2012—2021年济宁市新报告HIV/AIDS病例晚发现情况及影响因素分析

Status of late detection of newly reported HIV/AIDS cases and its influencing factors in Jining City,2012-2021

目的了解济宁市HIV/AIDS病例晚发现状况及其影响因素,为制定适合该地情况的防治政策提供科学依据。方法从中国疾病预防控制中心“艾滋病综合防治信息系统”中,选取2012—2021年济宁市新报告的HIV/AIDS病例,采用χ2趋势性检验和logistic回归模型,分析病例晚发现比例的变化趋势和影响因素。结果2012—2021年济宁市累计新报告HIV/AIDS病例1683例,平均年龄为(36.98±13.47)岁,晚发现554例,晚发现比例32.92%,2012—2021年病例晚发现比例呈逐年下降趋势(χ^(2)趋势=5.930,P=0.015)。多因素logistic回归分析显示,15岁以下儿童(OR=6.27,95%CI:2.14~18.36)、高年龄(OR45~岁=2.97,95%CI:2.15~4.11;OR≥60岁=4.26,95%CI:2.65~6.85)、外地户籍(OR=1.53,95%CI:1.14~2.06)和农民(OR=1.31,95%CI:1.04~1.64)为晚发现危险因素;确诊时间为2017—2021年(OR2017—2021年=0.57,95%CI:0.45~0.72)、重点人群(OR=0.33,95%CI:0.26~0.42)晚发现率较低。结论济宁市近10年新报告的HIV/AIDS病例晚发现比例呈逐年下降趋势,应采取有效措施,加强对老年人和农民的艾滋病宣传力度,扩大艾滋病的社会筛查面,提高艾滋病感染者的早发现率、早治疗率。

Objective To understand the status of late detection of newly reported HIV/AIDS cases and its affecting factors in Jining City,and to provide a scientific basis for formulating prevention and control policies suitable for local conditions.Methods Data about newly reported HIV/AIDS cases in Jining City from 2012 to 2021 were collected from the HIV/AIDS Comprehensive Prevention and Control Information System of Chinese Center for Disease Control and Prevention.χ^(2)test for trend and logistic regression model were used to analyze the changing trend of proportion of late detection and its influencing factors.Results A total of 1,683 new cases of HIV/AIDS were reported cumulatively in Jining City during 2012-2021,and the mean age was(36.98±13.47)years.There were 554 cases detected late,and the proportion of late detection was 32.92%.From 2012 to 2021,the proportion of late detection of cases showed a downward trend year by year(χ^(2)_(trend)=5.930,P=0.015).Multivariate logistic regression analysis displayed that risk factors for late detection were children under 15 years old(OR=6.27,95%CI:2.14-18.36),advanced age(OR45-year old=2.97,95%CI:2.15-4.11;OR≥60 years old=4.26,95%CI:2.65-6.85),nonlocal household registration(OR=1.53,95%CI:1.14-2.06)and farmers(OR=1.31,95%CI:1.04-1.64).The late detection rate was found to be lower in the period 2017-2021 as the time of confirmed diagnosis(OR2017-2021=0.57,95%CI:0.45-0.72)and key populations(OR=0.33,95%CI:0.26-0.42).Conclusion The proportion of late-detected HIV/AIDS cases in Jining City has decreased year by year in the past 10 years.It is necessary to take effective measures to enhance the intensity of propaganda about HIV/AIDS among the elderly and farmers,expand the social screening for HIV/AIDS,and improve the rates of early detection and early treatment in HIV-infected patients.