2011—2020年汕头市新报告HIV/AIDS病例晚发现情况及影响因素分析

Delays in HIV/AIDS diagnosis and associated factors among newly reported HIV/AIDS cases in Shantou city, 2011—2020

目的 了解汕头市新报告的人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者和艾滋病(acquired immune deficiency syndrome, AIDS)患者的晚发现情况及其影响因素。方法 通过全国艾滋病防治信息系统中收集2011—2020年汕头市新报告的HIV/AIDS病例数据,对晚发现病例特征进行描述流行病学分析,运用logistic回归分析和决策树模型探讨晚发现的影响因素。结果 汕头市新报告HIV/AIDS病例2 923例,其中晚发现病例913例(占31.24%),10年间晚发现比例呈上升趋势(χ^(2)_(趋势)=9.818,P=0.002)。Logistic回归分析显示,女性病例(OR=0.74,95%CI:0.57~0.96)、非本市现住址病例(OR=0.49,95%CI:0.38~0.63)、注射吸毒感染途径(OR=0.51,95%CI:0.28~0.92)和无偿献血人员检测来源(OR=0.40,95%CI:0.18~0.92)的病例晚发现风险较低;≥40岁年龄组(OR=2.07~4.43,95%CI:1.12~8.47)、高中或中专文化程度(OR=1.41,95%CI:1.07~1.85)、医疗机构(OR=2.89,95%CI:2.12~3.94)和性病门诊(OR=1.89,95%CI:1.26~2.82)来源的病例晚发现风险较高。决策树分析显示,年龄≥50岁,现住址在本市,并且感染途径为异性传播的病例晚发现的风险最高(61.40%)。结论 汕头市HIV/AIDS病例晚发现比例逐年升高,应针对相应影响因素加强宣传教育和干预检测工作,促进HIV感染者的早期发现。

Objective To understand the delays in HIV/AIDS diagnosis of newly reported HIV/AIDS cases in Shantou city during 2011 and 2020, and to explore its associated factors. Methods Data of newly identified HIV/AIDS cases from 2011 to 2020 were acquired from the National HIV/AIDS Prevention and Information System.Descriptive epidemiological analysis was performed on cases whose HIV/AIDS diagnosis were delayed.Multivariate logistic regression and decision tree method were used to analyze the related factors for delays in disease diagnosis. Results A total of new 2 923 HIV/AIDS cases were reported in Shantou city from 2011 to 2020, among them, 913 cases were delayed in the diagnosis, accounting for 31.24% of total cases, which increased significantly from 2011 to 2020(χ^(2)=9.818,P=0.002).Multivariate logistic regression analysis indicated that female cases(OR=0.74,95%CI:0.57-0.96), non-residents of Shantou city(OR=0.49,95%CI:0.38-0.63), cases infected via drug abuse(OR=0.51,95%CI:0.28-0.92) or those identified via unpaid blood donation screening(OR=0.40,95%CI:0.18-0.92) were less likely to be delayed in diagnosis, while cases aged 40 years and over(OR=2.07-4.43,95%CI:1.12-8.47), with high school education level or above(OR=1.41,95%CI:1.07-1.85), identified in medical institutions(OR=2.89,95%CI:2.1 2-3.94) or STD cl inics(OR=1.89,95%CI:1.26-2.82) were more likely to be delayed in diagnosis.Theresults of decisiontress showed that patients aged over 50, lived in Shantou city, and infected via sex had the highest risk of late diagnoses(61.40%). Conclusions The proportion of late diagnosed cases shows an upward trend among the newly reported HIV/AIDS cases in Shantou city from 2011 to 2020.It is necessary to enhance health education and intervention for a timely diagnosis of HIV/AIDS.