深圳市龙华区2017—2018年新报告HIV/AIDS病例晚发现情况及影响因素

Analysis on the influencing factors of late diagnosis of newly identified HIV/AIDS cases in Longhua District, Shenzhen, 2017-2018

目的描述2017―2018年深圳市龙华区医疗机构新报告HIV感染和AIDS病例晚发现基本情况及分析晚发现的可能影响因素。方法数据来源于中国疾病预防控制信息系统中的艾滋病防治信息系统,选择2017―2018年新报告的成年HIV/AIDS病例为研究对象。计量资料采用(-x±s)描述,计数资料采用率、构成比描述,并用Logistic回归分析模型分析HIV/AIDS晚发现的影响因素。结果 795例新报告HIV/AIDS病例的平均年龄为(32.6±10.2)岁,HIV/AIDS晚发现比例为39.1%,26.0%来源于艾滋病自愿咨询检测(HIV voluntary counseling and testing,VCT),22.5%来源于性病门诊。在多因素分析中,>30岁(OR=0.67, 95%CI:0.46~0.97, P=0.032)与>40岁(OR=0.55, 95%CI:0.32~0.93, P=0.026)人群比<30岁人群出现晚发现病例的风险更低,常住人口(OR=2.37, 95%CI:1.49~3.79, P<0.001)发生晚发现病例的风险较流动人口更高。而与其他途径检测相比,性病门诊(OR=2.21, 95%CI:1.22~4.01, P=0.009)、术前检测(OR=1.66, 95%CI:1.09~2.53, P=0.019)、专题检查(OR=2.59, 95%CI:1.71~3.91, P<0.001)与VCT(OR=2.23, 95%CI:1.13~4.42, P=0.021)出现晚发现的可能性更高。结论 2017―2018年深圳市龙华区HIV/AIDS晚发现比例为39.1%,年龄、是否为流动人口和样本来源是晚发现的影响因素。

Objective To analyze the basic information of late diagnosis(LD) of HIV and the factors related with LD of HIV/AIDS cases newly reported by medical institutions in Longhua District from 2017 to 2018. Methods The database was downloaded from the AIDS prevention and control information system of China’s disease prevention and control information system and newly reported HIV/AIDS cases between 2017 and 2018 were included. Mean, standard deviation and other indexes were used to describe measurement data. Rate, constituent ratio and other indexes were used to describe enumeration data. The multivariate Logistic regression model was used to analyze the relevant factors of LD. Results 795 research objects were included in this study. The average age of the included cases was(32.6±10.2) years old. The proportion of LD was 39.1%, 26.0% of LD cases came from HIV voluntary counseling and testing(VCT), and 22.5% came from sexually transmitted disease clinics. Compared with participants under 30, >30 years age group(OR=0.67, 95% CI: 0.46-0.97, P=0.032) and >40 years age group(OR=0.55, 95% CI: 0.32-0.93, P=0.026) had lower risk of LD. Compared with transient population, permanent population(OR=2.37, 95% CI: 1.49-3.79, P<0.001) had higher risk of LD. Compared with samples from other clinical examinations, the OR(95% CI) values of sexually transmitted disease clinics(OR=2.21, 95% CI: 1.22-4.01, P=0.009), testing before surgery(OR=1.66, 95% CI: 1.09-2.53, P=0.019), event-specific surveys(OR=2.59, 95% CI: 1.71-3.91, P<0.001) and VCT(OR=2.23, 95% CI: 1.13-4.42, P=0.021) had higher risk of LD. Conclusions The proportion of LD in Longhua District between 2017 and 2018 was 39.1%. The factors which statiscally associated with late HIV diagnosis included age, resident population and sample source.