2016—2020年深圳市不同样本来源HIV抗体检测情况分析

Status of testing for HIV antibodies from samples with different sources in Shenzhen City, 2016-2020

目的了解2016—2020年深圳市艾滋病抗体检测现状,有针对性地提出更为科学有序扩大检测的建议,实时调整该市HIV检测策略。方法对2016—2020年报告的深圳市HIV检测数据进行描述性统计分析,不同年份初筛阳性率和确证检测阳性率的比较采用趋势χ^(2)检验,P<0.05为差异有统计学意义。结果2016—2020年,深圳市HIV检测量由164.50万人次上升至201.20万人次,深圳市全人群HIV抗体初筛阳性率由2.73‰下降至2.42‰,确证检测阳性率在2016—2019年由77.5%下降至72.8%,在2020年升至78.1%;样本来源于医疗机构、自愿咨询、公安司法、阳性亲属、专题调查的初筛阳性率分别为1.71‰、30.58‰、9.54‰、233.98‰、24.32‰,确证检测阳性率分别为74.6%、94.1%、74.6%、83.5%、61.1%;HIV抗体初筛阳性确证检测比为70.4%,其中医疗机构确证检测比由2016年71.3%下降至2020年55.2%,公安司法确证检测比在2020年显著下降至41.4%。结论医疗机构检测是发现HIV感染者和艾滋病病例的主要来源,应在性病门诊等重点科室进一步推进HIV咨询与检测服务,同时,强化VCT、专题调查、阳性亲属筛查等HIV主动监测工作的力度,还应加强卫生、公安司法等部门间协作沟通,推动检测和信息工作提质增效。

Objective To understand the status quo of testing for HIV antibodies in Shenzhen City from 2016 to 2020, to put forward targeted suggestions for more scientific and orderly expansion of HIV detection, and to timely adjust HIV testing strategy in Shenzhen. Methods A descriptive statistical analysis was conducted on the HIV testing data reported in Shenzhen during 2016-2020. The chi-square test for trend was used to compare the positive rates of initial screening and confirmatory tests in different years, and a P-value of less than 0.05 was considered statistically significant. Results From 2016 to 2020, the number of HIV testing in Shenzhen increased from 1.6450 to 2.0120 million. The positive rate of HIV initial screening among population in Shenzhen decreased from 2.73‰ to 2.42‰. The positive rate of HIV confirmatory test declined from 77.5% in 2016to 72.8% in 2019, but rose to 78.1% in 2020. The positive rates of HIV initial screening in samples from medical institutions,voluntary counseling and testing(VCT), public security and judicial administration organs, HIV-positive relatives and specialinvestigation were 1.71‰, 30.58‰, 9.54‰, 233.98‰ and 24.32‰, respectively, and the positive rates of HIV confirmatory testwere 74.6%, 94. 1%, 74.6%, 83.5% and 61.1%, respectively. 70.4% of the positive samples in HIV initial screening underwentconfirmatory testing, of which the ratio of HIV confirmatory test in medical institutions decreased from 71.3% in 2016 to 55.2% in2020, and the ratio in public security and judicial administration organs was significantly reduced to 41.4% in 2020. Conclusion HIV testing in medical institutions is the main source of HIV infection and AIDS cases. It is necessary to further promote HIVconsultation and testing service in key departments like sexually transmitted disease clinics;meanwhile, we should strengthen HIVactive surveillance such as HIV voluntary counseling and testing, special investigation and screening of HIV-positive relatives andenhance coordination and communication among health, public security and judicial administration organs so as to promote thequality and efficiency of testing and information work.