我国2016-2018年报告HIV/AIDS首次随访后的跨省流动情况和抗病毒治疗效果分析

韩晶; 李健; 臧春鹏; 刘玉芬

文章摘要

韩晶,李健,臧春鹏,刘玉芬.我国2016-2018年报告HIV/AIDS首次随访后的跨省流动情况和抗病毒治疗效果分析[J].中华流行病学杂志,2021,42(1):126-130

我国2016-2018年报告HIV/AIDS首次随访后的跨省流动情况和抗病毒治疗效果分析

Analysis of inter-provincial movement and the effect of antiretroviral therapy of HIV/AIDS cases after first follow up in China, 2016-2018

收稿日期:2020-06-03 出版日期:2021-01-22

DOI：10.3760/cma.j.cn112338-20200603-00805

中文关键词: 艾滋病病毒/艾滋病抗病毒治疗病毒抑制随访跨省流动

英文关键词: HIV/AIDS Antiretroviral therapy Viral suppression Follow up Inter-provincial movement

基金项目:

作者	单位	E-mail
韩晶	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
臧春鹏	中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206
刘玉芬	中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206	yufenliu69@chinaaids.cn

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中文摘要:

目的分析2016年7月国家免费抗病毒治疗纳入标准调整后报告的HIV/AIDS首次随访后的跨省流动及其抗病毒治疗和病毒抑制情况，了解其流动特征及对抗病毒治疗效果的影响。方法利用艾滋病防治基本信息系统的HIV/AIDS报告及治疗数据，采用描述性分析和χ²检验探讨HIV/AIDS流动与治疗和病毒抑制的关系。结果首次随访后跨省流动HIV/AIDS占7.8%（22 426/289 218）。男性（8.3%，18 557/223 713）、高中（9.6%，4 317/44 877）和大专及以上文化程度（9.5%，4 792/45 858）、未婚（11.5%，10 538/91 572）、发现方式为羁押人员检测（16.0%，1 268/7 927）、通过同性性传播感染（11.4%，9 069/79 735）的HIV/AIDS跨省流动的比例较高。发生跨省流动的HIV/AIDS诊断1年内接受抗病毒治疗的比例（77.1%，17 296/22 426）和达到病毒抑制的比例（70.7%，15 858/22 426）均低于未发生跨省流动的HIV/AIDS（分别为86.7%，231 293/266 792和78.6%，209 760/266 792）。首次随访为非户籍省份的HIV/AIDS有41.4%（18 887/45 570）发生了跨省流动，其中，流动返回户籍省的占92.9%（17 538/18 887）。首次随访后发生病例流出人数在前5位的省份分别是广东、浙江、上海、北京和四川，病例流入人数在前5位的省份分别是四川、贵州、广东、安徽和湖南。结论 HIV/AIDS跨省流动影响其接受抗病毒治疗及病毒抑制。需要进一步关注户籍地与现住址分离的流动人口中HIV/AIDS的发现和管理，消除政策壁垒，确保抗病毒治疗的及时性和有效性。

英文摘要:

Objective To analyze the interprovincial movement of newly reported HIV/AIDS cases after the first follow up in China and understand their movement characteristics and the effect of antiretroviral therapy (ART) after adjustment of ART inclusion criteria. Methods The data of HIV/AIDS cases, including the effects of ART, were extracted from the information system for HIV/AIDS prevention and control. Descriptive analysis and χ² test was used to explore the characteristics of the movement of HIV/AIDS cases and its relationship with ART effect and viral suppression. Results In 289 218 HIV/AIDS cases, 22 426 (7.8%) cases experienced inter-provincial movement after the first follow up. Higher prevalence of inter-provincial movement was found in males (8.3%, 18 557/223 713), those with education level of senior high school (9.6%, 4 317/44 877) and college degree and above (9.5%, 4 792/45 858), the unmarried (11.5%, 10 538/91 572), those diagnosed in detention center (16.0%, 1 268/7 927) and those infected by homosexual behavior (11.4%, 9 069/79 735). The rates of ART initiation within 1 year of diagnosis and viral suppression were lower in HIV/AIDS cases with inter-provincial movement (77.1%, 17 296/22 426 and 70.7%, 15 858/22 426) than in those without inter-provincial movement (86.7%, 231 293/266 792 and 78.6%, 209 760/266 792). After the first follow-up, 41.4% (18 887/45 570) of HIV/AIDS cases diagnosed in non-native provinces experienced inter-provincial movement, of which 92.9% (17 538/18 887) went back to native province. The top five provinces (municipalities) with outflows of HIV/AIDS cases were Guangdong, Zhejiang, Shanghai, Beijing and Sichuan. The top five provinces with inflows of HIV/AIDS cases were Sichuan, Guizhou, Guangdong, Anhui and Hunan. Conclusions The inter-provincial movement affects ART effect and viral suppression of HIV/AIDS cases. It is necessary to pay more attention to the discovery and management of HIV/AIDS in floating population and eliminate policy barriers to ensure the timeliness and effectiveness of ART.

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