| 古羽舟,程伟彬,王艾斯,钟斐,蔡衍珊,罗业飞,韩志刚,何蔚云,刘奇,刘杰伟,徐慧芳.广州市MSM“互联网+艾滋病综合预防服务体系”对HIV/AIDS关怀效果分析[J].中华流行病学杂志,2019,40(10):1222-1226 |
| 广州市MSM“互联网+艾滋病综合预防服务体系”对HIV/AIDS关怀效果分析 |
| Effectiveness of the “Internet Plus-based AIDS Comprehensive Prevention Service System” among MSM in Guangzhou |
| 收稿日期:2019-04-17 出版日期:2019-10-18 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.10.010 |
| 中文关键词: 男男性行为人群 艾滋病病毒及艾滋病 关怀服务 互联网 |
| 英文关键词: Men who have sex with men HIV/AIDS Care service Internet |
| 基金项目:国家科技重大专项（2018ZX10715004）；广州市卫生和计划生育科技项目（20181A011057）；广州市科技计划（201704020219） |
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| 中文摘要: |
| 目的 分析广州市MSM“互联网+艾滋病综合服务体系”对HIV/AIDS关怀效果。方法 通过艾滋病防治基本信息系统下载广州市MSM HIV/AIDS报告及随访数据，分析2008－2014年（发现即治疗策略实施前）的HIV/AIDS随访转介情况和治疗前随访依从性、2017－2018年（发现即治疗策略实施后）的HIV/AIDS治疗转介情况。按照不同服务类型，分为互联网+服务组、艾滋病咨询检测组和医疗服务组。采用广义估计方程（General Estimating Equation，GEE）分析研究对象每年随访保持情况。采用Cox比例风险回归模型比较各组30 d治疗转介率的差异。结果 在发现即治疗策略实施前 |
| 英文摘要: |
| Objective To evaluate the effectiveness of the "Internet Plus-based AIDS Comprehensive Prevention Service System" among men who have sex with men in Guangzhou. Methods Data through case-reporting and follow-up programs on MSM HIV/AIDS in Guangzhou was collected from the China Information System for Disease Control and Prevention, which including those from the referral and follow-up treatment compliance programs in 2008-2014 (pre-treatment) and 2017-2018 (post-treatment). According to the types of care services, three groups were set as:with "Internet Plus" service, with ‘HIV counseling/testing service’ or with ‘routine medical service’. General Estimating Equation (GEE) was used to analyze the follow up situation of HIV/AIDS cases, annually. Cox proportional hazard regression model was used to analyze the proportions of treatment referral, within the 30 days of diagnosis. Results Before the implementation of immediate treatment after HIV diagnosis, 90.6% (707/780) of the HIV/AIDS cases received the first follow up program including the CD4+ T cells counts (CD4) test service within 90 days of diagnosis, in the "Internet Plus-based HIV/AIDS care service" group presented 1.19 times (95%CI:1.14-1.25) of the routine medical service group. The implementation of immediate treatment after HIV diagnosis, compared with the routine medical service group, the "Internet Plus" service group presented 1.71 times (95%CI:1.03-2.83) more treatment referrals within the 30 days of diagnosis, when the first testing CD4 was ≤ 200 cells/μl. Compared with the routine medical service group, the HIV counseling and testing service group showed 1.37 times (95%CI:1.20-1.56) more of the treatment referrals within the 30 days of HIV diagnosis, after the first testing CD4 counts as >200 cells/μl. Conclusion Standardized care and follow-up service should be promoted as soon as the referral and treatment programs were set after the diagnosis was made, under the "Internet Plus-based AIDS Comprehensive Prevention Service System" for the MSM population, in Guangzhou. |
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