2014～2018年菏泽市新报告HIV/AIDS病例晚发现特征及影响因素分析

Analysis on characteristics and influencing factors of newly reported late diagnosed HIV/AIDS cases,Heze city,2014-2018

目的了解菏泽市新报告艾滋病病毒感染者/艾滋病人(HIV/AIDS)的晚发现情况及其影响因素,为制定有效的艾滋病防治措施提供参考。方法通过艾滋病综合防治信息系统下载相关历史卡片,筛选2014~2018年新报告的现住地址为菏泽的HIV/AIDS病例,参照中国疾病预防控制中心晚发现定义,分析晚发现情况及其相关影响因素。结果 2014~2018年菏泽市新报告HIV/AIDS病例728例,晚发现252例,平均晚发现率为34.62%。各年新报告病例分别为116、134、151、204、123例,晚发现率分别为46.55%、34.33%、38.41%、29.90%、26.83%。医疗机构的病例晚发现率(40.52%)高于检测咨询和其他检测,不同样本来源的晚发现率差异有统计学意义(P<0.01)。异性传播的晚发现率高于同性传播,不同传播途径的晚发现率差异有统计学意义(P<0.05)。与0~19岁的HIV/AIDS感染病例相比,≥60岁组晚发现风险较高(OR=7.02,95%CI:2.62~18.78)(P<0.01);与文盲相比,高中或中专感染病例晚发现风险较低(OR=0.42,95%CI:0.20~0.89)(P<0.05);与其他样本来源相比,医疗机构晚发现风险较高(OR=1.76,95%CI:1.10~2.83)(P<0.05)。结论菏泽市2014~2018年新报告HIV/AIDS感染病例晚发现率较高,晚发现与文化程度、医疗机构、年龄密切相关。

Objective To understand the late diagnosis status and its influencing factors among newly identified HIV/AIDS cases in Heze city during 2014-2018,so as to provide the reference for the formulation of effective AIDS prevention and control measures.Methods HIV/AIDS cases information were downloaded from the National AIDS Comprehensive Information System to select those newly reported cases with current address was in Heze city during 2014-2018.According to the definition of late diagnosed cases proposed by China CDC,the late diagnosis status and its influencing factors were analyzed.Results A total of 728 new cases of HIV/AIDS were reported in Heze city during 2014-2018,of which 252 cases were found late.The average late detection rate was 34.62%.The number of newly report cases was 116,134,151,204 and 123 during the years respectively,and the late detection rate was 46.55%,34.33%,38.41%,29.90%and 26.83%respectively.The late detection rate in medical institutions(40.52%)was higher than that in testing consultation and other tests,there was statistically significant difference in the late detection rate among different sample sources(P<0.01).The late detection rate of heterosexual transmission was higher than that of homosexual transmission,with statistically significant difference among different transmission routes(P<0.05).Comparing with the age group of 0-19 years old,the elderly aged over 60 years had higher risk of delayed diagnosis(OR=7.02,95%CI:2.62-18.78)(P<0.01).Comparing with the illiterate group,people whose education level was high school or technical secondary school had lower risk of late diagnosis(OR=0.45,95%CI:0.20-1.02).Comparing with other sample sources,medical institutions had higher risk of late diagnosis(OR=1.76,95%CI:1.10-2.83)(P<0.05).Conclusion The proportion of late diagnosis among newly identified HIV/AIDS cases in Heze city is relatively high during 2014-2018,and late diagnosis is associated with education level,sample source of medical institutions and age.