福建省HIV/AIDS双阳家庭感染特征及其影响因素

连巧龄; 陈亮; 张明雅; 吴韶彬; 潘蕴蛟

doi:10.16462/j.cnki.zhjbkz.2020.12.005

福建省HIV/AIDS双阳家庭感染特征及其影响因素

doi: 10.16462/j.cnki.zhjbkz.2020.12.005

350001 福州，福建省疾病预防控制中心高危人群干预研究室

基金项目:

福建省卫生健康科技计划项目资助 2016-1-21

详细信息

通讯作者:
潘蕴蛟，E-mail:tjpanyunjiao@163.com

中图分类号: R512.91
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- 被引次数: 0
出版历程
- 收稿日期: 2020-07-13
- 修回日期: 2020-10-19
- 刊出日期: 2020-12-10

Study on the infection characteristics and influencing factors of HIV-seroconcordant couples in Fujian Province

Department of High Risk Population Intervention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China

Funds:

Fujian Provincial Health Project 2016-1-21

More Information

Corresponding author: PAN Yun-jiao, E-mail: tjpanyunjiao@163.com

摘要

摘要: 目的了解福建省人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者/艾滋病(acquired immune deficiency syndrome, AIDS)患者(简称HIV/AIDS)中双阳家庭感染特征及其影响因素。方法采用统一面访问卷调查福建省截至2019年12月31日报告的HIV/AIDS确诊双阳夫妻对，收集人口学和疾病相关信息。对双阳家庭感染状况的影响因素进行单因素和多因素非条件Logistic回归分析模型分析。结果共调查1 042个双阳家庭，即2 084例HIV/AIDS病例，先报告病例首次配偶检测阴性的占7.9%(82/1 042)；先报告病例与后报告病例报告时间间隔>365 d者占5.7%(59/1 042)，多因素非条件Logistic回归分析模型分析结果显示：先报告病例年龄 < 30岁者(OR=3.642, 95% CI:1.491~8.894)该比例较高；后报告感染者有97.5%(1 016/1 042)接受过CD4⁺ T淋巴细胞计数检测，其中，首次检测CD4⁺ T淋巴细胞计数 < 200个/μl者占26.2%(266/1 016)，多因素非条件Logistic回归分析模型分析结果显示，先报告病例为女性(OR=2.285, 95% CI:1.676~3.115)、病程为AIDS者(OR=1.845, 95% CI:1.356~2.510)该比例较高，而先报告病例年龄 < 30岁者(OR=0.463, 95% CI:0.259~0.825)，该比例较低。结论不同双阳家庭感染特征不同，应提高已婚有配偶人群HIV感染风险意识和检测意识，积极动员其告知配偶并检测，尤其应关注女性、病程为AIDS和老年感染者，以减少配偶间传播。
- HIV/AIDS /
- 双阳家庭 /
- 影响因素
Abstract: Objective To investigate the infection characteristics and influencing factors of HIV-seroconcordant couples in Fujian Province. Methods A unified face-to-face questionnaire was used to investigate the couples diagnosed with HIV/AIDS reported before December 31, 2019 in Fujian Province, and demographic information and disease-related information were collected.Univariate and multivariate Logistic regression models were used to analyze the influencing factors of infection status. Results A total of 1 042 couples (2 084 persons) infected with HIV/AIDS were under survey, among whom 82 (7.9%) cases' partners were HIV-serodiscordant during the first testing, and 5.7% couples whose reported interval were over 365 d. Multivariate Logistic regression analysis showed that those who aged < 30 years old (OR=3.642, 95% CI:1.491-8.894) were more likely to report an interval over 365 d. 97.5% (1 016/1 042) of subsequent reported cases among the HIV-seroconcordant couples completed the CD4⁺ T cell counts testing. There were 266 cases(26.2%)whose CD4⁺ T cell counts were under 200 cells/μl in the first testing. Multivariate Logistic regression analysis showed that the spouses of those who were female as first reported cases (OR=2.285, 95% CI:1.676-3.115), or AIDS (OR=1.845, 95% CI:1.356-2.510) were more likely under 200 cells/μl in first testing. The spouses of those who aged < 30 years old (OR=0.463, 95% CI:0.259-0.825) were just the opposite. Conclusion The characteristics of infection in different HIV-seroconcordant couples are different. The awareness of HIV infection and detection among married people should be enhanced, and their spouses should be actively mobilized for notification and detection. In order to reduce the transmission between spouses, targeted measures should be taken to promote early HIV testing and detection for those who were female, AIDS or the old.
- HIV/AIDS /
- HIV-seroconcordant couple /
- Influencing factors

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表 1 双阳家庭感染特征[n(%)]

Table 1. The infection characteristics of HIV-seroconcordant couple[n(%)]

因素	总例数	不同年份例数			χ²值	P值
因素	总例数	2010年前	2011-2015年	2016-2019年	χ²值	P值
首次配偶检测					40.959	< 0.001
阴性	82	26(18.6)	41(10.1)	15(3.0)
阳性	960	114(81.4)	365(89.9)	481(97.0)
报告时间间隔1					8.718	0.013
≤30 d	792	95(67.9)	303(74.6)	394(79.4)
>30 d	250	45(32.1)	103(25.4)	102(20.6)
报告时间间隔2					23.937	< 0.001
≤90 d	913	106(75.7)	355(87.4)	452(91.1)
>90 d	129	34(24.3)	51(12.6)	44(8.9)
报告时间间隔3					38.969	< 0.001
≤365 d	983	117(83.6)	383(94.3)	483(97.4)
>365 d	59	23(16.4)	23(5.7)	13(2.6)

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表 2 双阳家庭报告时间间隔是否超过365 d的单因素分析和多因素Logistic回归分析

Table 2. Analysis of single factor and multivariate Logistic regression model of whether the reporting time interval exceeds 365 days for HIV-seroconcordant couple

因素	总例数	报告时间间隔>365 d的例数	率(%)	单因素分析		多因素分析
因素	总例数	报告时间间隔>365 d的例数	率(%)	OR(95% CI)值	P值	OR(95% CI)值	P值
年龄(岁)^a
≥60	255	10	3.9	1.000		1.000
30~	669	32	4.8	1.231(0.596~2.542)	0.575	1.11(0.529~2.328)	0.782
< 30	118	17	14.4	4.124(1.826~9.314)	0.001	3.642(1.491~8.894)	0.005
性别^a
男性	643	34	5.3	1.000		1.000
女性	399	25	6.3	1.197(0.703~2.039)	0.507	1.017(0.561~1.844)	0.956
文化程度^a
高中及以上	138	8	5.8	1.000		1.000
初中及以下	904	51	5.6	0.972(0.451~2.094)	0.941	1.235(0.530~2.880)	0.625
文化程度^b
高中及以上	127	8	6.3	1.000		1.000
初中及以下	915	51	5.6	0.878(0.407~1.896)	0.740	1.070(0.458~2.499)	0.876
民族^a
汉族	1023	57	5.6	1.000		1.000
少数民族	19	2	10.5	1.994(0.450~8.841)	0.364	0.926(0.182~4.716)	0.926
户籍^a
省内	984	52	5.3	1.000		1.000
省外	58	7	12.1	2.460(1.064~5.686)	0.035	2.196(0.870~5.545)	0.096
病程^a
HIV	451	20	4.4	1.000		1.000
AIDS	591	39	6.6	1.523(0.875~2.648)	0.137	1.731(0.965~3.103)	0.066
感染途径^a
其他或不详	30	1	3.3	1.000		1.000
同性传播	36	2	5.6	1.706(0.147~19.789)	0.669	1.898(0.155~23.195)	0.616
异性传播	976	56	5.7	1.765(0.236~13.196)	0.580	1.977(0.258~15.122)	0.511
样本来源^a
其他	38	3	7.9	1.000		1.000
重点人群	197	17	8.6	1.102(0.306~3.962)	0.882	0.896(0.240~3.339)	0.870
医疗机构	807	39	4.8	0.592(0.175~2.011)	0.401	0.578(0.165~2.021)	0.391
治疗^a
是	965	56	5.8	1.000		1.000
否	77	3	3.9	0.658(0.201~2.153)	0.489	0.763(0.223~2.605)	0.665
注：^a为先报告病例，^b为后报告病例。

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表 3 双阳家庭后报告感染者首次检测CD4小于200的单因素分析和多因素Logistic回分析

Table 3. Analysis of single factor and multivariate Logistic regression model of subsequent reported cases among the HIV-seroconcordant couples whose CD4⁺ T cell were under 200 in the first testing

因素	总例数	后报告感染者首次检测CD4 < 200的例数	率(%)	单因素分析		多因素分析
因素	总例数	后报告感染者首次检测CD4 < 200的例数	率(%)	OR(95% CI)值	P值	OR(95% CI)值	P值
年龄(岁)^a
≥60	243	69	28.4	1.000		1.000
30~	659	174	26.4	0.905(0.652~1.256)	0.550	0.799(0.567~1.127)	0.201
< 30	114	23	20.2	0.637(0.373~1.089)	0.099	0.463(0.259~0.825)	0.009
性别^a
男性	624	137	22.0	1.000		1.000
女性	392	129	32.9	1.744(1.313~2.315)	< 0.001	2.285(1.676~3.115)	< 0.001
文化程度^a
高中及以上	134	37	27.6	1.000		1.000
初中及以下	882	229	26.0	0.919(0.612~1.382)	0.686	0.821(0.524~1.286)	0.389
文化程度^b
高中及以上	123	32	26.0	1.000		1.000
初中及以下	893	234	26.2	1.010(0.657~1.552)	0.965	1.052(0.657~1.685)	0.832
民族^a
汉族	997	262	26.3	1.000		1.000
少数民族	19	4	21.1	0.748(0.246~2.274)	0.609	0.962(0.304~3.043)	0.948
户籍^a
省内	959	256	26.7	1.000		1.000
省外	57	10	17.5	0.584(0.291~1.174)	0.131	0.598(0.287~1.247)	0.17
病程^a
HIV	433	91	21.0	1.000		1.000
AIDS	583	175	30.0	1.612(1.205~2.157)	0.001	1.845(1.356~2.510)	< 0.001
感染途径^a
其他或不详	28	6	21.4	1.000		1.000
同性传播	36	10	27.8	1.410(0.442~4.501)	0.562	2.180(0.650~7.312)	0.207
异性传播	952	250	26.3	1.306(0.523~3.258)	0.557	1.435(0.559~3.686)	0.453
样本来源^a
其他	36	6	16.7	1.000		1.000
重点人群	191	54	28.3	1.971(0.777~5.002)	0.153	2.188(0.847~5.650)	0.106
医疗机构	789	206	26.1	1.767(0.725~4.306)	0.210	1.612(0.651~3.987)	0.302
治疗^a
是	951	250	26.3	1.000		1.000
否	65	16	24.6	0.916(0.511~1.639)	0.767	1.102(0.602~2.019)	0.753
注：^a为先报告病例，^b为后报告病例。

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