广东省医疗机构和自愿咨询检测发现的HIV感染者/AIDS患者特征分析

Analysis on Characteristics Among People Living with HIV Reported from Medical Institutions and VCT in Guangdong Province

目的分析广东省医疗机构和艾滋病自愿咨询检测(voluntary counseling and testing,VCT)发现的HIV感染者/AIDS患者特征的差异,为促进HIV感染者/AIDS患者早检测、早发现提供参考依据。方法选择广东省6个地市作为研究现场,采用方便抽样的方法招募2018年5月—2019年6月报告的HIV感染者/AIDS患者。采用自行设计的调查问卷并结合国家艾滋病综合防治数据信息管理系统的数据,收集研究对象一般人口学资料、HIV检测及相关信息。采用非条件Logistic回归分析比较两种检测途径的研究对象特征的差异及晚诊断情况。结果在纳入分析的1008例研究对象中,733例(72.72%)来自医疗机构,275例(27.28%)来自VCT门诊。多因素Logistic回归分析显示,从事家政及家务(aOR=1.58,95%CI:1.01~2.51)、主动寻求检测(aOR=2.51,95%CI:1.73~3.68)、通过同性性传播感染HIV(aOR=2.00,95%CI:1.31~3.10)的研究对象在VCT门诊进行HIV检测的可能性更高;而无配偶(aOR=0.43,95%CI:0.26~0.69)、配偶没有感染HIV(aOR=0.45,95%CI:0.27~0.74)及不知道配偶HIV感染情况(aOR=0.58,95%CI:0.37~0.92)的研究对象在VCT门诊进行HIV检测的可能性更低;通过医疗机构进行HIV检测的研究对象晚诊断的可能性较高(aOR=1.74,95%CI:1.27~2.41)。结论广东省通过医疗机构和VCT发现的HIV感染者/AIDS患者的特征存在差异,通过医疗机构发现的病例晚诊断的可能性比较高。相关部门可针对不同特征的人群制定HIV感染者发现策略,推动HIV阳性者的早检测、早发现。

Objective To analyze characteristics among people living with HIV(PLHIV)reported from medical institutions and HIV voluntary counseling and testing(VCT)clinics in Guangdong province,so as to provide evidence for promoting early HIV testing and diagnosis.Methods A convenience sampling method was used to recruit PLHIV from May 2018 to June 2019 in 6 cities of Guangdong province.Data from the National HIV/AIDS Comprehensive Information System and a self-designed electronic questionnaire were used to collect demographic characteristics,HIV testing and other HIV-related information.Multivariable logistic regression analysis was applied to compare the difference in characteristics and late diagnosis among PLHIV from medical institutions and VCT clinics.Results Among the 1008 participants included in the analysis,733 of them were tested for HIV in medical institutions,and 275 were tested for HIV in VCT clinics.Multivariable logistic regression showed that PLHIV of housekeeping and housework(aOR=1.58,95%CI:1.01-2.51),initiative detection(aOR=2.51,95%CI:1.73-3.68)and homosexual transmission(aOR=2.00,95%CI:1.31-3.10)were more likely to be tested for HIV in VCT clinics.PLHIV of being single(aOR=0.43,95%CI:0.26-0.69),having HIV-negative spouse(aOR=0.45,95%CI:0.27-0.74),and having unknown HIV serostatus of spouse(aOR=0.58,95%CI:0.37-0.92)were less likely to be tested for HIV in VCT clinics.Individuals who were tested for HIV in medical institutions(aOR=1.74,95%CI:1.27-2.41)were more likely to have late HIV diagnosis.Conclusion Characteristics of PLHIV tested for HIV in medical institutions and VCT clinics were different.Individuals tested for HIV in medical institutions had a high risk of late HIV diagnosis.Targeted strategies for HIV testing and case finding should be tailored according to different characteristics,so as to promote early HIV testing and diagnosis.