吉林省≥50岁HIV/AIDS病例的晚发现情况分析

Analysis of late detection of HIV/AIDS cases aged 50 years and above in Jilin Province

【目的】了解吉林省≥50岁人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者的晚发现情况并分析影响因素,为改善生命质量提供理论依据。【方法】利用AIDS综合防治信息系统中现住址为吉林省的≥50岁HIV/AIDS患者首次CD4+T细胞(简称“CD4细胞”)值推测晚发现者,并分析病例晚发现的影响因素。【结果】1996—2021年吉林省新报告≥50岁HIV/AIDS病例首次检测CD4细胞计数平均值是230.55±191.97,低值组占比最大(50.8%),晚发现率为59.3%(1397/2325),晚发现病例主要来源于性传播(同性46.8%,异性48.2%)。从样本来源来看,大部分晚发现患者来自其他就诊者检测,其次是检测咨询。接触史中,男男同性传播病例晚发现的情况较高。经二元logistic回归分析发现,性别、婚姻、样本来源和报告年份是晚发现的影响因素,男性晚发现率较高,已婚有配偶更易被晚发现。随着报告年份的递增晚发现率降低,检测咨询能有效地降低AIDS晚发现率。【结论】吉林省≥50岁HIV/AIDS整体首次检测CD4细胞计数较低,男性病例的晚发现率较高。近几年吉林省扩大自愿咨询检测,检测咨询有效地降低了AIDS晚发现率,同时应加强中老年群体的性教育,提倡健康的婚姻关系并给予更多的心理关注。

[Objective]To investigate the late detection of HIV/AIDS cases in the elderly in Jilin Province and analyze its influencing factors,to provide theoretical basis for improving their life quality.[Methods]The first CD4 values of HIV/AIDS patients aged 50 years and above living in Jilin Province were used to estimate late detection,and the influencing factors of late detection in elderly cases were analyzed.[Results]The average CD4 cell count of newly reported HIV/AIDS cases aged 50 and above in Jilin Province from 1996 to 2021 was(230.55±191.97),the low value group accounted for the largest proportion(50.8%),and the late detection rate was 59.3%(1397/2325).The late detection cases were mainly from sexual transmission(46.8%for same-sex and 48.2%for heterosexual contact).From the perspective of sample sources,most of the late detection patients were diagnosed while testing for other illnesses,followed by testing and consulting.In terms of contact history,the late detection of cases of men who have sex with men was higher.The binary logistic regression analysis showed that gender,marriage,sample source and report year were the factors affecting the late detection of AIDS.The late detection rate of males was higher,and cases of married couples were more likely to be late detection.With the increase of report year,the late detection rate decreased,and testing and counseling could effectively reduce the late detection rate of AIDS.[Conclusion]The CD4 cell count in the first detection of HIV/AIDS in the elderly in Jilin Province is low,and the late detection rate of male cases is high.In recent years,the expansion of voluntary counseling and testing in Jilin Province has effectively reduced the late detection rate of HIV/AIDS.At the same time,sex education should be strengthened for the elderly,healthy marital relationships should be advocated and more attention should be paid to the mental health of the elderly.