1998—2022年上海市嘉定区HIV/AIDS患者晚发现的影响因素分析

Late diagnosis of HIV infection and its associated factors in Jiading District of Shanghai between 1998 and 2022

【目的】了解1998—2022年上海市嘉定区人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)病例(简称“HIV/AIDS患者”)晚发现情况及其影响因素,为制定AIDS防控政策提供参考依据。【方法】通过全国AIDS综合防治信息系统收集1998—2022年嘉定区新报告的HIV/AIDS患者信息。采用logistic回归对晚发现影响因素进行分析。【结果】共报告HIV/AIDS患者809例,晚发现324例,总体晚发现率为40.1%。1998—2015年晚发现率总体呈下降趋势,2015年达29.5%,但2016—2018年有上升趋势,2016—2022年平均晚发现率为34.9%。晚发现患者平均年龄(44.8±14.6)岁,>50岁年龄组晚发现率为57.7%,占总晚发现患者数的35.8%。多因素分析显示,>30岁年龄组(OR=1.37~3.50)晚发现率均高于21~30岁年龄组;性病门诊(OR=2.23,95%CI:1.42~3.49)和其他临床就诊(OR=2.75,95%CI:1.88~4.01)患者晚发现率均高于自愿咨询检测(VCT)门诊患者。【结论】嘉定区HIV/AIDS患者晚发现率较高。要注重对>50岁人群的AIDS宣传干预,充分发挥VCT门诊平台作用,医疗机构要重视就诊者HIV检测工作,以便及早发现人群中潜在的HIV/AIDS患者。

[Objective]To investigate the late diagnosis of HIV infection and associated factors in Jiading District between 1998 and 2022,and to provide the information for the development of AIDS prevention and control strategy.[Methods]Information of newly reported HIV/AIDS cases in Jiading District between 1998 and 2022 were obtained from the National Information System for Comprehensive AIDS Prevention and Control.Logistic regression was used to explore the associated factors of late diagnosis of HIV infection.[Results]In total,809 HIV/AIDS cases was newly reported,324 of which were late diagnosis with the overall rate of late diagnosis of 40.1%.Despite an increased tendency from 2016 to 2018,the rate of late diagnosis showed a downward trend from 1998 to 2015.The late diagnosis rate was 29.5%in 2015.From 2016 to 2022,the average rate was 34.9%.The average age of cases with a late diagnosis was 44.8±14.6 years old.Age groups over 50 had the highest risk,at 57.7%,accounting for 35.8%of all cases of late diagnosis.All age groups older than 30(OR=1.37‒3.50)had a higher rate of late diagnosis than the group between age 21 and 30.In comparison to patients at VCT clinic,the rate of late diagnosis among sexually transmitted disease(STD)outpatients(OR=2.23,95%CI:1.42‒3.49)and other clinical patients(OR=2.75,95%CI:1.88‒4.01)was higher.[Conclusion]The late diagnosis rate of HIV infection is relatively high in Jiading District.AIDS education and prevention activities should be strengthened among people aged over 50 years.For early detection of HIV infection,VCT clinic platform’s function should be fully utilized.Medical institutions should pay attention to HIV testing in patients.