广西农村地区HIV感染者生育意愿及其影响因素分析

Fertility intentions of people living with HIV in rural areas of Guangxi and its influencing factors

目的了解广西农村地区艾滋病病毒(HIV)阳性人群生育意愿,分析其影响因素。方法于2018年采用单纯随机抽样方法,从广西浦北县和平南县所有年龄在18~49岁、有性生活史的HIV感染者中随机抽取846名作为调查对象,其中浦北县446名、平南县400名。由调查员进行面对面问卷调查,内容包含基本情况、婚育情况及其生育意愿等,采用χ2检验和多因素logistic回归模型分析生育意愿的影响因素。结果共获得822份有效问卷,有效率为97.2%(822/846)。36.0%(296/822)的调查对象有生育意愿。单因素分析结果显示,民族、教育程度、家庭年收入、现有子女数和是否达到理想子女数是生育意愿的影响因素(P值均<0.05)。多因素分析结果显示,尚未生育的调查对象比已有3个以上孩子的调查对象生育意愿更高(OR=3.431,95%CI:1.368-8.601),而达到理想子女数将降低其生育意愿(OR=0.094,95%CI:0.060-0.150)。自我报告影响生育意愿的因素主要为身体状况(72.1%,593/822)和经济条件(29.2%,240/822)。结论广西农村地区HIV感染者的生育意愿较高,要关注HIV阳性人群的生育意愿,加强对其孕前的指导和随访,强化婚内传播风险和母婴阻断知识的宣讲,减少HIV的垂直和水平传播。

Objective To understand the willingness to give birth among HIV-positive people in rural areas of Guangxi and analyze its influencing factors.Methods In 2018,simple random sampling method was used to randomly select 846 participants from HIV-positive people in Pubei and Pingnan county,Guangxi,who aged between 18 to 49 years old,with sexual life.Four hundred and forty-six participants were from Pubei county,and 400 participants were from Pingnan county.Face-to-face questionnaire surveys were conducted by the investigators,which included basic information,marriage and childbirth status,and fertility intentions,etc.The chi square test and multi-factor logistic regression model were used to analyze the influencing factors of childbearing willingness.Results A total of 822 valid questionnaires were obtained,with an effective rate of 97.2%(822/846).The rate of willingness to give birth was 36.0%(296/822).The results of univariate analysis showed that the ethnicity,education level,annual family income,the number of existing children,and whether the ideal number of children was reached were the influencing factors of the willingness to bear children(all P values <0.05).The results of multivariate analysis showed those who had not yet given birth were more willing to bear children than those who had have more than 3 children(OR=3.431,95% CI=1.368-8.601),and reaching the ideal number of children would reduce their willingness to bear children(OR=0.094,95% CI=0.060-0.150).The self-reported factors affected childbearing willingness were physical conditions(72.1 %,593/822) and economic conditions(29.2%,240/822).Conclusions The willingness of HIV-positive people to bear children in rural areas of Guangxi was relatively high.It is necessary to pay attention to the willingness of HIV-positive people to bear children,strengthen the guidance and follow-up before pregnancy,strengthen the dissemination of knowledge about the risk of intramarital transmission and interruption of maternal-infantile transmission,and reduce the verticality and horizontal spread of HIV.