Analysis on the influencing factors of late diagnosis of newly identified HIV/AIDS cases in Longhua District, Shenzhen, 2017-2018
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摘要:
目的 描述2017-2018年深圳市龙华区医疗机构新报告HIV感染和AIDS病例晚发现基本情况及分析晚发现的可能影响因素。 方法 数据来源于中国疾病预防控制信息系统中的艾滋病防治信息系统，选择2017-2018年新报告的成年HIV/AIDS病例为研究对象。计量资料采用(x±s)描述，计数资料采用率、构成比描述，并用Logistic回归分析模型分析HIV/AIDS晚发现的影响因素。 结果 795例新报告HIV/AIDS病例的平均年龄为(32.6±10.2)岁，HIV/AIDS晚发现比例为39.1%，26.0%来源于艾滋病自愿咨询检测(HIV voluntary counseling and testing, VCT)，22.5%来源于性病门诊。在多因素分析中，＞30岁(OR=0.67, 95% CI: 0.46~0.97, P=0.032)与＞40岁(OR=0.55, 95% CI: 0.32~0.93, P=0.026)人群比 < 30岁人群出现晚发现病例的风险更低，常住人口(OR=2.37, 95% CI: 1.49~3.79, P < 0.001)发生晚发现病例的风险较流动人口更高。而与其他途径检测相比，性病门诊(OR=2.21, 95% CI: 1.22~4.01, P=0.009)、术前检测(OR=1.66, 95% CI: 1.09~2.53, P=0.019)、专题检查(OR=2.59, 95% CI: 1.71~3.91, P < 0.001)与VCT(OR=2.23, 95% CI: 1.13~4.42, P=0.021)出现晚发现的可能性更高。 结论 2017-2018年深圳市龙华区HIV/AIDS晚发现比例为39.1%，年龄、是否为流动人口和样本来源是晚发现的影响因素。 Abstract:Objective To analyze the basic information of late diagnosis (LD) of HIV and the factors related with LD of HIV/AIDS cases newly reported by medical institutions in Longhua District from 2017 to 2018. Methods The database was downloaded from the AIDS prevention and control information system of China's disease prevention and control information system and newly reported HIV/AIDS cases between 2017 and 2018 were included. Mean, standard deviation and other indexes were used to describe measurement data. Rate, constituent ratio and other indexes were used to describe enumeration data. The multivariate Logistic regression model was used to analyze the relevant factors of LD. Results 795 research objects were included in this study. The average age of the included cases was (32.6±10.2) years old. The proportion of LD was 39.1%, 26.0% of LD cases came from HIV voluntary counseling and testing (VCT), and 22.5% came from sexually transmitted disease clinics. Compared with participants under 30, > 30 years age group (OR=0.67, 95% CI: 0.46-0.97, P=0.032) and > 40 years age group (OR=0.55, 95% CI: 0.32-0.93, P=0.026) had lower risk of LD. Compared with transient population, permanent population (OR=2.37, 95% CI: 1.49-3.79, P < 0.001) had higher risk of LD. Compared with samples from other clinical examinations, the OR (95% CI) values of sexually transmitted disease clinics (OR=2.21, 95% CI: 1.22-4.01, P=0.009), testing before surgery (OR=1.66, 95% CI: 1.09-2.53, P=0.019), event-specific surveys (OR=2.59, 95% CI: 1.71-3.91, P < 0.001) and VCT (OR=2.23, 95% CI: 1.13-4.42, P=0.021) had higher risk of LD. Conclusions The proportion of LD in Longhua District between 2017 and 2018 was 39.1%. The factors which statiscally associated with late HIV diagnosis included age, resident population and sample source. -
Key words:
- Acquired immunodeficiency syndrome /
- Newly report /
- Late diagnosis /
- Influencing factor
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表 1 2017-2018年深圳市龙华区HIV/AIDS晚发现相关因素的单因素分析[n (%)]
Table 1. Single factor analysis of late HIV diagnosis of 795 newly reported HIV/AIDS cases in Longhua District, Shenzhen, 2017-2018 [n (%)]
变量 合计 晚发现 χ2值 P值 是 否 年龄(岁) 28.894 ＜0.001 < 30 375(47.2) 113(36.3) 262(54.1) 30~ 256(32.2) 113(36.3) 143(29.5) 40~ 105(13.2) 55(17.7) 50(10.3) 50~ 40(5.0) 23(7.4) 17(3.5) ≥60 19(2.4) 7(2.3) 12(2.5) 性别 0.230 0.632 男 738(92.8) 287(92.3) 451(93.2) 女 57(7.2) 24(7.7) 33(6.8) 民族 0.002 0.962 汉族 729(91.7) 285(91.6) 444(91.7) 其他 66(8.3) 26(8.4) 40(8.3) 是否为流动人口a 15.872 < 0.001 是 702(88.3) 257(82.6) 445(91.9) 否 93(11.6) 54(17.4) 39(8.1) 职业 7.090 0.069 工人 325(40.9) 124(39.9) 201(41.5) 家政、家务及待业 178(22.4) 83(26.7) 95(19.6) 商业服务 159(20.0) 52(16.7) 107(22.1) 其他 133(16.7) 52(16.7) 81(16.7) 婚姻状态 25.168 < 0.001 未婚 561(70.5) 188(60.5) 373(77.1) 已婚 158(19.8) 83(26.7) 75(15.5) 离异/丧偶 76(9.5) 40(12.9) 36(7.4) 学历 6.184 0.103 小学及以下 60(7.5) 29(9.3) 31(6.4) 初中 295(37.1) 124(39.9) 171(35.3) 高中或中专 207(26.0) 69(22.2) 138(28.5) 大专及以上 233(29.3) 89(28.6) 144(29.8) 样本来源 34.712 < 0.001 VCT 271(34.1) 81(26.0) 190(39.3) 性病门诊 184(23.1) 70(22.5) 114(23.6) 术前检测 67(8.4) 26(8.4) 41(8.5) 专题检查 62(7.8) 18(5.8) 44(9.1) 其他途径 211(26.5) 116(37.3) 95(19.6) 是否为同性性传播 8.029 0.005 是 508(63.9) 180(57.9) 328(67.8) 否 287(36.1) 131(42.1) 156(32.2) 商业性行为 3.670 0.055 有 105(13.2) 50(16.1) 55(11.4) 无 690(86.8) 261(83.9) 429(88.6) 多性伴(人) 0.605 0.437 ≤2 380(47.7) 154(49.5) 226(46.7) >2 415(52.2) 157(50.5) 258(53.3) 性病史 0.403 0.817 是 138(17.4) 56(18.0) 82(16.9) 否 622(78.2) 240(77.2) 382(78.9) 不详 35(4.4) 15(4.8) 20(4.1) HIV检测史 0.126 0.723 有 70(8.8) 26(8.4) 44(9.1) 无 725(91.2) 285(91.6) 440(90.9) 注：a是否为流动人口：户籍地和现住址县区级编码一致为常住人口，不一致为流动人口。 
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表 2 2017-2018深圳市龙华区HIV/AIDS晚发现相关因素的Logistic回归分析
Table 2. Logistic regression analysis of factors related to late HIV diagnosis of newly reported cases in Longhua District, Shenzhen, 2017-2018
变量 β值 sx Wald χ2值 OR(95% CI)值 P值 年龄(岁) < 30 1.00 30~ -0.41 0.19 4.62 0.67(0.46~0.97) 0.032 40~ -0.61 0.27 4.96 0.55(0.32~0.93) 0.026 50~ -0.60 0.39 2.36 0.55(0.26~1.18) 0.130 ≥60 0.62 0.56 1.23 1.85(0.62~5.50) 0.270 是否为流动人口 是 1.00 否 0.86 0.24 13.09 2.37(1.49~3.79) < 0.001 职业 工人 1.00 家政、家务及待业 -0.42 0.21 3.95 0.66(0.44~0.10) 0.047 商业服务 -0.07 0.23 0.09 0.93(0.60~1.46) 0.760 其他 -0.30 0.24 1.59 0.74(0.47~1.18) 0.210 婚姻状态 未婚 1.00 已婚 -0.37 0.23 2.51 0.69(0.44~1.09) 0.110 离异/丧偶 -0.49 0.30 2.77 0.61(0.34~1.09) 0.100 样本来源 其他途径 1.00 VCT 0.80 0.35 5.32 2.23(1.13~4.42) 0.021 性病门诊 0.79 0.30 6.85 2.21(1.22~4.01) 0.009 术前检测 0.51 0.22 5.48 1.66(1.09~2.53) 0.019 专题检查 0.95 0.21 20.47 2.59(1.71~3.91) < 0.001 是否为同性性传播 是 1.00 否 -0.08 0.18 0.21 0.92(0.64~1.32) 0.650 商业性行为 有 1.00 无 -0.19 0.24 0.64 0.82(0.51~1.32) 0.420
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