2016-2020年河南省新报告HIV/AIDS晚发现情况分析

Analysis on the late diagnosis phenomena among newly reported HIV/AIDS cases in Henan province,2016-2020

目的分析2016-2020年河南省新报告艾滋病病毒感染者/艾滋病患者(HIV/AIDS)晚发现情况。方法从中国传染病监测系统艾滋病防治基本信息中下载2016-2020年河南省新报告HIV/AIDS个案信息,选取≥15岁且具有报告1年内CD4^(+)T淋巴细胞(CD4)计数检测结果的HIV/AIDS作为研究对象,对其基本情况、样本来源、传播途径、晚发现比例等特征进行统计描述;采用趋势χ^(2)检验分析构成比变化趋势;采用多因素Logistic回归模型分析晚发现相关因素。结果24792例研究对象的晚发现比例为55.6%(13796例)。2016-2020年新报告HIV/AIDS的晚发现比例依次为52.7%、54.7%、55.2%、56.2%和59.9%,呈逐年上升趋势(χ_(趋势)^(2)=45.714,P<0.001)。多因素分析结果显示,年龄25~49岁和≥50岁的HIV/AIDS晚发现风险分别是15~24岁的1.775倍(95%CI:1.624~1.940)和2.377倍(95%CI:2.136~2.644),已婚、离异/丧偶的HIV/AIDS晚发现风险分别是未婚的1.171倍(95%CI:1.086~1.263)和1.118倍(95%CI:1.024~1.219),小学及以下文化程度的HIV/AIDS晚发现风险是大专及以上的1.102倍(95%CI:1.001~1.213),医疗机构检测发现的HIV/AIDS晚发现风险是检测咨询发现的1.197倍(95%CI:1.133~1.264),经异性性行为感染的HIV/AIDS晚发现风险是经男男性行为感染的1.094倍(95%CI:1.027~1.165),地区类别为本市其它县区和本省其它地市的HIV/AIDS晚发现的风险分别是本县区的1.134倍(95%CI:1.054~1.221)和1.317倍(95%CI:1.225~1.416)。结论2016-2020年河南省新报告HIV/AIDS晚发现比例呈逐年上升趋势;晚发现主要与年龄较大、文化程度较低、已婚/离异、医疗机构检测发现、经异性性行为途径感染和流动人口有关。

Objective To analyze the late diagnosis phenomena among newly reported HIV/AIDS cases in Henan province from2016 to 2020.Methods Newly reported HIV/AIDS cases from 2016 to 2020 were downloaded from the National HIV/AIDS Information System of China Infectious Disease Surveillance System,then HIV/AIDS cases≥15 years old with the CD4^(+)T lymphocyte(CD4)count test results reported within one year were selected as the research objects,its basic situation,sample source,transmission route,late diagnosis proportion and other characteristics were statistically described,linear by linear association χ^(2) test was used to analyze the change trend of composition ratio over the years,and multivariate logistic regression models were used to analyze the late diagnosis related factors.Results The proportion of late diagnosis among 24792 subjects was 55.6%(13796 cases).From 2016 to 2020,the proportion of late diagnosis among newly reported HIV/AIDS were52.7%,54.7%,55.2%,56.2%and 59.9% respectively,showing an upward trend year by year(χ_(trend)^(2)=45.714,P<0.001).Multivariate logistic regression showed the associated factors including that,compared with the cases with age of 15-24 years old,the risk of late diagnosis was1.775 times(95%CI:1.624-1.940)higher than in the cases with age of 25-49 years old and 2.377 times(95%CI:2.136-2.644)higher than in the cases with age of≥50 years old,respectively.Compared with the cases unmarried,the risk of late diagnosis was 1.171 times(95%CI:1.086-1.263)higher than in the cases married and 1.118 times(95%CI:1.024-1.219)higher than in the cases who divorced or widowed,respectively.Compared with the cases having education level of college and above,the risk of late diagnosis was 1.102 times(95%CI:1.001-1.213)higher than in the cases with the educational level of primary school or below.Compared with the cases detected from counseling&testing,the risk of late diagnosis was 1.197 times(95%CI:1.133-1.264)higher than in the cases detected from medical institutions.Compared with the cases infected by MSM behavior,the risk of late diagnosis was 1.094 times(95%CI:1.027-1.165)higher than in the cases infected by heterosexual behaviors.Compared with cases in the county,the risk of late diagnosis was 1.134 times(95%CI:1.054-1.221)higher than in the cases in other counties and districts of the city and 1.317 times(95%CI:1.225-1.416)higher than in the cases in other cities of the province,respectively.Conclusions From 2016 to 2020,the proportion of late diagnosis among newly reported HIV/AIDS in Henan province was 55.6%and showed an upward trend year by year.Late diagnosis was mainly related to high age group,low education level,married or divorced,detection in medical institutions,heterosexual transmission and floating population.