山东省2015年艾滋病防治策略“三个90%”目标进展状况分析

张娜; 黄涛; 杨兴光; 王国永; 陶小润; 康殿民; 汪宁

Abstract

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].Chinese journal of Epidemiology,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

Received:March 31, 2017

DOI：10.3760/cma.j.issn.0254-6450.2017.10.014

KeyWord: 艾滋病防治策略现况 “三个90%”目标

English Key Word: HIV/AIDS Control and prevention strategy Status 90-90-90 treatment target

FundProject: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）

Author Name	Affiliation	E-mail
Zhang Na	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China Institute for AIDS Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Huang Tao	Institute for AIDS Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Yang Xingguang	Institute for AIDS Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Wang Guoyong	Institute for AIDS Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Tao Xiaorun	Institute for AIDS Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Kang Dianmin	Institute for AIDS Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
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。

English Abstract:

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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