Late HIV diagnosis and its correlates among newly reported Chinese and Burmese HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture from 2014 to 2021
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摘要:
目的 了解2014-2021年德宏傣族景颇族自治州(德宏州)新报告中国籍和缅甸籍HIV/AIDS病例晚发现状况及其影响因素。 方法 通过中国“艾滋病综合防治信息系统”，选择2014-2021年德宏州新报告的全部HIV/AIDS病例进行分析，通过logistic回归模型分析病例晚发现的影响因素。 结果 2014-2021年新报告中国籍HIV/AIDS病例2 586例，晚发现病例763例，平均晚发现比例29.5%；新报告境内缅甸籍HIV/AIDS病例4 788例，晚发现病例707例，平均晚发现比例为14.8%。多因素logistic回归分析模型分析结果显示：中国籍HIV/AIDS病例中男性、年龄≥30岁、文盲、经异性传播、发现途径为医疗机构检测发现的病例晚发现风险高于其他组别的感染者(均P＜0.05)；缅甸籍HIV/AIDS病例中年龄≥30岁、文盲、发现途径为医疗机构检测发现病例晚发现风险高于其他组别的感染者(均P＜0.05)。 结论 德宏州应继续加强各类人群的AIDS防治知识及HIV检测的宣传，促进隐匿高危人群的主动检测，减少病例的晚发现。 Abstract:Objective To investigate the proportions and correlates of late HIV diagnosis among newly reported Chinese and Burmese HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture, between 2014 and 2021. Methods Data were derived from China "Comprehensive AIDS Prevention and Control Information System", all newly reported HIV/AIDS cases in Dehong Prefecture from 2014 to 2021 were included. Logistic regression models were used to explore the correlates of late diagnosis. Results Among 2 586 and 4 788 newly reported Chinese and Burmese HIV/AIDS cases, 763 cases (29.5%) and 707 cases (14.8%) were late diagnosis, respectively. In multivariable regression models, male gender, aged over 30 years, illiteracy, heterosexual transmission, and cases reported by medical institutions were positively associated with late HIV diagnosis among Chinese HIV/AIDS cases (all P<0.05), whereas aged over 30 years, illiteracy, and cases reported by medical institutions were positively associated with late HIV diagnosis among Burmese HIV/AIDS cases (all P<0.05). Conclusions Dehong Prefecture should continue to strengthen the awareness of HIV/AIDS prevention, treatment and testing among various types of population and promote the active testing among hidden populations to reduce late HIV diagnosis. -
Key words:
- HIV/AIDS /
- Late diagnosis /
- Correlates
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表 1 2014-2021年德宏州新报告中国籍和缅甸籍HIV/AIDS病例晚发现情况
Table 1. Late HIV diagnosis among newly reported Chinese and Burmese HIV/AIDS cases in Dehong Prefecture, 2014-2021
报告时间/年
Report time/year中国籍Chinese 缅甸籍Burmese 报告病例数
No. reported case
(n=2 586)晚发现病例数
No. late diagnosis reported casee (n=763)晚发现比例/%
Late diagnosis
rate/%报告病例数
No. reported case(n=4 788)晚发现病例数
No. late diagnosis reported casee(n=707)晚发现比例/%
Late diagnosis
rate/%2014 434 135 31.1 656 110 16.8 2015 361 113 31.3 526 110 20.9 2016 375 116 30.9 717 90 12.6 2017 351 105 29.9 698 101 14.5 2018 297 76 25.6 719 84 11.7 2019 351 95 27.1 828 111 13.4 2020 238 73 30.7 487 72 14.8 2021 179 50 27.9 157 29 18.5 
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表 2 2014-2021年德宏州新报告中国籍和缅甸籍HIV/AIDS病例晚发现比例及单因素logistic回归分析模型分析结果
Table 2. Proportion of late HIV diagnosis among newly reported Chinese and Burmese HIV/AIDS cases in Dehong Prefecture from 2014 to 2021 and results of univariable logistic regression model analysis
变量Variable 中国籍Chinese 缅甸籍Burmese 报告病例数
(占比/%)
No. reported case
(proportion/%)晚发现病例数
(占比/%)
No. late diagnosis reported case
(proportion/%)OR值value
(95% CI)P值
value报告病例数
(占比/%)
No. reported case
(proportion/%)晚发现病例数
(占比/%)
No. late diagnosis reported case
(proportion/%)OR值value
(95% CI)P值
value性别Gender 男Male 1 657(64.1) 505(30.5) 1.00 3 235(67.6) 422(13.0) 1.00 女Female 929(35.9) 258(27.8) 0.88(0.73~1.05) 0.148 1 553(32.4) 285(18.3) 1.51(1.27~1.77) <0.001 报告年龄/岁Reporting age/year <20 117(4.5) 23(19.7) 1.00 228(4.8) 19(8.3) 1.00 20~<30 554(21.4) 99(17.9) 0.89(0.54~1.47) 0.649 1 911(40.0) 191(9.9) 1.22(0.76~1.97) 0.415 30~<40 747(28.9) 221(29.6) 1.72(1.06~2.78) 0.028 1 640(34.3) 290(17.6) 2.36(1.47~3.79) <0.001 40~<50 643(24.9) 229(35.6) 2.26(1.39~3.67) 0.001 770(16.0) 142(18.4) 2.53(1.55~4.13) <0.001 ≥50 525(20.3) 191(36.4) 2.34(1.43~3.81) 0.001 239(4.9) 65(27.2) 4.17(2.43~7.14) <0.001 职业Occupation 农民Peasant 1 894(73.2) 561(29.6) 1.00 3 203(66.9) 526(16.4) 1.00 其他Other 692(26.8) 202(29.2) 0.98(0.81~1.19) 0.832 1 585(33.1) 181(11.4) 0.67(0.56~0.80) <0.001 婚姻状况Marital status 未婚Spinster 709(27.4) 181(25.5) 1.00 1 773(37.0) 215(12.1) 1.00 已婚有配偶Be married with spouse 1 210(46.8) 347(28.7) 1.17(0.95~1.45) 0.136 2 591(54.1) 372(14.3) 1.21(1.01~1.45) 0.032 离异或丧偶Divorced or widowed 667(25.8) 235(35.2) 1.59(1.26~2.00) <0.001 424(8.9) 120(28.3) 2.88(2.23~3.71) <0.001 文化程度Educational level 文盲Illiteracy 338(13.1) 122(36.1) 1.00 1 747(36.5) 342(19.6) 1.00 小学Primary school 1 001(38.7) 299(29.9) 0.75(0.58~0.98) 0.033 1 925(40.2) 260(13.5) 0.64(0.54~0.76) <0.001 初中Junior high school 874(33.8) 243(27.8) 0.68(0.52~0.89) 0.005 876(18.3) 85(9.7) 0.47(0.33~0.60) <0.001 高中及以上High school and above 373(14.4) 99(26.5) 0.64(0.47~0.88) 0.006 240(5.0) 20(8.3) 0.42(0.26~0.65) <0.001 感染途径Route of infection 异性传播Heterosexual transmission 2 184(84.5) 665(30.5) 1.00 3 501(73.1) 506(14.4) 1.00 同性传播Homosexual transmission 142(5.5) 22(15.5) 0.42(0.26~0.67) <0.001 30(0.6) 1(3.3) 0.20(0.03~1.47) 0.124 注射吸毒Injecting drug use 227(8.8) 67(29.5) 0.96(0.71~1.29) 0.771 1 230(25.7) 195(15.8) 1.11(0.93~1.32) 0.271 母婴传播Mother-to-child transmission 33(1.2) 9(27.3) 0.86(0.40~1.85) 0.694 27(0.6) 5(18.5) 1.36(0.51~3.62) 0.535 发现途径① Discovery approach① 医疗机构Medical institution 1 070(41.4) 423(39.5) 1.00 500(10.4) 183(36.6) 1.00 检测咨询Testing and consulting 561(21.7) 177(31.6) 0.71(0.57~0.88) 0.002 237(4.9) 80(33.8) 0.90(0.65~1.24) 0.513 阳性者配偶或性伴/子女检测
Positive spouse or sexual partner/child test182(7.0) 27(14.8) 0.27(0.17~0.41) <0.001 76(1.6) 11(14.5) 0.30(0.15~0.58) <0.001 羁押人员检测Custody inspection 197(7.6) 42(21.3) 0.41(0.29~0.60) <0.001 1 029(21.5) 155(15.0) 0.31(0.24~0.40) <0.001 婚前检查(含涉外婚姻)
Pre-marital examination(including foreign marriage)124(4.8) 17(13.7) 0.24(0.14~0.41) <0.001 25(0.5) 6(24.0) 0.50(0.20~1.27) 0.127 孕产期检查Prenatal examination 53(2.1) 9(17.0) 0.31(0.15~0.65) 0.002 106(2.2) 19(17.9) 0.39(0.23~0.65) <0.001 其他Other 399(15.4) 68(17.0) 0.31(0.24~0.42) <0.001 2 815(58.9) 253(8.9) 0.17(0.14~0.22) <0.001 注：①发现途径中医疗机构包括：其他就诊者检测、术前检测、性病门诊检测、受血(制品)前检测等；羁押人员检测包括：强制/劳教戒毒人员检测和其他羁押人员检测；其他包括：专题调查、流动人口调查、出入境人员体检等。
Note: ① Healthcare facilities in the pathway of discovery include: other patient testing, pre-operative testing, sexually transmitted disease clinic testing, testing prior to receiving blood (products), etc. Detainee testing includes: mandatory/re-education-through-labor detainee testing and other detainees. Others include: thematic surveys, mobile population surveys, and medical examinations of persons entering and leaving the country.
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表 3 2014-2021年德宏州新报告中国籍和缅甸籍HIV/AIDS病例晚发现的多因素logistic回归分析模型分析结果
Table 3. Multivariable logistic regression model analysis on late HIV diagnosis among newly reported Burmese HIV/AIDS cases in Dehong Prefecture from 2014 to 2021
变量Variable 中国籍Chinese 缅甸籍Burmese OR值value
(95% CI)P值
valueOR值value
(95% CI)P值
value性别Gender 男Male 1.00 1.00 女Female 0.81(0.66~0.99) 0.041 1.03(0.84~1.27) 0.756 报告年龄/岁Reporting age/year <20 1.00 1.00 20~<30 1.10(0.59~2.08) 0.759 1.54(0.93~2.53) 0.083 30~<40 2.03(1.08~3.81) 0.028 3.18(1.91~5.28) <0.001 40~<50 2.53(1.33~4.83) 0.005 3.17(1.86~5.39) <0.001 ≥50 2.41(1.25~4.66) 0.009 3.37(1.88~6.04) <0.001 职业Occupation 农民Farmer - - 1.00 其他Other - - 0.88(0.72~1.08) 0.230 婚姻状况Marital status 未婚Spinster 1.00 1.00 已婚有配偶Be married 0.85(0.65~1.11) 0.233 1.12(0.90~1.39) 0.299 离异或丧偶Divorced or widowed 0.99(0.74~1.31) 0.921 1.35(0.99~1.84) 0.051 文化程度Educational level 文盲Illiteracy 1.00 1.00 小学Primary school 0.75(0.57~0.99) 0.040 0.81(0.67~0.99) 0.044 初中Junior high school 0.82(0.61~1.10) 0.181 0.69(0.52~0.91) 0.009 高中及以上High school and above 0.79(0.55~1.13) 0.202 0.66(0.41~1.06) 0.086 感染途径Route of infection 异性传播Heterosexual transmission 1.00 - - 同性传播Homosexual transmission 0.59(0.36~0.99) 0.045 - - 注射吸毒Injecting drug use 1.22(0.83~1.78) 0.315 - - 母婴传播Mother-to-child transmission 1.85(0.68~5.03) 0.231 - - 发现途径① Discovery approach ① 医疗机构Medical institution 1.00 1.00 检测咨询Testing and consulting 0.75(0.60~0.94) 0.011 0.87(0.62~1.23) 0.442 阳性者配偶或性伴/子女检测Positive spouse or sexual partner/child test 0.28(0.18~0.43) <0.001 0.31(0.16~0.61) 0.001 羁押人员检测Custody inspection 0.35(0.22~0.54) <0.001 0.30(0.22~0.40) <0.001 婚前检查(含涉外婚姻) Pre-marital examination (including foreign marriage) 0.31(0.18~0.53) <0.001 0.58(0.22~1.51) 0.363 孕产期检查Prenatal examination 0.52(0.24~1.10) 0.088 0.54(0.31~0.93) 0.025 其他Other 0.36(0.27~0.48) <0.001 0.20(0.16~0.25) <0.001 注：“-”类别代表该因素单因素分析P>0.15，不纳入多因素回归模型。
①发现途径中医疗机构包括：其他就诊者检测、术前检测、性病门诊检测、受血(制品)前检测等；羁押人员检测包括：强制/劳教戒毒人员检测和其他羁押人员检测；其他包括：专题调查、流动人口调查、出入境人员体检等。
Note: "-" represents a one-way analytic P>0.15 for the factor and was not included in the multifactor regression model.
① Healthcare facilities in the pathway of discovery include: other patient testing, pre-operative testing, sexually transmitted disease clinic testing, testing prior to receiving blood (products), etc. Detainee testing includes: mandatory/re-education-through-labor detainee testing and other detainees. Others include: thematic surveys, mobile population surveys, and medical examinations of persons entering and leaving the country.
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