杭州市异性性传播HIV感染者和艾滋病患者生活质量分类树分析

Quality of life among HIV-infected and AIDS patients via heterosexual contact in Hangzhou using classification tree analysis

目的 了解杭州市异性性传播人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者和艾滋病患者的生活质量现状及其分布特征。方法 调查2014年1月1日—2017年12月31日HIV确证阳性,现住址为杭州市的异性性传播HIV感染者和艾滋病患者的一般人口学特征和收入、就医支出、疾病状态等情况,采用简体中文版MOS-HIV量表和社会支持评定量表分别评价其生活质量(生理健康和心理健康)及社会支持状况,采用分类树模型进行统计分析。结果 完成调查并纳入研究共943例。研究对象以男性居多,为714例(75.72%);25~<60岁755例(80.06%);已婚有配偶者443例(46.98%);初中及以下文化程度502例(53.23%)。生活质量评分中,生理健康总得分为(53.41±7.28)分,心理健康总得分为(46.61±9.72)分;分类树分析结果显示,月均收入(F=91.895,P<0.01)、最近1年就医自理费用(F=41.518,P<0.01)、出现患病情况(F=6.309,P=0.012)、年龄(F=14.338,P=0.002)及社会支持总得分(F=13.273,P=0.003)影响生理健康总得分;社会支持总得分(F=26.507,P<0.01)、月均收入(F=25.635,P<0.01)和最近一年就医自理费用(F=17.050,P<0.01)影响心理健康总得分。结论 收入、就医费用支出、社会支持状况等影响异性性传播HIV感染者和艾滋病患者的生活质量,在随访管理中应重点关注低收入、就医费用支出较多、社会支持水平较低的HIV感染者和艾滋病患者。

Objective To investigate the quality of life of people living with human immunodeficiency virus(HIV)and acquired immunodeficiency syndrome(AIDS) patients infected via heterosexual contact in Hangzhou and to analyze the distribution of quality of life. Methods A cross-sectional survey was conducted among the HIV-infected people and AIDS patients who acquired HIV via heterosexual contact in Hangzhou and confirmed HIV-positive between January 1, 2014 and December 31, 2017. Information related to their demographic characteristics, income level, medical expenses, and disease status were collected. The simplified Chinese edition of medical outcomes study-HIV health survey(MOS-HIV) and social support scale(SSRS) were used to assess their quality of life(in terms of physical and mental health) and social support status. Classification tree model was used to analyze the results. Results A total of 943 participants were surveyed and included in the analysis, most of whom were male(714, 75. 72%), aged 25-60 years(755, 80. 06%), married(443, 46. 98%), and having junior high school education or below(502, 53. 23%). For quality of life measured by MOS-HIV, the mean physical summary score was(53. 41±7. 28),and the mean mental summary score was(46. 61±9. 72). Classification tree model showed that monthly income(F=91. 895, P<0. 01), the medical expenses in the past year all being out-of-pocket(F=41. 518,P<0. 01), having illness(F=6. 309, P=0. 012), age(F=14. 338, P=0. 002), and social support level(F=13. 273, P=0. 003) were the influencing factors of the physical summary score;and social support level(F=26. 507,P<0. 01), monthly income(F=25. 635, P<0. 01) and the medical expenses in the past year all being out-of-pocket(F=17. 050, P<0. 01) were the influencing factors of the mental summary score. Conclusions Income, medical expenses, and social support level influence the quality of life of people living with HIV and AIDS patients who are infected via heterosexual contact. Within this population, more attention should be paid to the subgroup with lower income, higher medical expenses, and lower social support level during follow-up management.