福建省HIV/AIDS双阳家庭感染特征及其影响因素

Study on the infection characteristics and influencing factors of HIV-seroconcordant couples in Fujian Province

目的了解福建省人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者/艾滋病(acquired immune deficiency syndrome, AIDS)患者(简称HIV/AIDS)中双阳家庭感染特征及其影响因素。方法采用统一面访问卷调查福建省截至2019年12月31日报告的HIV/AIDS确诊双阳夫妻对,收集人口学和疾病相关信息。对双阳家庭感染状况的影响因素进行单因素和多因素非条件Logistic回归分析模型分析。结果共调查1 042个双阳家庭,即2 084例HIV/AIDS病例,先报告病例首次配偶检测阴性的占7.9%(82/1 042);先报告病例与后报告病例报告时间间隔>365 d者占5.7%(59/1 042),多因素非条件Logistic回归分析模型分析结果显示:先报告病例年龄<30岁者(OR=3.642, 95%CI=1.491~8.894)该比例较高;后报告感染者有97.5%(1 016/1 042)接受过CD4+ T淋巴细胞计数检测,其中,首次检测CD4+ T淋巴细胞计数<200个/μl者占26.2%(266/1 016),多因素非条件Logistic回归分析模型分析结果显示,先报告病例为女性(OR=2.285, 95%CI=1.676~3.115)、病程为AIDS者(OR=1.845, 95%CI=1.356~2.510)该比例较高,而先报告病例年龄<30岁者(OR=0.463, 95%CI=0.259~0.825),该比例较低。结论不同双阳家庭感染特征不同,应提高已婚有配偶人群HIV感染风险意识和检测意识,积极动员其告知配偶并检测,尤其应关注女性、病程为AIDS和老年感染者,以减少配偶间传播。

Objective To investigate the infection characteristics and influencing factors of HIV-seroconcordant couples in Fujian Province. Methods A unified face-to-face questionnaire was used to investigate the couples diagnosed with HIV/AIDS reported before December 31, 2019 in Fujian Province, and demographic information and disease-related information were collected.Univariate and multivariate Logistic regression models were used to analyze the influencing factors of infection status. Results A total of 1 042 couples(2 084 persons) infected with HIV/AIDS were under survey, among whom 82(7.9%) cases’ partners were HIV-serodiscordant during the first testing, and 5.7% couples whose reported interval were over 365 d. Multivariate Logistic regression analysis showed that those who aged<30 years old(OR=3.642, 95% CI=1.491-8.894) were more likely to report an interval over 365 d. 97.5%(1 016/1 042) of subsequent reported cases among the HIV-seroconcordant couples completed the CD4^+ T cell counts testing. There were 266 cases(26.2%)whose CD4^+ T cell counts were under 200 cells/μl in the first testing. Multivariate Logistic regression analysis showed that the spouses of those who were female as first reported cases(OR=2.285, 95%CI=1.676-3.115), or AIDS(OR=1.845, 95% CI=1.356-2.510) were more likely under 200 cells/μl in first testing. The spouses of those who aged<30 years old(OR=0.463,95% CI=0.259-0.825) were just the opposite. Conclusion The characteristics of infection in different HIV-seroconcordant couples are different. The awareness of HIV infection and detection among married people should be enhanced, and their spouses should be actively mobilized for notification and detection. In order to reduce the transmission between spouses, targeted measures should be taken to promote early HIV testing and detection for those who were female, AIDS or the old.