2012-2022年周口市淮阳区新报告HIV/AIDS病例晚发现情况分析

Analysis on late diagnosis status of newly reported HIV/AIDS cases in Huaiyang district,Zhoukou city,2012-2022

目的了解河南省周口市淮阳区新报告HIV/AIDS病例的晚发现情况,为进一步改善防控措施提供科学依据。方法从中国疾病预防控制信息系统中,选取2012-2022年周口市淮阳区新报告的HIV/AIDS病例进行分析,包括患者流行病学特征及晚发现病例;采用趋势χ^(2)检验分析各年度晚发现病例变化趋势,运用多因素logisitc回归模型分析晚发现影响因素。结果淮阳区共报告HIV/AIDS病例601例,其中HIV237例,AIDS病例364例。晚发现共398例,平均晚发现比例为66.2%,总体呈现下降趋势(χ^(2)_(趋势)=221.97,P<0.05);多因素分析结果显示,相对于50岁以上年龄组,40~49岁组的晚发现风险(OR=2.82,95%CI:1.47~5.44)相对较高;相对于职业为学生人群,农民(OR=13.15,95%CI:2.52~68.73)晚发现风险较高;感染途径中异性非婚非商业(OR=0.46,95%CI:0.23~0.94)晚发现的风险低于同性性传播,非婚商业(OR=2.67,95%CI:1.45~4.92)、非婚未分类(OR=28.01,95%CI:5.76~136.15)以及其他(OR=9.10,95%CI:1.27~65.03)晚发现的风险均高于同性性传播;样本来源中,检测咨询(OR=5.78,95%CI:1.16~28.90)和医疗机构检测(OR=8.85,95%CI:1.72~45.43)病例的晚发现风险均高于重点人群筛查。结论淮阳区HIV/AIDS患者晚发现比例呈现逐年下降趋势,40岁及以上、农民、异性性传播、医疗机构检测发现的感染者晚发现风险较高,应加强检测力度,提高相关人群的主动检测意识。

Objective To understand late diagnosis status of newly reported HIV/AIDS cases in Huaiyang district,Zhoukou,and provide scientific evidence for improving AIDS preventive and control measures.Methods Newly reported HIV/AIDS cases from 2012 to 2022 were selected from China Diseases Prevention and Control Information System to analyze their epidemiological characteristics and late diagnosis status.Linear by linear associationχ^(2) was used to analyze the change trend of proportion of cases with late diagnosis over the years,and multivariate logistic regression models were used to analyze the influencing factors of late diagnosis.Results A total of 601 HIV/AIDS cases were reported in Huaiyang district from 2012 to 2022,including 237 HIV cases and 364 AIDS cases.The number of late diagnosis cases were 398 with an average proportion of 66.2%,showing a downward trend year by year(χ^(2)=221.97,P<0.05).Multivariate analysis results showed that the risk of late diagnosis was higher in cases with age of 40-49 years(OR=2.82,95%CI:1.47-5.44)was higher than that in cases age≥50 years;the risk of late diagnosis was higher in cases of farmers(OR=13.15,95%CI:2.52-68.73)than that in cases of students;the risk of late diagnosis in cases transmitted through route of non-marital and non-commercial heterosexual behaviors(OR=0.46,95%CI:0.23-0.94)was lower than that in cases transmitted through route of homosexual behavior;the risk of late diagnosis was higher in cases transmitted through route of non-marital and commercial heterosexual behaviors(OR=2.67,95%CI:1.45-4.92),non-classified non-marital heterosexual behaviors(OR=28.01,95%CI:5.76-136.15)and other transmission route(OR=9.10,95%CI:1.27-65.03)was higher than that in cases transmitted through route of homosexual transmission;the risk of late diagnosis in cases detected from counseling&testing clinics(OR=5.78,95%CI:1.16-28.90)and medical institution(OR=8.85,95%CI:1.72-45.43)was higher than that in cases detected from key population screening.Conclusions The proportion of late diagnosis among newly reported HIV/AIDS cases in Huaiyang district showing a downward trend year by year.Risk of late diagnosis was relatively high in group aged≥40 years,farmers,heterosexual behaviors and cases detected from medical institutions.It is necessary to strengthen the intensity of testing and improve the awareness of active test in the relevant population.