应用诊断发现比简易数学模型估计广州市育龄女性中HIV感染者诊断比例

The application of a mathematical model estimating the proportion of HIV infected persons that have been diagnosed among women of reproductive age in Guangzhou

目的估算广州市育龄期(15~49岁)女性HIV感染者的诊断比例。方法利用诊断发现比简易数学模型,在两种假设下,估算广州市育龄期女性中潜在HIV感染者规模,进而计算出诊断比例。假设1假定育龄期女性孕产检时强制性HIV检测率在HIV感染未诊断者和已诊断感染者中一致;假设2假定育龄期女性孕产检时强制性HIV检测率在HIV感染未诊断者和未感染者中一致。结果两种假设结果均表明广州市育龄期女性HIV感染者的诊断比例在近5年间有较大幅度提升。根据假设2所推算的模型结果(主要观察结局)显示,诊断比例由2016年的70.67%(95%CI:59.74~80.81),上升到2019年的84.59%(95%CI:75.87~91.40)。结论广州市育龄期女性中HIV感染者诊断比例虽总体情况良好,但需进一步针对该人群开展健康教育,扩大HIV检测范围,以尽快达到第一个90%目标。

Objective To estimate the proportion of HIV-infected women of reproductive age(15-49 years)who were diagnosed in Guangzhou.Methods We used a simple mathematical model to estimate the population size of undiagnosed HIV-infected women under two basic hypotheses in Guangzhou and projected the proportion of diagnosed HIV-infected women of reproductive age.Hypothesis 1 assumed that the detection rate of women undergoing mandatory HIV testing due to pregnancy was the same among undiagnosed HIV-infected and diagnosed HIV-infected women.Hypothesis 2 assumed that the detection rate of women undergoing mandatory HIV testing due to pregnancy was the same among undiagnosed HIV-infected and HIV-uninfected women.Results The results of both scenarios suggested that the proportion of women of reproductive age with HIV infection in Guangzhou has increased substantially in the last 5 years.The model results(primary observed outcome)derived under scenario 2 showed that the proportion of diagnoses increased from 70.67%(95%CI:59.74-80.81)in 2016 to 84.59%(95%CI:75.87-91.40)in 2019.Conclusion Although the overall situation of HIV diagnosis among HIV-infected women in Guangzhou was improving.Further health education and expansion of HIV testing for this population are needed to reach the first 90%target of the UNAIDS 90-90-90 goals.