暗娼人群艾滋病队列研究中失访对HIV新发感染估计的影响

苏迎盈; 丁国伟; 刘慧鑫; 李峥; 王桂香; 方岗刚; 常东方; 汪宁

Abstract

苏迎盈,丁国伟,刘慧鑫,李峥,王桂香,方岗刚,常东方,汪宁.暗娼人群艾滋病队列研究中失访对HIV新发感染估计的影响[J].Chinese journal of Epidemiology,2015,36(3):250-253

暗娼人群艾滋病队列研究中失访对HIV新发感染估计的影响

Influencing factors for loss to follow-up in a longitudinal study on HIV incidence of female sex workers

Received:September 27, 2014

DOI：10.3760/cma.j.issn.0254-6450.2015.03.013

KeyWord: 暗娼人类免疫缺陷病毒队列研究失访

English Key Word: Female sex worker Human immunodeficiency virus Cohort study Loss to follow-up

FundProject:国家科技重大专项(2012ZX10001-001)

Author Name	Affiliation	E-mail
Su Yingying	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Ding Guowei	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Liu Huixin	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Li Zheng	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China Yunnan Kaiyuan Center for Disease Control and Prevention
Wang Guixiang	Yunnan Kaiyuan Center for Disease Control and Prevention
Fang Ganggang	Yunnan Kaiyuan Center for Disease Control and Prevention
Chang Dongfang	Yunnan Kaiyuan Center for Disease Control and Prevention
Wang Ning	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	wangnbj@163.com

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Abstract:

目的分析在云南省开远市暗娼(female sex worker,FSW)队列中的失访率、HIV新发感染率及其影响因素,探讨失访对HIV新发感染率估计的影响。方法云南省开远市FSW人群开放式队列研究,始于2006年3月,每6个月进行1次调查,截止2013年6月,共进行了7年的随访调查。本研究选取2006年3月基线调查的661名HIV阴性FSW人群,分析其7年随访调查的失访率,采用Cox回归模型探讨HIV新发感染的危险因素及影响失访的因素。同时于2013年6月通过联系本人或知情人士对失访的FSW人群进行失访原因调查,分析失访对HIV新发感染估计的影响。结果 661例HIV阴性FSW人群共随访1 238.5人年,HIV新发感染率为1.29(95%CI:0.74～2.10)/100人年,失访的发生率为48.68(95%CI:44.88～52.73)/100人年。Cox多因素分析显示,对于HIV新发感染,吸毒是FSW感染HIV的独立危险因素(aRR=4.15,95%CI:1.43～12.02);对于失访,年龄>25岁(aRR=0.68,95%CI:0.57～0.81)、吸毒(aRR=0.52,95%CI:0.35～0.79)的FSW有着较低的失访率,更易保持在队列中。结论开远市FSW队列在长期随访中存在较高的失访率,而失访人群发生HIV感染的风险低于HIV随访的人群,可能高估了该市FSW的新发感染率,今后有必要进一步研究FSW人群失访的原因,同时研究提高FSW人群队列随访保持率的策略。

English Abstract:

Objective To study the loss to follow-up (LTF) rate,HIV emerging incidence and influencing factors in the longitudinal study of female sex workers (FSWs) in Kaiyuan,Yunnan,and their influence on HIV emerging incidence estimate. Methods The open cohort study on FSWs was launched in March 2006 and ended in June 2013 in Kaiyuan,Yunnan. Investigations were made every six months and lasted for 7 years. 661 FSWs found as HIV negative in the baseline study in March 2006 were chosen to study their LTF in the 7 year follow-up investigation. The Cox regression model was used to explore risk factors for HIV emerging infection and those for LTF. In June 2013,a survey was also conducted to explore the detailed reasons for loss to follow-up by contacting FSWs themselves. Results During 1 238.5 person-years of follow-up among 661 HIV negative FSWs,the HIV incidence rate was 1.29(95%CI:0.74-2.10)/100 person-year,and the LFT incidence rate was 48.68(95%CI:44.88-52.73)/100 person-year. The multivariate analysis showed drug abuse as an independent risk factor for FSWs' infection of HIV (adjusted risk ratio=4.15,95% CI:1.43-12.02); FSWs over 25 years old (adjusted risk ratio=0.68, 95%CI:0.57-0.81), and drug abuse (adjusted risk ratio=0.52,95%CI:0.35-0.79) were found with lower LFT rate to remain in the cohort. Conclusion High LFT rate was found in FSW cohort study in Kaiyuan,Yunnan,while the HIV infection risk exposure of the LFT group was lower than the groups of HIV follow-up. HIV prevalence of FSWs in the city might be overestimated. Causes of LFT of FSWs group required further study in the future,and the cohort follow-up retention strategy for FSWs needs to be developed.

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