Loss to follow-up over the first five years and its influencing factors in the cohort of sero-negative spouses of HIV-infected individuals in Dehong Prefecture, Yunnan Province
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摘要: 目的 了解云南省德宏州人类免疫缺陷病毒(human immumodeficiency virus,HIV)感染者阴性配偶队列失访情况及影响因素。方法 以2009年招募进入队列的德宏州1 110例阴性配偶为研究对象,收集其社会人口学信息、HIV相关信息,每年随访一次,至2014年12月底结束。利用COX比例风险模型分析阴性配偶失访的影响因素。结果 1 110例阴性配偶中,有37例新发感染HIV,总发病密度为0.92/100人年。1 015例(91.4%)的研究对象至少随访了一次。到2014年底,有227例失访,4例死亡,129例感染者配偶死亡,63例离异。5年队列保持率为58.7%(652/1 110),可随访阴性配偶占应随访的74.2%(652/879),总失访密度为5.66/100人年。COX比例风险模型分析显示来自瑞丽市(HR=1.83,95%CI:1.16~2.87,P=0.009)、芒市(HR=1.90,95%CI:1.23~2.93,P=0.004),男性(HR=1.74,95%CI:1.27~2.38,P=0.001),阳性配偶未接受抗病毒治疗(HR=4.39,95%CI:3.21~6.02,P<0.001)的阴性配偶失访率较高。结论 居住在瑞丽市、芒市,男性,阳性配偶未接受抗病毒治疗的阴性配偶失访风险较高。为提高阴性配偶队列保持率,德宏州艾滋病防治机构需在今后的工作中考虑以上因素的影响。Abstract: Objective To explore the factors influencing the loss to follow-up over the first five years among seronegative spouses of HIV-infected individuals in Dehong Prefecture, Yunnan Province. Methods A total of 1 110 HIV seronegative spouses were recruited in 2009, social-demographic characteristics and HIV/AIDS related information were collected, follow-up survey was conducted every year till the end of 2014.COX proportional hazards regression model was used to analyze risk factors of loss to follow-up. Results Among total 1 110 seronegative spouses recruited, HIV seroconvertion was developed in 37 subjects with a total incidence rate of 0.92 per 100 person years. 1 015(91.4%) had at least one follow-up visit, however, 227 lost to follow-up at the end of 2014, contributing to a rate of 5.66 per 100 person years. four subjects and 129 seropositive subjects died, 63 divorced. The retention rate was 58.7%(652/1 110) at 5 years. Of all sero-negative spouses who needed follow-up, 74.2% (652/879) performed follow-up visit. COX proportional hazards regression model showed that the risk factors of loss to follow-up were living in Ruili (HR=1.83,95% CI:1.16-2.87,P=0.009) or Mangshi (HR=1.90,95% CI:1.23-2.93,P=0.004), male (HR=1.74,95% CI:1.27-2.38,P=0.001) and having sero-positive spouses not under anti-retroviral therapy (ART) (HR=4.39,95% CI:3.21-6.02,P<0.001). Conclusions Living in Ruili or Mangshi, male and having seropositive spouses not under ART are risk factors of loss to follow-up. To maintain a high retention rate, the institute of HIV/AIDS prevention and control in Dehong prefecture should pay more attention to these influencing factors in the future work.
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Key words:
- Human immunodeficiency virus /
- Spouses /
- Cohort studies
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