四川省凉山州预防艾滋病母婴传播攻坚防治模式效果评价

Effectiveness of intensive prevention and control of mother to child transmission of AIDS in Liangshan,Sichuan

目的评估四川省凉山彝族自治州(凉山州)艾滋病防治和健康扶贫攻坚期间预防艾滋病母婴传播防治模式的实施效果。方法对2010—2021年全州孕产妇HIV抗体检测情况和HIV感染孕产妇及所生儿童干预措施落实情况进行调查,收集和分析凉山州启动艾滋病防治和健康扶贫攻坚行动前后预防艾滋病母婴传播相关指标的变化情况。结果预防艾滋病母婴传播攻坚防治模式实施后,凉山州和4个重点县艾滋病母婴传播率呈逐年下降趋势(Ρ<0.05),感染孕产妇的孕早期抗病毒用药率、病毒载量检测率、CD4^(+)T淋巴细胞检测率和满18月龄儿童全程随访率呈上升趋势,平均每年分别增加20.31%、27.03%、20.10%、7.78%(Ρ<0.05),孕产妇HIV抗体检测率、感染孕产妇住院分娩率、抗病毒用药率和所生儿童抗病毒用药率、6月龄内儿童早期诊断率、满18月龄儿童HIV抗体检测率在攻坚防治模式实施前均呈上升趋势,实施后除满18月龄儿童HIV抗体检测率未发生变化,也无逐年变化趋势(Ρ>0.05)外,其余各项平均每年分别增加0.13%、1.83%、0.70%、1.09%、3.89%(Ρ<0.05)。结论凉山州预防艾滋病母婴传播攻坚防治模式有效控制了艾滋病母婴传播,预防艾滋病母婴传播工作质量和水平得到有效改善。

Objective To evaluate the effect of intensive prevention and control of mother to child transmission of AIDS in the project of poverty alleviation through AIDS prevention and control in Liangshan prefecture,Sichuan province.Methods The HIV antibody test results of pregnant women,intervention results in HIV-infected mothers and their children were collected to analyze the changes of indicators related to the prevention and control of mother to child transmission of AIDS during this period from 2010 to 2021 in Liangshan.Results After the implementation of the project in Liangshan,the rate of mother to child transmission of HIV in four key counties and Liangshan decreased year by year(Ρ<0.05),the average annual antiviral drug use rate in the early phase,the viral load detection rate,the CD4^(+)T lymphocytes detection rate of HIV-infected mothers,the follow up rate in children over 18 months increased by 20.31%,27.03%,20.10%and 7.78%respectively(Ρ<0.05).The HIV antibody detection rate in pregnant women,the hospital delivery rate in HIV-infected mothers,the antiviral drug use rate in HIV-infected mothers,the antiviral drug use rate in children mothered by HIV-infected women,the early diagnosis rate within 6 months after birth,and the HIV antibody detection rate in children over 18 months all showed an upward trend before the implementation of the project(Ρ<0.05).After the implementation of the project,except the HIV antibody detection rate in children over 18 months which had no change or increased year by year trend(Ρ>0.05),the other items had average annual increases of 0.13%,1.83%,0.70%,1.09%,3.89%respectively.(Ρ<0.05).Conclusion The intensive prevention and control of AIDS has effectively controlled mother to child transmission of HIV and improved the quality and level of preventing mother to child transmission of HIV in Liangshan.