| 张娜,黄涛,杨兴光,王国永,陶小润,康殿民,汪宁.山东省2015年艾滋病防治策略“三个90%”目标进展状况分析[J].中华流行病学杂志,2017,38(10):1367-1371 |
| 山东省2015年艾滋病防治策略“三个90%”目标进展状况分析 |
| A cross-sectional study on HIV/AIDS “90-90-90” treatment target in Shandong province, 2015 |
| 收稿日期:2017-03-31 出版日期:2017-10-23 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.10.014 |
| 中文关键词: 艾滋病 防治策略 现况 “三个90%”目标 |
| 英文关键词: HIV/AIDS Control and prevention strategy Status 90-90-90 treatment target |
| 基金项目:山东省自然科学基金青年基金（ZR2014HQ038）；山东省医药卫生科技发展计划（2013WS0166） |
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| 中文摘要: |
| 目的 分析山东省2015年艾滋病防治策略"三个90%"（即90%诊断、90%治疗及90%有效）"目标的进展情况及相关影响因素。方法 收集山东省现存活HIV感染者/AIDS患者（HIV/AIDS）检测发现、接受高效抗反转录病毒治疗（HAART）服务的相关信息，分析进展情况。采用χ2检验进行单因素分析，多因素logistic回归模型进行多因素分析。结果 2015年12月31日，山东省估计现存活HIV/AIDS有11 700例，检测发现率61.2%，HAART率74.4%，病毒载量（VL）抑制率81.8%。经同性传播的HIV/AIDS检测发现比例较低（P<0.05）。青岛市（OR=1.30，95% CI：1.05~1.60）、烟台市（OR=1.53，95% CI：1.02~2.31）和威海市（OR=1.96，95% CI：1.07~3.58）的HIV/AIDS接受HAART的比例较高；同性传播（OR=0.12，95% CI：0.06~0.24）、异性传播（OR=0.13，95% CI：0.07~0.26）、注射吸毒传播（OR=0.08，95% CI：0.03~0.17），羁押场所检测发现（OR=0.29，95% CI：0.21~0.41）的HIV/AIDS接受HAART比例较低；医疗机构接受HAART服务的HIV/AIDS（OR=1.81，95% CI：1.05~3.47）的VL抑制比例较高；同性传播（OR=0.43，95% CI：0.25~0.75）、异性传播（OR=0.49，95% CI：0.28~0.81），羁押场所检测发现（OR=0.48，95% CI：0.28~0.80）的HIV/AIDS的VL抑制比例较低。结论 山东省2015年现存活HIV/AIDS的检测发现率、HAART率和VL抑制率与2020年实现的艾滋病防治策略"三个90%"目标仍有一定差距，尤其是检测发现目标。需加强检测和艾滋病综合关怀服务。 |
| 英文摘要: |
| Objective To analyze the status and its factors associated with HIV/AIDS-"90-90-90"-treatment-target in Shandong province, China. Methods Data regarding testing, treatment on HIV/AIDS in Shandong province by December 31, 2015 was collected. Chi-square test and logistic regression model were used to analyze related factors associated with the "90-90-90"-treatment-target. Results Of the 11 700 estimated HIV/AIDS, 61.2% were diagnosed, of whom 74.4% had received Highly active antiretroviral therapy (HAART). More than 80% of the HIV/AIDS on HAART reached the criteria on viral suppression. HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P<0.05). HIV/AIDS lived in Qingdao city (OR=1.30, 95% CI:1.05-1.60), Yantai city (OR=1.53, 95% CI:1.02-2.31) and Weihai city (OR=1.96, 95% CI:1.07-3.58) were more likely to receive HAART. HIV/AIDS patients that infected through homosexual or (OR=0.12, 95% CI:0.06-0.24) or heterosexual contacts (OR=0.13, 95% CI:0.07-0.26), through injecting drug use (OR=0.08, 95% CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29, 95% CI:0.21-0.41) were less likely to receive HAART. HIV/AIDS patients who received HAART at medical institutions (OR=1.81, 95% CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression. However, those who were infected through homosexual (OR=0.43, 95% CI:0.25-0.75) or heterosexual contacts (OR=0.49, 95% CI:0.28-0.81) or diagnosed at the custodial institutions (OR=0.48, 95% CI:0.28-0.80) were less likely to meet the criteria set for VL suppression. Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID "90-90-90"-treatment,especially on the target set for testing, in Shandong Province. Both HIV testing and comprehensive care services need to be strengthened. |
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