 – 0.662) were more likely with a spouse having HIV detection in the year of the patients being diagnosed. The patients of female gender(OR = 3.903, 95% CI:3.095 – 4.922), aged ≥ 60 years(OR = 2.349, 95% CI: 1.493 – 3.693), diagnosed with AIDS(OR = 1.750, 95% CI: 1.415 –2.164), and being a member of high-risk population(OR = 1.945, 95% CI: 1.093 – 3.462) were more likely with HIV positive spouses detected in the same year of the patients′ diagnosis;however, the patients with high education(OR = 0.418, 95% CI:0.300 – 0.582) and being infected through heterosexual contact(OR = 0.348, 95% CI: 0.139 – 0.868) were less likely with HIV positive spouses detected in the same year of the patients ′ diagnosis. Conclusion In Fujian province, the newly diagnosed HIV/AIDS patients with various characteristics reported different HIV positive rate among their spouses within the same year of diagnosis, suggesting that targeted measures should be developed for early HIV detection among the spouses of the newly diagnosed HIV/AIDS patients. The results of the study also indicate that HIV detection among the spouses of newly registered migrant HIV/AIDS patients needs to be promoted.