四川省两个艾滋病疫情重点地区单阳家庭配偶告知情况差异分析

Analysis of the differences of spousal notification among HIV discordant couples in two key areas of AIDS epidemic in Sichuan Province

目的调查分析成都市和凉山州艾滋病单阳家庭配偶告知情况及其影响因素。方法采用自行设计的问卷调查单阳家庭感染者的基本情况、配偶告知情况及可能的影响因素,统计学方法采用χ2检验、t检验、Logistic回归分析模型等。结果艾滋病病毒感染者及病人(persons living with HIV/AIDS, PLWHA)的配偶告比例为86.5%(735/850),其中凉山为84.3%(462/548),成都90.4(273/302),两地差异有统计学意义(χ2=6.174,P=0.013)。影响因素分析结果显示:在成都,不知晓艾滋病知识(OR=4.962, 95%CI:1.592~15.465,P=0.006)、确诊时间在2016―2017年及2018―2019年(OR=9.057, 95%CI:1.110~73.926,P=0.040;OR=27.746, 95%CI:3.625~212.392,P=0.001)的PLWHA告知比例更低;在凉山,其他民族(OR=8.195, 95%CI:3.489~19.244,P<0.001)、初中文化程度(OR=2.393, 95%CI:1.248~4.590,P=0.009)、未合并感染(OR=16.146, 95%CI:2.178~119.692,P=0.006)的PLWHA告知比例更低,家庭内子女数量≥3个(OR=0.325, 95%CI:0.128~0.830,P=0.019)、最近1个月与配偶性行为2~4次(OR=0.513, 95%CI:0.288~0.912,P=0.023)的PLWHA告知比例更高。结论凉山配偶告知比例低于成都,可能与不同地区人口学特征、相关知识知晓程度、合并感染其他性传播疾病、及家庭关系等因素相关。建议各地因地制宜采取相关措施促进配偶告知,预防艾滋病家庭内传播。

Objective To investigate the situation of partner notification and its influencing factors among human immunodeficiency virus(HIV) sero-discordant couples in Liangshan and Chengdu. Methods Using a self-designed questionnaire, HIV sero-discordant couples were surveyed to understand their individual situations, partner notification circumstances and possible influencing factors, etc. The chi-square test, t test, and binary Logistic regression were used for data analysis. Results The partner notification rate of the persons living with HIV/AIDS(PLWHA) was 86.5%(735/850), specifically 90.40% in Chengdu and 84.31% in Liangshan. The difference was statistically significant(χ~2= 6.174, P=0.013). Analysis of the influencing factors showed that the proportion of partner notification was lower among the PLWHAs with little awareness of HIV knowledge(OR=4.962, 95% CI: 1.592-15.465, P=0.006) and PLWHAs who were diagnosed in 2016 or later(OR=9.057, 95% CI: 1.110-73.926, P=0.040;OR=27.746, 95% CI: 3.625-212.392, P=0.001) in Chengdu. However, in Liangshan, PLWHAs with these characteristics were less likely to notify partners of their infection status, including ethnic minority(OR=8.195, 95% CI:3.489-19.244,P<0.001), junior high school education(OR=2.393, 95% CI:1.248-4.590, P=0.009), without co-infections(OR=16.146, 95% CI: 2.178-119.692, P=0.006), while PLWHAs with the following characteristics were more likely to notify partners, including having 3 or more children in the family(OR=0.325, 95% CI: 0.128-0.830, P=0.019), and having 2-4 sexual intercourse with partner in the recent month(OR=0.513, 95% CI: 0.288-0.912, P=0.023;OR=0.449). Conclusions The partner notification rate in Liangshan was lower than that in Chengdu, which may be related to factors such as demographic characteristics of different regions, awareness of AIDS-related knowledge, co-infection with other sexually transmitted diseases, and family relationships, etc. It suggested that different areas should take relevant measures according to local conditions to promote spousal notification, and to prevent intra-familiar transmission of HIV.