2016-2020年海南省HIV感染孕产妇预防母婴传播措施利用状况分析

Utilization of PMTCT interventions among HIV-infected mothers in Hainan Province,2016-2020

目的了解海南省2016-2020年HIV感染孕产妇的特征及其接受预防艾滋病母婴传播(PMTCT)等孕产期保健服务情况,为指导海南省消除HIV母婴传播提供科学依据。方法利用“国家预防艾滋病、梅毒和乙肝母婴传播管理信息系统”中导出的2016-2020年海南省报告的“预防HIV母婴传播综合服务”数据进行分析,将HIV感染的孕产妇分为既往感染组和本次妊娠确诊组,分析两组孕产妇特征及预防母婴传播服务利用情况。结果2016-2020年海南省孕产妇HIV抗体检测率为99.65%(630050/632262),检出HIV感染孕产妇101例,阳性率为1.60/万,产妇抗病毒用药率83.10%(59/71),婴儿抗病毒用药率92.96%(66/71)。既往感染组孕产妇56例,HIV暴露儿童43例;首次确诊组孕产妇45例,HIV暴露儿童28例。既往感染组孕产妇文化程度高于本次妊娠确诊组,并在初检孕周、接受PMTCT服务时期等方面优于本次妊娠确诊组,差异有统计学意义;本次妊娠确诊组孕产妇所生婴儿HIV早期诊断结果阳性比例(10.71%,3/28)高于既往感染组(2.33%,1/43)。结论海南省孕产妇HIV感染率处于较低水平,既往感染妇女仍有较高的生育需求,且在怀孕后较本次妊娠确诊的孕产妇更关注孕产期保健服务,容易接受母婴阻断服务,母婴阻断效果更佳。海南省预防艾滋病母婴传播工作需关注重点人群,进一步提高孕早期HIV抗体检测率及确诊比例,提高感染孕产妇及暴露儿童的抗病毒用药率。

Objective To understand the characteristics of HIV-infected pregnant women in Hainan Province from2016 to 2020 and their access to maternal health services such as prevention of mother-to-child transmission of HIV(PMTCT),and to provide a scientific basis for guiding the elimination of mother-to-child transmission of HIV in Hainan Province.Methods The data of the"Integrated HIV Prevention Service Data"of Hainan Province,2016-2020 were analyzed,derived from the"National Management Information System for Prevention of Mother-to-Child Transmission of HIV,Syphilis and Hepatitis B."The HIV-infected pregnant women were divided into a previously diagnosed group and a first-time diagnosed group and the maternal characteristics and utilization of PMTCT services in the two groups were analyzed.Results From 2016 to 2020,pregnant women in Hainan Province were provided with HIV antibody testing services,with a testing rate of 99.65%(630050/632262).101 HIV-infected pregnant women were detected,with a positive rate of 1.60 per 10,000.71 were delivered,with a maternal antiviral medication rate of 83.10%(59/71)and an infant antiviral medication rate of 92.96%(66/71).There were56 maternal cases and 43 HIV-exposed children in the previously diagnosed group and 45 maternal cases and28 HIV-exposed children in the first diagnosed group.In addition,there were significant differences between the previously diagnosed group and the first diagnosed group regarding education level,gestational week of the first examination,and period of receiving PMTCT services.Conclusions The maternal HIV infection rate in Hainan Province is low.However,previously diagnosed women still have a high demand for childbirth and are more concerned about maternal health services after pregnancy than those diagnosed in the current pregnancy,and are more likely to accept PMTCT services and have better PMTCT outcomes.Therefore,the prevention of mother-to-child transmission in Hainan needs to focus on key populations,increase the rate of HIV antibody testing and diagnosis in early pregnancy,and increase the rate of antiretroviral medication for infected mothers exposed to children.