2015—2020年云南保山市HIV/AIDS晚发现比例及影响因素分析

Proportion of late diagnosis of HIV/AIDS and its influencing factors in Baoshan City,Yunnan Province,2015-2020

目的通过对云南省保山市2015—2020年HIV/AIDS晚发现比例趋势和总体特征分析,探究影响晚发现的原因及对策。方法选择2015年1月—2020年12月6年现住址为保山市且新发现的HIV/AIDS病例,对晚发现比例趋势水平及总体特征进行分析。结果保山市2015—2020年共报告现住址感染者/病人2111例,平均年龄为(42.05±13.75)岁,其中87.7%为汉族,87.0%为初中及以下文化程度,55.2%为已婚,79.8%为农民,异性性传播比例最高,为89.1%。6年总的晚发现病例746例,晚发现比例35.3%,晚发现比例未呈现下降趋势(t=-0.300,P=0.803)。44.9%晚发现为其他就诊者和术前人群,不同样本来源的HIV/AIDS晚发现比例差异有统计学意义(χ^(2)=117.539,P<0.001)。多因素logistic回归分析显示,男性(OR=1.373,95%CI:1.122~1.680),相对于20岁以下年龄组,年龄为30~39岁(OR=3.043,95%CI:1.247~7.426),40~49岁(OR=4.606,95%CI:1.897~11.186),50岁以上(OR=4.596,95%CI:1.892~11.167),相对于同性性传播,异性性传播(OR=1.952,95%CI:1.011~3.767),母婴传播(OR=7.163,95%CI:2.147~23.901),相对于婚前检查人群,其他就诊者和术前人群(OR=2.884,95%CI:1.468~5.668)是病例晚发现的危险因素。结论保山市晚发现比例依然较高,且无下降趋势,应根据晚发现的人群特点,制定精准的扩大检测策略,持续强化早检测各项措施的落实,巩固“3个90%”艾滋病防治成果。

Objective To explore the causes and countermeasures of late diagnosis of HIV/AIDS through analyzing the trend of proportion of late diagnosis of HIV/AIDS cases and their general characteristics in Baoshan City of Yunnan Province from 2015 to 2020.Methods We selected newly-reported HIV cases whose current address was Baoshan from January,2015 to December,2020,and analyzed the trend of proportion of delayed diagnoses and their general characteristics.Results A total of 2,111 HIV infectors/AIDS patients were reported in Baoshan City from 2015 to 2020,with an average age of(42.05±13.75)years.Among them,87.7%were Han ethnic group,87.0%had junior middle school education or below,55.2%were married,79.8%were farmers,and the proportion of heterosexual transmission was the highest(89.1%).There were 746 cases with delayed diagnosis in the six years,and the proportion of late diagnosis was 35.3%,without a downward trend(t=-0.300,P=0.803).44.9%of the late diagnosis cases were patients with other diseases and preoperative population.The proportions of late diagnosis of HIV/AIDS in samples from different sources showed statistically significant differences(χ^(2)=117.539,P<0.001).Multivariate logistic regression analysis showed that male cases(OR=1.373,95%CI:1.122-1.680),comparing with the group aged below 20 years,30-39 years old(OR=3.043,95%CI:1.247-7.426),40-49 years old(OR=4.606,95%CI:1.897-11.186)and above 50 years old(OR=4.596,95%CI:1.892-11.167),comparing with homosexual transmission,heterosexual transmission(OR=1.952,95%CI:1.011-3.767),mother to child transmission(OR=7.163,95%CI:2.147-23.901),and comparing with population undergoing premaritalexamination,patients with other diseases and preoperative population(OR=2.884,95%CI:1.468-5.668)were risk factors for latediagnosis in the cases.Conclusion The proportion of late diagnosis was still high in Baoshan City,without a downward trend.It is necessary to formulate accurate expanded detection strategy according to the characteristics of late diagnosis population,constantly strengthen the implementation of early detection measures,and consolidate the"three 90%"AIDS prevention andcontrol achievements.