海南省三亚市2010-2021年新报告HIV/AIDS晚发现情况及影响因素分析

Influencing factors of late diagnosis of newly identified HIV/AIDS cases in Sanya Hainan, 2010-2021

目的 了解三亚市2010—2021年艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS)晚发现情况及影响因素,为降低晚发现比例提供依据。方法 从中国疾病预防控制信息系统中收集三亚市2010—2021年新报告的HIV/AIDS信息,依据中国疾病预防控制中心2014年提出的5类晚发现判断标准识别晚发现者,以是否为晚发现者为因变量,人口学信息为自变量,运用二元Logistic逐步回归模型分析HIV/AIDS发生晚发现的影响因素。结果 三亚市2010—2021年新报告HIV/AIDS 710例,晚发现比例为33.4%(237例);第1~5类晚发现构成比分别是0.8%、59.1%、10.1%、17.3%和12.7%。2010—2021年晚发现比例由95.5%降至22.4%,呈下降趋势(χ^(2)_(趋势)=34.777,P<0.05)。多因素分析结果,民族、文化程度、样本来源和确证年份是三亚市HIV/AIDS晚发现的影响因素,黎族HIV/AIDS晚发现比例为56.8%,晚发现风险高于汉族(OR=2.253,95%CI=1.361~3.670);初中及以下文化程度HIV/AIDS晚发现比例为55.5%,晚发现风险是高中及以上者的1.722倍(95%CI=1.072~2.765);样本来源于医疗机构和检测咨询者晚发现比例分别为63.1%和45.5%,晚发现风险均高于来源于MSM人群者(OR=5.564,95%CI=3.278~9.444;OR=2.204,95%CI=1.239~3.923);与2018—2021年相比,2010—2013年确证者风险较高(OR=2.246,95%CI=1.311~4.488)。结论 三亚市HIV/AIDS晚发现形势不容忽视,尤其是来源于咨询检测和医疗机构的HIV/AIDS,应加强检测力度,提高人群主动检测意识。

Objective To analyze the epidemiological characteristics of late diagnosed HIV/AIDS cases(LD) in Sanya from 2010 to 2021, and to provide evidence for reducing the LD rate.Methods The database was downloaded from the AIDS Prevention and Control Information System of China’s Disease Prevention and Control Information System and newly reported HIV/AIDS cases between 2010 and 2021 in Sanya were included, identified LD according to the LD criteria proposed by Chinese Center for Disease Control and Prevention in 2014 and analyzed the relevant factors of LD.Results From 2010 to 2021, a total of 710 research objects were included in this study. The proportion of LD was 33.4%(237/710), and decreased from 95.5% to 22.4% between 2010 and 2021(χ^(2)_(trend)=34.777, P<0.001). Ethnic groups, educational level, sample sources and confirmed date were the relevant factors of LD of HIV/AIDS in Sanya City. The proportion of LD was 56.8% in Li ethnic group,which was higher than that in Han ethnic(OR=2.253, 95%CI=1.361-3.670). The proportion of LD of patients who were middleschool and less was 55.5%, which were more likely to be LD than high school or above(OR=1.722, 95%CI=1.072-2.765). The proportion of LD was 56.8% in patients whose samples were from medical institutions or testing consultation were more likely to be LD than MSM(OR=5.564, 95%CI=3.278-9.444;OR=2.204, 95%CI=1.239-3.923). Compared with patients who were confirmed between 2018-2021, the patients derived from 2010 to 2013 had higher LD(OR=2.246, 95%CI=1.311-4.488).Conclusion The LD of HIV/AIDS in Sanya cannot be ignored, especially the HIV/AIDS from counseling and testing and medical institutions. We should strengthen HIV testing, strengthen health education.