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我国某艾滋病高流行地区主动提供艾滋病检测咨询早期发现感染者状况分析
作者:单多 段松 高洁 杨跃诚 叶润华 胡翼云 薛珲 张广 孙江平
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摘要:

目的  分析我国某艾滋病高流行地区医务人员主动提供艾滋病检测与咨询(PITC)服务情况,及其对早期发现感染者的影响。方法  于2013年1—12月,以我国某艾滋病高流行地区所辖县(区)级37家医疗机构为研究场所,其中公共医疗机构19家,民营医院18家。按照医务人员主动提供艾滋病检测咨询工作规范、流程及相关工作内容要求,以其间到医疗机构就诊/住院的患者为调查对象,对其提供PITC服务。通过个案调查表记录调查对象的基本信息和艾滋病高危因素,并采集其静脉血5~10 ml,以进行HIV抗体初筛和确认检测。对新发现HIV-1感染者的血清样本用BED HIV-1发病率捕获酶联(BED-CEIA)法进行检测以区分长期感染者和早期感染者。采用χ2检验比较不同特征早期感染者发现比例的差异。结果  共有55 164人次接受HIV筛查,初筛阳性658例,确诊阳性598例。598例HIV感染者均提供了转介服务。不同年龄、婚姻状况、文化程度、可能的感染途径和不同检测机构的HIV感染者早期发现比例差异有统计学意义(χ2值分别为23.54,10.50,17.96,21.22和4.80,P值分别为<0.001,0.005,<0.004,<0.003和0.029),其中20~29和50~84岁感染者早期发现比例较高,分别为47.1%(114/242)和42.1%(24/57);未婚和已婚感染者早期发现比例均较高,分别为37.8%(56/148)和38.9%(143/368);高中以上文化程度者早期发现比例较高,为42.6%(26/61);固定异性传播者早期发现比例较高,为46.0%(86/187);来自民营医院者早期发现比例较高,为40.3%(58/144)。结论  该地区通过开展PITC服务早期发现了一定比例的HIV感染者,重点年龄段、固定异性传播者等人群被早期发现的比例相对较高。

关键词:获得性免疫缺陷综合征;HIV;医务人员主动提供艾滋病检测与咨询服务;早期发现

Abstract:

Objective  To understand provider initiated HIV testing and counselling(PITC) in a region with high HIV/AIDS epidemic in China, and analyze its effect to early detection of HIV infections.Methods  Between January and December, 2013, 37 county level medical institutions were selected as the study sites, among which, 19 were public medical institutions and 18 were private institutions. According to the related regulation, procedures and contents of PITC, the study was implemented among outpatients and inpatients who seek for doctors in these medical institutions and PITC were provided for them. The 'Individual Investigation Form' was used to record the information and high-risky factors, and the respondents were taken venous blood and given HIV screening and confirmation. All available serum samples of newly found HIV/AIDS cases were tested using the BED HIV Incidence Capture Enzyme Immunoassay (BED-CEIA) to differentiate the long-term infections and new infections (early detected infections). Chi-square analysis was used to compare the differences of characteristics of newly infected patients.Results  Between January and December,2013, a total of 37 medical institutions provided PITC. 55 164 person times were received HIV screening, among which 658 were HIV positive, and 598 were confirmed to be HIV positive. The 598 cases were all provided transferring service. The differences of age, marital status, education levels, transmission routes and testing institutions had statistical significance to early detection (χ2 equals to 23.54, 10.50, 17.96, 21.22 and 4.80; P equals to<0.001, 0.005,<0.001,<0.001 and 0.029, respectively). And the early detection proportions among patients aged from 20 to 29 and from 50 to 84 were 47.1% (114/242) and 42.1% (24/57), respectively; the proportions among single and married patients were 37.8% (56/148) and 38.9% (143/368), respectively; the proportion among patients with high school education levels were 42.6% (26/61); the proportion among patients transmitted by fixed heterosexual sexual partners was 46.0% (86/187); the proportion among private hospitals was 40.3% (58/144).Conclusion  A certain proportion of HIV infections were early detected by PITC in this region. The HIV early detection proportions among specific age group and population with spouse/fixed sexual partners were relatively high.

Key words: Acquired immunodeficiency syndrome;HIV;Provider initiated HIV testing and counseling;Early detection

发表日期:2015/11

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2015.11.007.T001:表1 我国某艾滋病高流行地区主动PITC服务发现HIV感染者基本情况

    10.3760/cma.j.issn.0253-9624.2015.11.007.T001:表1 我国某艾滋病高流行地区主动PITC服务发现HIV感染者基本情况

  • 10.3760/cma.j.issn.0253-9624.2015.11.007.T002:表2 我国某艾滋病高流行地区开展PITC服务发现的598例HIV感染者的人口学特征

    10.3760/cma.j.issn.0253-9624.2015.11.007.T002:表2 我国某艾滋病高流行地区开展PITC服务发现的598例HIV感染者的人口学特征

  • 10.3760/cma.j.issn.0253-9624.2015.11.007.T003:表3 我国某艾滋病高流行地区开展PITC服务早期发现感染者状况比较

    10.3760/cma.j.issn.0253-9624.2015.11.007.T003:表3 我国某艾滋病高流行地区开展PITC服务早期发现感染者状况比较

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