2011—2017年嘉兴市HIV感染孕产妇的流行病学特征及预防策略

Epidemiological characteristics and prevention strategies of HIV-infected pregnant women in Jiaxing from 2011 to 2017

目的分析2011—2017年嘉兴市人类免疫缺陷病毒(HIV)感染孕产妇的流行病学特征,并提出预防策略。方法采用回顾性研究,从"预防艾滋病(AIDS)母婴传播管理信息系统"收集嘉兴市2011年1月至2017年12月HIV阳性报告病例数据,分析其流行病学特征。结果HIV感染阳性孕妇数共100人,其中终止妊娠51(51.00%)人,分娩49(49.00%)人。孕产妇接受HIV检测的比率呈逐年上升趋势,但2013年出现短暂下降,之后上升至2017年的99.99%(χ^2=180.18,P<0.05)。孕晚期确诊率呈下降趋势,Fisher检验后的精确P值为0.014,其余时期的确诊趋势变化无统计学意义(P>0.05)。最终分娩的49例HIV感染孕产妇中,无业、已婚的HIV感染比例明显多于在职、未婚者(χ^2=14.317、12.681,均P<0.05),年龄、民族、文化程度、所在地对比差异无统计学意义(P>0.05)。49例孕产妇中有33例(67.35%)使用抗病毒治疗,分娩的婴儿45例(91.84%)使用了抗病毒治疗,治疗率均呈上升趋势,但均无显著性差异(P>0.05)。所有婴儿都采取了人工喂养。结论2011—2017年嘉兴市产妇HIV/AIDS流行情况较为严峻,应加大宣传教育力度,加强对孕产妇的检测工作,对无业、已婚者等重点人群采取有效干预措施。另外,HIV/AIDS母婴阻断可有效减少母婴传播,效果显著,值得推广使用。

Objective To analyze the epidemiological characteristics of pregnant women infected with human immunodeficiency virus(HIV)from 2011 to 2017 in Jiaxing City,and put forward prevention strategies.Methods A retrospective study was conducted to collect data of HIV-positive cases reported in Jiaxing from January 2011 to December 2017 from the management information system for the prevention of mother-to-child transmission of AIDS,and analyze its epidemiological characteristics.Results The total number of HIV positive pregnant women was 100,including 51(51.00%)who terminated pregnancy and 49(49.00%)who had delivered.The diagnosis rate in the third trimester showed a decreasing trend,and the accurate P value after Fisher’s test was0.014,while the change in the diagnosis trend in other periods was not statistically significant(P>0.05).Among the 49 pregnant women with HIV infection in the final delivery,the proportion of unemployed and married women with HIV infection was significantly higher than that of the working and unmarried women(χ^2=14.317,12.681,all P<0.05).There was no significant difference in age,nationality,education level and location(P>0.05).There were 33 cases(67.35%)of 49 pregnant women and 45 cases(91.84%)of infants who gave birth.The treatment rate showed an upward trend,but there was no significant difference(P>0.05).All the babies were fed by hand.Conclusion From 2011 to 2017,the prevalence of HIV/AIDS among pregnant women in Jiaxing City was severe.Therefore,we should strengthen the publicity and education,strengthen the detection of pregnant women,and take effective intervention measures for the unemployed,married and other key groups.In addition,the blocking of mother-to-child HIV/AIDS can effectively reduce mother-to-child transmission,with significant effect,which is worth promoting.