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[中国艾滋病高流行地区由医务人员主动提供艾滋病检测咨询服务实现艾滋病早期发现的分析]

[Analysis of early detection of HIV infections by provider initiated HIV testing and counselling in regions with high HIV/AIDS epidemic in China].

作者信息

Shan Duo, Duan Song, Gao Jie, Yang Yuecheng, Ye Runhua, Hu Yiyun, Xue Hui, Zhang Guang, Sun Jiangping

机构信息

National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

Email:

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Nov;49(11):962-6.

Abstract

OBJECTIVE

To understand provider initiated HIV testing and counseling (PITC) in a region with high HIV/AIDS epidemic in China, and analyze its effect to early detection of HIV infections.

METHODS

Between January and December, 2013, 37 county level medical institutions were selected as the study sites, among which, 19 were public medical institutions and 18 were private institutions. According to the related regulation, procedures and contents of PITC, the study was implemented among outpatients and inpatients who seek for doctors in these medical institutions and PITC were provided for them. The 'Individual Investigation Form' was used to record the information and high-risky factors, and the respondents were taken venous blood and given HIV screening and confirmation. All available serum samples of newly found HIV/AIDS cases were tested using the BED HIV Incidence Capture Enzyme Immunoassay (BED-CEIA) to differentiate the long-term infections and new infections (early detected infections). Chi-square analysis was used to compare the differences of characteristics of newly infected patients.

RESULTS

Between January and December, 2013, a total of 37 medical institutions provided PITC. 55 164 person times were received HIV screening, among which 658 were HIV positive, and 598 were confirmed to be HIV positive. The 598 cases were all provided transferring service. The differences of age, marital status, education levels, transmission routes and testing institutions had statistical significance to early detection (χ(2) equals to 23.54, 10.50, 17.96, 21.22 and 4.80; P equals to < 0.001, 0.005, < 0.001, < 0.001 and 0.029, respectively). And the early detection proportions among patients aged from 20 to 29 and from 50 to 84 were 47.1% (114/242) and 42.1% (24/57), respectively; the proportions among single and married patients were 37.8% (56/148) and 38.9% (143/368), respectively; the proportion among patients with high school education levels were 42.6% (26/61); the proportion among patients transmitted by fixed heterosexual sexual partners was 46.0% (86/187); the proportion among private hospitals was 40.3% (58/144).

CONCLUSION

A certain proportion of HIV infections were early detected by PITC in this region. The HIV early detection proportions among specific age group and population with spouse/fixed sexual partners were relatively high.

摘要

目的

了解中国艾滋病病毒/艾滋病(HIV/AIDS)高流行地区的医务人员主动提供HIV检测咨询服务(PITC)情况,并分析其对HIV感染早期发现的效果。

方法

2013年1月至12月,选取37家县级医疗机构作为研究地点,其中19家为公立医疗机构,18家为私立医疗机构。按照PITC的相关规定、流程和内容,对这些医疗机构中就诊的门诊患者和住院患者开展研究并为其提供PITC。使用“个人调查表”记录信息和高危因素,采集被调查者静脉血进行HIV筛查和确证。对新发现的HIV/AIDS病例的所有可用血清样本采用BED HIV感染率捕获酶免疫分析法(BED-CEIA)进行检测,以区分长期感染和新感染(早期发现的感染)。采用卡方检验比较新感染患者特征的差异。

结果

2013年1月至12月,共有37家医疗机构提供PITC。共55164人次接受HIV筛查,其中658人HIV初筛阳性,598人确证为HIV阳性。对这598例均提供了转诊服务。年龄、婚姻状况、文化程度、传播途径和检测机构对早期发现有统计学意义(χ²分别为23.54、10.50、17.96、21.22和4.80;P分别为<0.001、0.005、<0.001、<0.001和0.029)。20~29岁和50~84岁患者的早期发现比例分别为47.1%(114/242)和42.1%(24/57);单身和已婚患者的比例分别为37.8%(56/148)和38.9%(143/368);高中文化程度患者的比例为42.6%(26/61);经固定异性性伴传播患者的比例为46.0%(86/187);私立医院患者的比例为40.3%(58/144)。

结论

该地区通过PITC早期发现了一定比例的HIV感染。特定年龄组以及有配偶/固定性伴人群的HIV早期发现比例相对较高。

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