辽宁省HIV/AIDS病人规范化随访现况及影响因素

周丹; 盖小群; 康续; 孙笠翔; 姚文清; 王莉

doi:10.16462/j.cnki.zhjbkz.2020.12.006

辽宁省HIV/AIDS病人规范化随访现况及影响因素

doi: 10.16462/j.cnki.zhjbkz.2020.12.006

110005 沈阳，辽宁省疾病预防控制中心艾滋病与性传播疾病预防控制所

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通讯作者:
王莉，E-mail: wangli363@sina.com

中图分类号: R181
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出版历程
- 收稿日期: 2020-07-23
- 修回日期: 2020-09-15
- 刊出日期: 2020-12-10

Status and influencing factors of standardized follow-up among the people with HIV/AIDS in Liaoning Province

Liaoning Provincial Center for Diseases Control and Prevention, Shenyang 110005, China

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Corresponding author: WANG Li, E-mail: wangli363@sina.com

摘要

摘要: 目的了解辽宁省人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者/艾滋病(acquired immunodeficiency syndrome, AIDS)病人(简称HIV/AIDS病人)规范化随访现况，并分析其影响因素。方法数据来自AIDS防治基本信息系统中2016年-2019年底的病例报告历史卡片和定时随访数据库，采用多因素Logistic回归分析模型分析HIV/AIDS病人规范化随访的相关因素。结果截至2016年、2017年、2018年和2019年底，辽宁省HIV/AIDS病人分别为13 008例、15 215例、17 583例和19 365例，接受规范化随访比例分别为84.41%、86.87%、86.45%和89.87%，呈现上升趋势(χ² _趋势=184.953，P < 0.001)。多因素回归分析结果显示，20~岁、40~岁年龄组、已婚有配偶和离异或丧偶、文化程度大专及以上和疾病状态为AIDS较20岁以下年龄组、未婚、初中及以下和疾病状态为HIV接受规范化随访比例更高(均有P < 0.05)；感染途径为异性传播和注射吸毒、样本来源为就诊者检测和羁押人员体检较同性传播、检测咨询/专题调查的病人接受规范化随访比例更低(均有P < 0.05)。结论还需要进一步加强辽宁省艾滋病规范化随访管理工作，针对不同人群特点采取针对性的措施，提高随访工作质量，有效地控制艾滋病的传播。
- HIV/AIDS /
- 随访 /
- 影响因素
Abstract: Objective To understand the status and influencing factors of standardized follow-up of the people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Liaoning Province. Methods Data were collected from both Case Reporting Cards and Follow-up Cards in National HIV/AIDS Information System for the end of 2016 to 2019, respectively. Logistic regression model was used to analyze influencing factors of standardized follow-up of the HIV/AIDS. Results There were 13 008, 15 215, 17 583 and 19 365 patients in Liaoning Province in four years, respectively. The proportion of patients having received standardized follow-up were 84.41%, 86.87%, 86.45% and 89.87% from 2016 to 2019, with significant upward trend (χ² _trend=184.953, P < 0.001). Results of multivariate regression analysis showed that HIV/AIDS patients who were aged 20 to 39 years, aged 40 to 59 years, married with spouse, divorced or widowed, cultural level of college and above or in AIDS phase were more likely to have received standardized follow-up than patients who were younger than 20 years old, unmarried, junior secondary and below or in HIV phase (all P < 0.05). Compared to the patients infected by homosexuality transmission and from testing consultation/thematic survey, the patients infected by heterosexual transmission and injecting drugs, from patient testing and medical examination of detainees were less likely to have received standardized follow-up (all P < 0.05). Conclusions Standardized follow-up management need to be strengthened for HIV/AIDS patients in Liaoning Province. The different measures according to the people with different characteristics should be taken to improve the quality of follow-up and control the spread of AIDS effectively.
- HIV/AIDS /
- Follow-up /
- Influencing factors

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表 1 辽宁省HIV/AIDS病人接受规范化随访比例地区统计[n(%)]

Table 1. The proportion of having received standardized follow-up of the HIV/AIDS patients among 14 Cities in Liaoning Province [n(%)]

地区	病例数(例)	是否接受规范化随访
地区	病例数(例)	是	否
沈阳市	6 823(35.24)	6 205(90.94)	618(9.06)
大连市	4 117(21.26)	3 745(90.96)	372(9.04)
鞍山市	1 422(7.34)	1 240(87.20)	182(12.80)
抚顺市	779(4.02)	694(89.09)	85(10.91)
本溪市	429(2.22)	403(93.94)	26(6.06)
丹东市	702(3.63)	577(82.19)	125(17.81)
锦州市	858(4.43)	768(89.51)	90(10.49)
营口市	943(4.87)	820(86.96)	123(13.04)
阜新市	297(1.53)	291(97.98)	6(2.02)
辽阳市	605(3.12)	538(88.93)	67(11.07)
盘锦市	474(2.45)	437(92.19)	37(7.81)
铁岭市	792(4.09)	668(84.34)	124(15.66)
朝阳市	457(2.36)	434(94.97)	23(5.03)
葫芦岛市	666(3.44)	583(87.54)	83(12.46)

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表 2 辽宁省HIV/AIDS病人规范化随访的单因素分析结果[n(%)]

Table 2. Univariate analysis of the standardized follow-up of the HIV/AIDS patients in Liaoning Province [n(%)]

变量	病例数(例)	是否接受规范化随访		χ²值	P值
变量	病例数(例)	是	否	χ²值	P值
性别				2.081	0.149
男	17 876(92.31)	16 081(89.96)	1 795(10.04)
女	1 489(7.69)	1 322(88.78)	167(11.22)
年龄(岁)				56.643	< 0.001
< 20	861(4.45)	712(82.69)	149(17.31)
20~	11 957(61.75)	10 759(89.98)	1 198(10.02)
40~	5 668(29.27)	5 152(90.90)	516(9.1)
≥60	879(4.54)	780(88.74)	99(11.26)
民族				2.903	0.088
汉族	17 083(88.22)	15 376(90.01)	1 707(9.99)
其他	2 271(11.73)	2 018(88.86)	253(11.14)
婚姻				29.556	< 0.001
未婚	10 997(56.79)	9 799(89.11)	1 198(10.89)
已婚有配偶	4 061(20.97)	3 733(91.92)	328(8.08)
离异或丧偶	4 264(22.02)	3 836(89.96)	428(10.04)
不详	42(0.22)	34(80.95)	8(19.05)
文化程度				75.929	< 0.001
初中及以下	7 613(39.31)	6 707(88.10)	906(11.9)
高中或中专	4 532(23.40)	4 035(89.03)	497(10.97)
大专及以上	7 207(37.22)	6 651(92.29)	556(7.71)
职业				26.282	< 0.001
家政、家务及待业	9 581(49.48)	8 590(89.66)	991(10.34)
商业服务	1 861(9.61)	1 665(89.47)	196(10.53)
农民	1 455(7.51)	1 290(88.66)	165(11.34)
工人	1 283(6.63)	1 165(90.80)	118(9.2)
干部职员	1 217(6.28)	1 142(93.84)	75(6.16)
学生	961(4.96)	856(89.07)	105(10.93)
其他和不详	3 007(15.53)	2 695(89.62)	312(10.38)
疾病状态				311.027	< 0.001
HIV	12 705(65.61)	11 066(87.10)	1 639(12.9)
AIDS	6 660(34.39)	6 337(95.15)	323(4.85)
报告年限(年)				1.069	0.784
< 2	5 033(25.99)	4 519(89.79)	514(10.21)
2~	9 501(49.06)	8 528(89.76)	973(10.24)
6~	3 849(19.88)	3 465(90.02)	384(9.98)
≥10	982(5.07)	891(90.73)	91(9.27)
感染途径				200.071	< 0.001
同性传播	13 436(69.38)	12 209(90.87)	1 227(9.13)
异性传播	5 315(27.45)	4 729(88.97)	586(11.03)
注射毒品	363(1.87)	250(68.87)	113(31.13)
其他和不详	251(1.30)	215(85.66)	36(14.34)
样本来源				217.895	< 0.001
检测咨询/专题调查	8 261(42.66)	7 559(91.5)	702(8.5)
就诊者检测	8 850(45.70)	7 973(90.09)	877(9.91)
羁押人员体检	419(2.16)	299(71.36)	120(28.64)
其他	1 835(9.48)	1 572(85.67)	263(14.33)

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表 3 辽宁省HIV/AIDS病人规范化随访的多因素分析结果

Table 3. Multivariate Logistic regression analysis of the standardized follow-up of the HIV/AIDS patients in Liaoning Province

变量	β	s_x	Wald值	OR(95% CI)值	P值
年龄(岁)
< 20				1.000
20~	0.363	0.098	13.605	1.438(1.186~1.744)	< 0.001
40~59	0.386	0.119	10.519	1.472(1.165~1.859)	< 0.001
婚姻
未婚				1.000
已婚有配偶	0.451	0.082	30.343	1.569(1.337~1.842)	< 0.001
离异或丧偶	0.207	0.079	6.858	1.230(1.054~1.437)	0.009
文化程度
初中及以下				1.000
大专及以上	0.460	0.063	53.697	1.584(1.401~1.792)	< 0.001
疾病状态
HIV				1.000
AIDS	1.086	0.065	282.794	2.964(2.611~3.364)	< 0.001
感染途径
同性传播				1.000
异性传播	-0.218	0.059	13.586	0.804(0.716~0.903)	< 0.001
注射毒品	-1.149	0.138	68.914	0.317(0.242~0.416)	< 0.001
样本来源
检测咨询/专题调查				1.000
就诊者检测	-0.257	0.056	21.304	0.773(0.693~0.862)	< 0.001
羁押人员体检	-0.934	0.134	48.673	0.393(0.302~0.511)	< 0.001
其他	-0.547	0.080	46.187	0.579(0.495~0.678)	< 0.001
注：多因素分析结果中无统计学意义(P>0.05)的自变量未在此表中列出。

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