江苏省6市不同发现途径HIV感染者主动检测现状及其相关因素分析

Current situation and associated factors of active HIV testing among people living with HIV diagnosed through different routes in six cities of Jiangsu Province

目的了解江苏省6市不同发现途径HIV感染者的主动检测现状及其相关因素。方法采用自行编制的调查表对2022年5-12月江苏省6个设区市新诊断的HIV感染者进行问卷调查,收集其基本人口学特征和HIV主动检测情况等内容。采用χ^(2)检验分析HIV感染者主动检测与发现途径的相关性,采用多因素Logistic回归模型分析发现途径对主动检测的影响及不同发现途径HIV感染者主动检测的相关因素。结果共纳入HIV感染者431例,主动检测比例为55.92%,其中通过医院途径和非医院途径发现的HIV感染者的主动检测比例分别为43.72%和72.28%,差异有统计学意义(χ^(2)=34.888,P<0.001)。多因素结果显示:与医院途径发现者相比,非医院途径发现者(aOR=3.08,95%CI:1.96~4.91)主动检测的可能性更高;医院途径发现者中,与异性性传播和其他科室相比,同性性传播(aOR=1.99,95%CI:1.02~3.90)、皮肤性病科(aOR=2.33,95%CI:1.05~5.15)和感染科(aOR=2.58,95%CI:1.09~6.09)发现者主动检测的可能性更高;非医院途径发现者中,与≥50岁、异性性传播和自我检测相比,<50岁(aOR=3.59,95%CI:1.22~10.53)、同性性传播(aOR=2.69,95%CI:1.08~6.66)和疾病预防控制中心(aOR=15.28,95%CI:4.23~55.19)发现者主动检测的可能性更高。结论江苏省六市医院途径发现HIV感染者主动检测比例和检测意识均较低,应强化医院内艾滋病防治知识宣传,在皮肤性病科、感染科等重点科室主动为就诊者提供艾滋病和性病检测咨询服务。加强疾病预防控制中心综合VCT服务,为就诊者提供便利和及时的检测咨询服务,促进艾滋病的早检测、早发现和早干预。

Objective This study aimed to investigate the current situation and its associated factors of active HIV testing among people living with HIV(PLWH)diagnosed through different routes in six Jiangsu Province.Methods A self-designed questionnaire was conducted from May to December 2022,targeting newly diagnosed PLWH in six cities in Jiangsu Province to collect information on basic demographic characteristics and information on active HIV testing behaviors.The Chi-square test was employed to analyze the association between active testing and diagnosis routes,while a multivariate logistic regression model was used to examine the impact of different diagnosis routes on active testing and its associated factors among PLWH.Results A total of 431 PLWH were included,with an active testing prevalence of 55.92%.The prevalence of active testing among PLWH identified through hospital-based and non-hospital-based routes were 43.72%and 72.28%,respectively,showing a statistically significant difference(χ^(2)=34.888,P<0.001).Multivariate analysis revealed that,compared to those diagnosed through hospital-based routes,individuals diagnosed through nonhospital-based routes were more likely to undergo active HIV testing(a OR=3.08,95%CI:1.96-4.91).Among the individuals diagnosed through hospital-based routes,those with homosexual transmission(a OR=1.99,95%CI:1.02-3.90),identified in departments of dermatology and sexually transmitted infection(STI)clinics(a OR=2.33,95%CI:1.05-5.15),and departments of infectious disease(a OR=2.58,95%CI:1.09-6.09)were more likely to undergo active testing compared to those diagnosed through heterosexual transmission or other departments.For individuals diagnosed through non-hospital-based routes,those younger than 50 years old(a OR=3.59,95%CI:1.22-10.53),with homosexual transmission(a OR=2.69,95%CI:1.08-6.66),and diagnosed by the Centers for Disease Control and Prevention(CDC)(a OR=15.28,95%CI:4.23-55.19)were more likely to undergo active testing compared to those aged 50 and above,with heterosexual transmission,and who had a self-testing.Conclusions The proportion of active HIV testing and awareness among hospital-diagnosed individuals in the six cities of Jiangsu Province remains relatively low.Efforts should be strengthened to promote HIV/AIDS prevention and education within hospitals,particularly in key departments such as dermatology,STI clinics,and infectious disease departments.These departments should proactively offer HIV and STI testing and counseling services to patients.Additionally,comprehensive voluntary counseling and testing(VCT)services at CDC should be enhanced to provide convenient and timely testing and counseling services,thereby to promote early testing,diagnosis,and intervention for HIV/AIDS.