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目的了解张家港市实施PITC策略工作进展,分析更有效发现HIV感染者策略。方法收集整理2015年全市各级医疗机构开展HIV抗体筛查的资料、疾控中心自愿咨询检测资料及HIV/AIDS病例个案资料,并进行统计分析。结果 2015年医疗机构HIV阳性检出率为3.68/万,疾控中心自愿咨询检测途径阳性检出率为620.57/万,差异有统计学意义(P=0.000)。不同级别医疗机构阳性检出率差异无统计学意义(χ~2=0.177,P=0.674)。医疗机构不同科别阳性检出率差异有统计学意义,由高到低依次为皮肤科、肛肠科、内科、外科和妇产科。不同发现途径阳性检出率差异有统计学意义,由高到低依次为临床可疑者、性病就诊者、人流者、其他就诊者、术前对象和孕产妇。阳性检出成本自愿咨询检测途径最经济,医疗机构阳性检出成本较低前三位为临床可疑、性病就诊者和人流者。结论医疗机构的主动筛查已成为张家港市HIV感染者发现的主要来源,建议按检出率高低和检出成本调整检测策略,优化对HIV阳性者的后续服务,以避免资源浪费,取得更好防治效果。
Objective To understand the progress of implementing PITC strategy in Zhangjiagang City and analyze the strategies to find out HIV infection more effectively. Methods The data of HIV antibody screening conducted by medical institutions at all levels of the city in 2015, voluntary counseling and testing data of CDC and cases of HIV / AIDS were collected and analyzed. Results The positive rate of HIV positive was 3.68 / million in medical institutions in 2015, and the positive rate of voluntary counseling and testing in CDC was 620.57 / million. The difference was statistically significant (P = 0.000). There was no significant difference in the positive detection rates of different medical institutions (χ ~ 2 = 0.177, P = 0.674). There were significant differences in the positive detection rates of different departments in the medical institutions, ranging from dermatology, anorectal surgery, internal medicine, surgery and obstetrics and gynecology in descending order. There were significant differences in the positive detection rate of different ways of detection, from high to low in order of clinical suspects, STD patients, abortion, other treatment, preoperative objects and pregnant women. Positive detection costs Voluntary counseling and testing the most economical way, the lower the positive detection costs of medical institutions The first three were clinically suspicious, STD patients and abortion. Conclusion The active screening of medical institutions has become the main source of HIV infection in Zhangjiagang City. It is suggested that the detection strategies should be adjusted according to the detection rate and detection cost so as to optimize follow-up services to HIV-positive patients so as to avoid wasting resources and achieve better results Control effect.