文章摘要
樊鹏飞,杨晴,毛宇嵘,胡强,汤后林,李健,罗雅凌,汪芬,占焕庆,臧思明.江西省农村地区HIV感染者接受基层医疗卫生机构随访管理现状及相关因素分析[J].中华流行病学杂志,2019,40(3):346-349
江西省农村地区HIV感染者接受基层医疗卫生机构随访管理现状及相关因素分析
Follow-up of people living with HIV/AIDS by primary health care institutions in rural area of Jiangxi province
投稿时间:2018-11-02  
DOI:10.3760/cma.j.issn.0254-6450.2019.03.017
中文关键词: 艾滋病;随访;基层医疗卫生机构
英文关键词: AIDS;Follow-up;Primary health care institutions
基金项目:
作者单位E-mail
樊鹏飞 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
杨晴 江西省疾病预防控制中心, 南昌 330029  
毛宇嵘 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206 maoyr@chinaaids.cn 
胡强 江西省疾病预防控制中心, 南昌 330029 huqiang1616@126.com 
汤后林 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
李健 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
罗雅凌 江西省疾病预防控制中心, 南昌 330029  
汪芬 新建县疾病预防控制中心 330100  
占焕庆 玉山县皮肤病性病防治所 334700  
臧思明 贵溪市疾病预防控制中心 335400  
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中文摘要:
      目的 了解江西省农村地区现存活的HIV感染者接受基层医疗卫生机构随访管理(随访下沉)现状及相关因素,为推动艾滋病随访下沉工作提供参考。方法 研究现场为江西省新建县、玉山县和贵溪市(目前仅在辖区内6个乡镇开展随访下沉工作)。调查对象纳入标准为截至2017年12月31日检测发现并确证为HIV感染者,年龄≥ 18岁,首次流调后随访管理≥ 1次,现存活。收集调查对象人口学信息、HIV感染情况等信息。采用logistic回归分析HIV感染者随访下沉的相关因素。结果 共调查373例HIV感染者,年龄(53.06±16.15)岁;男性占70.0%(261/373);文盲及小学占54.7%(204/373)。HIV感染者的随访下沉率为55.8%(208/373),异性性传播的HIV感染者随访下沉率为58.5%(190/325)。多因素logistic回归分析结果显示,务农者比非务农者(OR=7.36,95% CI:2.52~21.45)、家人支持随访下沉者比家人不支持者或无家人者(OR=16.01,95% CI:2.25~49.73)、不担心随访下沉遭受歧视者比担心者(OR=12.97,95% CI:4.75~35.42)、信任基层随访人员者比不信任者(OR=5.07,95% CI:2.19~11.76)、有艾滋病临床症状者比无症状者(OR=10.58,95% CI:2.25~49.73),更容易接受随访下沉。结论 江西省农村地区现存活的HIV感染者随访下沉率较高。在这些地区开展随访下沉工作是一种切实可行的管理模式。是否务农、家人是否支持随访下沉、是否担心随访下沉遭受歧视、是否信任基层随访人员、是否有艾滋病临床症状是影响HIV感染者随访下沉的相关因素。
英文摘要:
      Objective To understand the current status of follow up of people living with HIV/AIDS by health service at grass root in rural area of Jiangxi province and related factors, and provide references for the promotion of the follow up by grass root health service. Methods People living HIV/AIDS aged ≥ 18 years and diagnosed before 31 December 2017 in 6 townships of Xinjian, Yushan counties and Guixi city were included in the study in Jiangxi province. They had been followed up for more than one time after the first epidemiologic survey. The information about their demographic characteristics and HIV infection status were collected by using self-designed questionnaire. Univariate and multivariate logistic regression analyses were conducted to identify the factors that influencing the acceptance of follow up by grass root health service. Results Of the 373 surveyed HIV infected subjects aged (53.06±16.15) years, 261 were males (70.0%, 261/373). Among the surveyed subjects, the illiteracy and people who received only primary school education accounted for 54.7% (204/373). The rate of follow up of the HIV infected subjects by grass root health service was 55.8% (208/373), and those through heterosexual contact were 58.5% (190/325). The multivariate regression analysis showed that the acceptance of follow up by grass root health service was higher in those who were farmers (OR=7.36, 95% CI:2.52-21.45), had family support (OR=16.01, 95% CI:2.25-49.73), didn't worry about discrimination (OR=12.97, 95% CI:4.75-35.42), trusted health care provider (OR=5.07, 95% CI:2.19-11.76) and showed AIDS symptoms (OR=10.58, 95% CI:2.25-49.73). Conclusions The performance of follow up of people living with HIV/AIDS by grass root health service was well, suggesting it is a feasible management model. Being famer or not, family member supporting or not, worry about discrimination or not, trusting health care provider or not and showing AIDS symptoms or not were the main factors influencing the acceptance of follow up by grass root health service.
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