杭州市上城区各级医疗机构不同途径HIV检测情况分析

Analysis of HIV detection in different medical institutions and different ways in Shangcheng district, Hangzhou

目的对杭州市上城区2013-2017年艾滋病(AIDS)检测资料通过不同发现机构和发现途径进行分析,为制订科学、有效的艾滋病病毒(HIV)感染者发现策略提供依据。方法通过网络直报和日常工作,收集整理上城区2013-2017年各级医疗卫生机构开展HIV抗体筛查的资料,进行描述性流行病学分析。结果从2013-2017年,累计有10家医疗卫生机构共进行HIV筛查2320125人次,共发现HIV感染者/AIDS病人(简称HIV/AIDS病人)1401例,阳性率为6.04/万,医疗机构发现占89.15%,疾病预防控制(简称疾控)中心发现占10.85%,医疗机构HIV阳性检出率为5.48/万,其中市级医院HIV阳性检出率最高为9.15/万,疾控中心阳性检出率为37.87/万,疾控中心阳性检出率有随年度增加而增高的线性趋势。不同发现途径阳性检出率以自愿检测咨询(174.59/万)最高,其次为性病就诊者(24.90/万),性病就诊者阳性检出率有随年度增加而增高的线性趋势。结论医疗机构是发现HIV感染者的主要来源,自愿咨询检测和性病门诊HIV阳性检出率高,继续加强医疗机构HIV常规检测,应维持疾控中心自愿咨询检测能力,且采取扩大检测和精准检测相结合的防控策略,扩大性病门诊等高危人群HIV筛查力度。

Objective To analyze the data of AIDS detection in Shangcheng district of Hangzhou from 2013 to 2017 in different medical institutions and different ways, so as to provide basis for developing scientific and effective strategies for HIV detection. Methods Data of HIV antibody screening was collected by medical and health institutions at all levels in Shangcheng from 2013 to 2017, and descriptive epidemiological analysis was made for the analysis. Results From 2013 to 2017, there were 2 320 125 times of HIV screening in 10 medical and health institutions. A total of 1 401 HIV/AIDS cases were detected, with a positive rate of 60.04/10 000, 89.15% in medical institutions, and 10.85% in CDC. The HIV positive detection rate was 5.48/10 000 in medical institutions, of which the municipal hospitals had the highest positive detection rate of 9.15/10 000, and CDC had that of 37.87/10 000. The positive detection rate of CDC increased year by year. The positive detection rate of different detection routes was the highest in the clinics of voluntary counseling and testing(VCT)(174.59/10 000), followed by STD clinics(249/10 000), and others. The positive detection rate of STD clinics increased year by year. Conclusion Medical institutions are the main source for detection of HIV infection, and clinics of VCT and STD have high rate of HIV positive detection. We should continue to strengthen routine HIV testing in medical institutions, and improve the detection capacity of VCT and STD clinics to expand HIV testing, esp. for the high-risk groups.