2014—2023年合肥市HIV/AIDS患者晚发现情况

董婷丽; 姚晖; 邓晓岚; 朱国新; 冯金保; 陈超杰; 吴萌; 张卓

doi:10.16462/j.cnki.zhjbkz.2025.03.005

2014—2023年合肥市HIV/AIDS患者晚发现情况

doi: 10.16462/j.cnki.zhjbkz.2025.03.005

合肥市疾病预防控制中心艾滋病性病防治科，合肥 230091

董婷丽与姚晖为共同第一作者

详细信息

通讯作者:
姚晖，E-mail: hfcdcyaohui@126.com

中图分类号: R512.91;R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2024-09-05
- 修回日期: 2024-12-19
- 网络出版日期: 2025-04-11
- 刊出日期: 2025-03-10

Analysis on the "late diagnosis" phenomena among newly identified human immunodeficiency virus/acquired immunodeficiency syndrome cases in Hefei, 2014-2023

Hefei Center for Disease Control and Prevention, AIDS/STD Prevention Department, Hefei 230091, China

DONG Tingli and YAO Hui contributed equally to this article

More Information

Corresponding author: YAO Hui, E-mail: hfcdcyaohui@126.com

摘要

摘要: 目的分析2014—2023年合肥市人类免疫缺陷病毒(human immunodeficiency virus, HIV)/艾滋病(acquired immunodeficiency syndrome, AIDS)患者特征，探究晚发现相关影响因素。方法从AIDS综合防治信息系统中选择2014—2023年新发现的HIV/AIDS病例，按照目前我国使用的晚发现定义标准，采用logistic回归分析模型分析晚发现情况与相关影响因素的关系。结果 2014—2023年合肥市HIV/AIDS患者晚发现数为1 218例，晚发现比例为34.18%(1 218/3 564)，其中医疗机构检测晚发现占58.13%(708/1 218)，检测咨询占36.21%(441/1 218)。晚发现患者中，以汉族为主，男性占90.97%，平均年龄为(42.15±14.22)岁。年龄组、婚姻状况、人口性质、文化程度、职业、传播途径、样本来源、区(县)、确诊到CD4⁺T淋巴细胞(简称CD4)检测时间变量组间分布差异均有统计学意义(均P＜0.05)。多因素logistic回归分析模型分析结果显示，与＜25岁年龄组相比，年龄越大，晚发现的风险越高。与小学及以下文化程度者相比，大专及以上者晚发现的风险更低(OR=0.70, 95% CI: 0.51~0.95, P=0.020)。与医疗机构检测来源相比，检测咨询(OR=0.45, 95% CI: 0.38~0.53)、阳性配偶/性伴检测(OR=0.31, 95% CI: 0.14~0.67)、羁押人员检测(OR=0.50, 95% CI: 0.29~0.86)、无偿献血人员检测(OR=0.35, 95% CI: 0.20~0.62)、其他检测(OR=0.50, 95% CI: 0.28~0.90)HIV/AIDS患者晚发现风险更低(均P＜0.05)。与病例确诊到CD4检测时间间隔＜15 d相比，确诊到CD4检测时间≥15 d HIV/AIDS患者晚发现风险较低。与有性病史者相比，性病史不详者HIV/AIDS患者晚发现风险更低(OR=0.61, 95% CI: 0.40~0.94, P=0.024)。结论 2014—2023年合肥市HIV/AIDS晚发现病例数总体呈下降趋势，但医疗机构检测来源晚发现率仍较高。应进一步加强宣传教育力度，促进高危和老年人群开展早期检测，继续在医疗机构推行医疗机构医务人员主动提供检测与咨询策略，以及推进重点科室常规AIDS检测。
- 艾滋病 /
- 晚发现 /
- 医疗机构
Abstract: Objective The characteristics of human immunodeficiency virus (HIV) -infected and acquired immunodeficiency syndrome (AIDS) patients in Hefei from 2014 to 2023 were analyzed to explore the relevant influencing factors of late diagnosis. Methods The newly discovered HIV/AIDS cases from 2014 to 2023 were selected from the integrated AIDS prevention and control information system, late diagnosis were analyzed according to the definition standard of late diagnosis currently used in China. Logistic regression was employed to investigate the association of late diagnosis and related influencing factors. Results From 2014 to 2023, a total of 1 218 cases of HIV-infected and AIDS patients were found late in Hefei, the proportion of late diagnosis was 34.18% (1 218/3 564). Among them, 58.13% (708/1 218) were found by medical institutions, and 36.21% (441/1 218) were found by testing and consulting. The majority of late found patients were Han, with male accounted for 90.97%. The mean age was (42.15±14.22) years. The inter-group distribution of age group, marital status, population nature, education level, occupation, transmission route, sample source, district/county, and time from diagnosis to CD4 detection were statistically significant (all P < 0.05). Logistic multi-factor analysis showed that, compared with < 25 age group, the older the age group, the higher the risk of late diagnosis. Compared with those with primary school education and below, those with college education and above had a lower risk of late diagnosis (OR=0.70, 95% CI: 0.51-0.95, P=0.020). Compared to the sources tested by medical institutions, testing and counseling (OR=0.45, 95% CI: 0.38-0.53), positive spouse/sexual partner testing (OR=0.31, 95% CI: 0.14-0.67), detention personnel testing (OR=0.50, 95% CI: 0.29-0.86), unpaid blood donors testing (OR=0.35, 95% CI: 0.20-0.62), other tests (OR=0.50, 95% CI: 0.28-0.90) had a lower risk of late diagnosis of HIV/AIDS (all P < 0.05). The risk of late diagnosis was lower when the time interval between case diagnosis and CD4 detection was ≥15 days compared with < 15 d. People with unknown STD history had a lower risk of late diagnosis of HIV/AIDS than those infected (OR=0.61, 95% CI: 0.40-0.94, P=0.024). Conclusions The number of late diagnosis cases of HIV-infected and AIDS patients in Hefei has decreased in the past 10 years, but the late diagnosis rate of medical institutions is still high. Publicity and education should be further strengthened to promote early diagnosis of high-risk and elderly groups, continue to implement provider-initiated HIV testing and counseling strategy in medical institutions and promote routine AIDS testing in key departments.
- Acquired immunodeficiency syndrome /
- Late diagnosis /
- Medical institutions

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图 1 2014—2023年报告现住址为合肥市的HIV/AIDS患者人数及晚发现比例

HIV：人类免疫缺陷病毒；AIDS：艾滋病。

Figure 1. The number of HIV/AIDS cases reported with current residence in Hefei and the proportion of late diagnosis during 2014-2023

HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome.

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图 2 2014—2023年合肥市不同样本来源HIV/AIDS患者晚发现情况

HIV：人类免疫缺陷病毒；AIDS：艾滋病。

Figure 2. Late diagnosis of HIV/AIDS from different sample sources in Hefei from 2014 to 2023

HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome.

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表 1 2014—2023年合肥市新报告HIV/AIDS晚发现病例基本特征

Table 1. Basic characteristics of newly reported HIV/AIDS late diagnosis cases in Hefei from 2014 to 2023

变量 Variable	合计 Total	晚发现 Late diagnosis^①		χ²值value	P值value
变量 Variable	合计 Total	是Yes (n=1 218)	否No (n=2 346)	χ²值value	P值value
年龄组/岁Age group/years				228.23	＜0.001
＜25	179	14(7.8)	165(92.2)
25~＜40	1 715	435(25.4)	1 280(74.6)
40~＜60	1 210	531(43.9)	679(56.1)
≥60	460	238(51.7)	222(48.3)
性别Gender				0.67	0.414
男Male	3 261	1 108(34.0)	2 153(66.0)
女Female	303	110(36.3)	193(63.7)
民族Nationality				0.30	0.583
汉族Han	3 521	1 205(34.2)	2 316(65.8)
其他Others	43	13(30.2)	30(69.8)
婚姻状况Marital status				125.94	＜0.001
未婚Single	1 894	489(25.8)	1 405(74.2)
已婚有配偶Married with spouse	1 022	441(43.2)	581(56.8)
离异或丧偶Divorced or widowed	645	287(44.5)	358(55.5)
不详Unknown	3	1(33.3)	2(66.7)
人口性质Demographic nature				51.20	＜0.001
常住人口Permanent residents	1 884	745(39.5)	1 139(60.5)
流动人口Floating population	1 680	473(28.2)	1 207(71.8)
文化程度Education level				149.12	＜0.001
小学及以下Primary school and below	438	222(50.7)	216(49.3)
初中Junior high school	805	353(43.9)	452(56.1)
高中或中专High school or technical secondary school	710	243(34.2)	467(65.8)
大专及以上College and above	1 611	400(24.8)	1 211(75.2)
职业Career				100.04	＜0.001
商业服务Commercial service	1 647	504(30.6)	1 143(69.4)
农民/民工/工人Farmer/migrant worker/worker	588	271(46.1)	317(53.9)
家政/家务及待业Housekeeping/housework and unemployment	754	277(36.7)	477(63.3)
离退人员Former and retired personnel	57	33(57.9)	24(42.1)
学生Student	239	37(15.5)	202(84.5)
其他Others	279	96(34.4)	183(65.6)
传播途径Transmission categories				71.55	＜0.001
同性性传播Homosexual transmission	2 369	697(29.4)	1 672(70.6)
异性性传播Heterosexual transmission	1 168	508(43.5)	660(56.5)
注射吸毒Injecting drug use	18	8(44.4)	10(55.6)
其他Others	9	5(55.6)	4(44.4)
性病史History of sexually transmitted diseases				4.20	0.122
有Yes	398	139(34.9)	259(65.1)
无No	2 992	1 032(34.5)	1 960(65.5)
不详Unknown	174	47(27.0)	127(73.0)
样本来源Sample source				220.35	＜0.001
医疗机构检测Medical institution testing	1 470	708(48.2)	762(51.8)
检测咨询Voluntary counseling and testing	1 824	441(24.2)	1 383(75.8)
阳性配偶/性伴检测Positive spouse/sexual partner testing	34	10(29.4)	24(70.6)
羁押人员检测Detection of detainees	83	25(30.1)	58(69.9)
无偿献血人员检测Blood donors were tested	88	17(19.3)	71(80.7)
其他检测Other tests	65	17(26.2)	48(73.8)
区(县) District(county)				56.15	＜0.001
瑶海区Yaohai	546	167(30.6)	379(69.4)
包河区Baohe	498	165(33.1)	333(66.9)
蜀山区Shushan	742	200(27.0)	542(73.0)
庐阳区Luyang	238	97(40.8)	141(59.2)
肥东县Feidong	326	125(38.3)	201(61.7)
肥西县Feixi	309	103(33.3)	206(66.7)
庐江县Lujiang	267	122(45.7)	145(54.3)
长丰县Changfeng	413	137(33.2)	276(66.8)
巢湖市Chaohu	225	102(45.3)	123(54.7)
确诊到CD4⁺T淋巴细胞检测时间Time from diagnosis to CD4 test/d				24.14	＜0.001
＜15	1 946	713(36.6)	1 233(63.4)
15~＜31	632	174(27.5)	458(72.5)
31~90	533	159(29.8)	374(70.2)
＞90	394	118(29.9)	276(70.1)
注：HIV，人类免疫缺陷病毒；AIDS，艾滋病。 ①以人数(占比/%)表示。 Note: HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome. ① Number of people (proportion /%).

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表 2 2014—2023年合肥市新报告HIV/AIDS病例晚发现多因素logistic回归分析

Table 2. Multivariate logistic regression analysis of late diagnosis among HIV/AIDS cases in Hefei from 2014 to 2023

变量 Variable	β值 value	s_x值 value	Wald χ² 值value	P值 value	OR值value (95% CI)
变量 Variable	年龄组/岁Age group/years
＜25					1.00
25~＜40	1.37	0.31	19.33	＜0.001	3.94(2.14~7.26)
40~＜60	1.93	0.33	35.03	＜0.001	6.91(3.64~13.10)
≥60	1.95	0.35	31.95	＜0.001	7.05(3.58~13.87)
婚姻状况Marital status
未婚Not married					1.00
已婚有配偶Married with spouse	-0.03	0.12	0.07	0.797	0.97(0.77~1.22)
离异或丧偶Divorced or widowed	0.01	0.13	0.01	0.935	1.01(0.79~1.30)
不详Unknown	-0.08	1.29	＜0.01	0.951	0.92(0.07~11.52)
人口性质Demographic nature
流动人口Floating population					1.00
常住人口Permanent residents	0.12	0.09	1.95	0.162	1.13(0.95~1.34)
文化程度Education level
小学及以下Primary school and below					1.00
初中Junior high school	0.03	0.14	0.06	0.808	1.03(0.79~1.35)
高中或中专High school or technical secondary school	-0.13	0.15	0.75	0.386	0.88(0.65~1.18)
大专及以上College and above	-0.36	0.16	5.39	0.020	0.70(0.51~0.95)
职业Occupation
学生Student					1.00
农民/民工/工人Farmer/migrant worker/worker	0.01	0.24	＜0.01	0.961	1.01(0.63~1.63)
家政/家务及待业Housekeeping/housework and unemployment	-0.10	0.23	0.20	0.656	0.90(0.58~1.42)
离退人员Former and retired personnel	0.25	0.37	0.45	0.501	1.29(0.62~2.67)
商业服务Commercial service	-0.04	0.22	0.04	0.842	0.96(0.63~1.46)
其他Others	-0.03	0.25	0.01	0.914	0.97(0.60~1.59)
传播途径Transmission categories
同性性传播Homosexual transmission					1.00
异性性传播Heterosexual transmission	0.01	0.09	＜0.01	0.961	1.00(0.83~1.20)
注射吸毒Injecting drug use	0.68	0.52	1.71	0.191	1.97(0.71~5.44)
其他Others	1.26	0.73	2.99	0.084	3.52(0.85~14.65)
样本来源Sample source
医疗机构检测Medical institution testing					1.00
检测咨询Voluntary counseling and testing	-0.79	0.08	89.44	＜0.001	0.45(0.38~0.53)
阳性配偶/性伴检测Positive spouse/sexual partner testing	-1.17	0.39	8.80	0.003	0.31(0.14~0.67)
羁押人员检测Detection of detainees	-0.70	0.28	6.19	0.013	0.50(0.29~0.86)
无偿献血人员检测Blood donors were tested	-1.05	0.29	13.29	＜0.001	0.35(0.20~0.62)
其他检测Other tests	-0.69	0.30	5.29	0.021	0.50(0.28~0.90)
区(县) District(county)
包河区Yaohai					1.00
瑶海区Baohe	-0.19	0.14	1.76	0.185	0.83(0.62~1.10)
蜀山区Shushan	-0.16	0.14	1.34	0.247	0.86(0.66~1.11)
庐阳区Luyang	0.19	0.18	1.22	0.270	1.22(0.86~1.72)
肥东县Feidong	-0.19	0.17	1.18	0.277	0.83(0.59~1.16)
肥西县Feixi	-0.10	0.18	0.33	0.568	0.91(0.64~1.28)
庐江县Lujiang	0.09	0.18	0.25	0.621	1.10(0.77~1.57)
长丰县Changfeng	-0.28	0.16	2.94	0.087	0.76(0.56~1.04)
巢湖市Chaohu	0.13	0.19	0.46	0.500	1.14(0.79~1.64)
确诊到CD4⁺T淋巴细胞检测时间Time from diagnosis to CD4 test/d
＜15					1.00
15~＜31	-0.41	0.11	14.90	＜0.001	0.66(0.54~0.82)
31~90	-0.33	0.11	8.82	0.003	0.72(0.58~0.89)
＞90	-0.33	0.13	6.49	0.011	0.72(0.56~0.93)
性病史History of sexually transmitted diseases
有Yes					1.00
无N0	0.01	0.12	＜0.01	0.959	1.01(0.79~1.28)
不详Unknown	-0.50	0.22	5.08	0.024	0.61(0.40~0.94)
注：HIV，人类免疫缺陷病毒；AIDS，艾滋病。 Note: HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome.

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