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目的分析2012-2016年南京市艾滋病综合防治示范区艾滋病流行特征,计算HIV感染者晚发现率并分析其影响因素,为今后示范区更好地开展防控工作提供依据。方法对2012-2016年南京市艾滋病综合防治示范区报告的HIV感染者流行病学资料进行统计分析。结果 3 064例研究对象中,以男性为主(占93.0%),报告职业为学生的占10.0%,传播途径以性途径为主(占95.3%),50~岁组占15.1%。样本来源以检测咨询(占42.5%)和医疗机构(占42.0%)为主。3 064例研究对象中,晚发现931例,晚发现率30.4%。多因素分析发现,30~(OR=2.72,95%CI:1.49~4.99)、40~(OR=4.38,95%CI:2.34~8.21)、50~岁组(OR=3.51,95%CI:1.86~6.62)、来源于医疗机构(OR=2.34,95%CI:1.93~2.85)的病例晚发现率较高,同性传播(OR=0.66,95%CI:0.53~0.83)、注射吸毒传播(OR=0.29,95%CI:0.15~0.57)、来源于监管场所(OR=0.44,95%CI:0.21~0.94)的病例晚发现率较低。结论今后南京市艾滋病综合防治示范区应进一步加强男男性接触人群(men who have sex with men,MSM)、学生和50~岁岁组重点人群的防控,在继续实施自愿咨询检测门诊(voluntary counseling and testing,VCT)、专题调查等基础上还需要全面推进医务人员主动提供的艾滋病检测咨询(provider initiated HIV testing and counseling,PITC)工作,提高早发现病例能力,扩大艾滋病检测覆盖面。
Objective To analyze the epidemiological characteristics of HIV / AIDS in Nanjing from 2012 to 2016, calculate the late detection rate of HIV infected persons and analyze the influencing factors, so as to provide basis for better prevention and control work in future demonstration areas. Methods The epidemiological data of HIV-infected persons reported from 2012 to 2016 in the comprehensive prevention and treatment of AIDS in Nanjing city were statistically analyzed. Results Among the 3 064 subjects, male was the major component (93.0%), occupational occupations were 10.0% of the students, and sexual route was the main route of transmission (95.3%), while the adult patients aged 50 to 15.1%. The main source of sample testing and consulting (42.5%) and medical institutions (42.0%) based. Among 3 064 subjects, 931 were found late, with a late detection rate of 30.4%. Multivariate analysis showed that there was no significant difference between the two groups (OR = 2.72, 95% CI: 1.49-4.99), 40 ~ (OR = 4.38,95% CI: 2.34 ~ 8.21) (OR = 0.66, 95% CI: 0.53 ~ 0.83). The incidence of drug abuse (1.86 ~ 6.62) was higher in the medical institutions (OR = 2.34, 95% CI: 1.93-2.85) OR = 0.29, 95% CI: 0.15-0.57). The incidence of late-onset cases from regulatory sites (OR = 0.44, 95% CI: 0.21 to 0.94) was lower. Conclusion From now on, the prevention and control of HIV / AIDS prevention and control in Nanjing should be further strengthened for men who have sex with men (MSM), students and key populations in the 50 to age group. Voluntary counseling and testing clinics and testing, VCT), and special surveys. We also need to fully promote the work of HIV / AIDS counseling and counseling (PITC) initiatively provided by medical staff to improve the ability of early detection of cases and expand the coverage of HIV testing.