Colucci Anna, Balzano Roberta, Camoni Laura, Regine Vincenza, Longo Benedetta, Pezzotti Patrizio, Starace Fabrizio, Cafaro Loredana, Aloisi Maria Stella, Suligoi Barbara, Rezza Giovanni, Girardi Enrico
Department of Infectious Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
AIDS Care. 2011 Sep;23(9):1067-75. doi: 10.1080/09540121.2011.554525. Epub 2011 Jun 1.
The objective of this study was to define the sociodemographic and behavioral characteristics of people unaware of being HIV-positive at AIDS diagnosis. A multi-center cross-sectional study was conducted in 11 Italian centers of infectious diseases, recruited on a voluntary basis. Each center enrolled individuals diagnosed with AIDS aged ≥ 18 years from May 2003 to December 2005. The patients were classified into two groups on the basis of the amount of time that elapsed from diagnosis of HIV infection to AIDS diagnosis. "Late testers" were defined as those with a time period of ≤ 6 months between first HIV positive test and AIDS diagnosis. In order to evaluate the factors independently associated with being a late tester, a multivariate logistic regression model was performed. The McNemar χ(2) test was used to analyze behavioral changes before and after HIV diagnosis. During the study period, 245 patients were enrolled; of these, 51.8% were late testers. The variables independently associated with being a late testers were as follows: being employed; having acquired the infection through sexual contacts; having taken the HIV test because they didn't feel well; having at least one symptom or illness among those indicating infection; and not having had paid sex within the 12 months prior to HIV diagnosis. Before and after HIV diagnosis a significant increase in safe-sex behaviors was observed among individuals with no delay in diagnosis. However, the proportion of people who continue not to use condoms is still high. This study seems to indicate that sexual transmission is often associated with late testing. Individuals enrolled seem to have a low perception of risk, they do not undergo HIV testing, and consequently miss the opportunity of early diagnosis.
本研究的目的是确定在艾滋病诊断时未意识到自己感染艾滋病毒的人群的社会人口学和行为特征。在11个意大利传染病中心进行了一项多中心横断面研究，这些中心是自愿招募的。每个中心纳入了2003年5月至2005年12月期间诊断为艾滋病且年龄≥18岁的个体。根据从艾滋病毒感染诊断到艾滋病诊断所经过的时间，将患者分为两组。“晚期检测者”定义为首次艾滋病毒检测呈阳性与艾滋病诊断之间时间间隔≤6个月的患者。为了评估与成为晚期检测者独立相关的因素，进行了多变量逻辑回归模型分析。采用McNemar χ(2)检验分析艾滋病毒诊断前后的行为变化。在研究期间，共纳入245例患者；其中，51.8%为晚期检测者。与成为晚期检测者独立相关的变量如下：就业；通过性接触感染；因感觉不适而进行艾滋病毒检测；在提示感染的症状或疾病中至少有一种；以及在艾滋病毒诊断前12个月内没有有偿性行为。在艾滋病毒诊断前后，诊断无延迟的个体中安全性行为显著增加。然而，继续不使用避孕套的人群比例仍然很高。这项研究似乎表明，性传播往往与晚期检测相关。纳入的个体似乎对风险的认知较低，他们不进行艾滋病毒检测，因此错过早期诊断的机会。
