云南省昭通市外出务工HIV感染者抗病毒治疗管理现状探析——基于抗病毒治疗门诊视角

Analysis of the current situation of antiretroviral therapy and management for HIV infected migrant workers in Zhaotong of Yunnan Province-from the perspective of antiretroviral therapy in outpatient clinics

[目的]了解在昭通市艾滋病抗病毒治疗门诊治疗的外出务工HIV感染者规模和管理现状。[方法]于2023年11月查阅昭通市12家艾滋病抗病毒治疗门诊的现场随访记录等资料,初步统计在治患者中外出务工人数、最近一次随访领药方式、必要检测的实现情况,并对医生开展结构式访谈,获取相关信息。[结果]2023年1-10月,在昭通市接受抗病毒治疗的外出务工HIV感染者共2890例,占昭通市在治感染者的34.0%。其中,2225例(77.0%)通过邮寄药品接受治疗,628例(21.7%)由家属/朋友代领药,37例(1.3%)转诊到务工地继续治疗。邮寄药品流程和管理细节各门诊不统一,必要的检测和依从性教育主要集中在春节外出务工人员返乡期间集中开展。[结论]昭通市在治患者外出务工比例高,邮寄药品是针对该人群的主要管理方法,但存在流程简单、必要的检测难以按要求实现、依从性教育方式单一且针对性差等问题。

Objective To understand the scale and management status of HIV infected migrant workers treated in AIDS antiretroviral therapy clinics in Zhaotong city.Methods In November 2023,on-site follow-up records and other data of 12 clinics for HIV/AIDS antiretroviral therapy in Zhaotong city were consulted.The number of migrant workers among the patients under treatment,the way of receiving medicine in the latest follow-up,and the realization of necessary tests were preliminatively counted,and structured interviews were conducted with doctors to obtain relevant information.Results From January to October 2023,a total of 2890 HIV infected migrant workers received antiretroviral therapy in Zhaotong city,accounting for 34.0%of the total number of patients under treatment in Zhaotong city.Among them,2225 cases(77.0%)received medicine by mail;628 cases(21.7%)received medicine by family or friends,and 37 cases(1.3%)were referred to the workplace for further treatment.The process and management details of mailing drugs were not unified among outpatient clinics,and necessary testing and compliance education were mainly concentrated during the Spring Festival when migrant workers returned home.Conclusions In Zhaotong city,a high proportion of patients under treatment go out for work,and mailing drugs is the main management method for this population.However,there are problems such as simple process,difficulty in achieving necessary testing as required,and single and poorly targeted compliance education.