北京市2017－2019年经报告机构转介的HIV/AIDS抗病毒治疗情况及影响因素分析

李洋; 陈婧; 王娟; 贺淑芳; 卢红艳

Abstract

李洋,陈婧,王娟,贺淑芳,卢红艳.北京市2017－2019年经报告机构转介的HIV/AIDS抗病毒治疗情况及影响因素分析[J].Chinese journal of Epidemiology,2020,41(5):690-694

北京市2017－2019年经报告机构转介的HIV/AIDS抗病毒治疗情况及影响因素分析

Status and influencing factors of antiretroviral treatment referred by case reporting institutions among HIV/AIDS cases in Beijing, 2017-2019

Received:July 09, 2019

DOI：10.3760/cma.j.cn112338-20190709-00504

KeyWord: 艾滋病病毒抗病毒治疗转介失败延迟

English Key Word: HIV Antiretroviral treatment Referral failure Delayed

FundProject:

Author Name	Affiliation	E-mail
Li Yang	Department of HIV/STDs Prevention and Control, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Chen Jing	Department of HIV/STDs Prevention and Control, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Wang Juan	Department of HIV/STDs Prevention and Control, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China
He Shufang	Department of HIV/STDs Prevention and Control, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Lu Hongyan	Department of HIV/STDs Prevention and Control, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China	hongyan_lu@sohu.com

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Abstract:

目的了解2017-2019年北京市经报告机构转介的HIV/AIDS抗病毒治疗（ART）情况，并探讨其影响因素。方法利用我国艾滋病防治基本信息系统中2017-2019年北京市4 917例HIV/AIDS报告卡数据及ART机构数据，无ART记录者记为ART转介失败，确证报告至启动ART的日期间隔>15 d记为ART延迟，分析ART情况及其影响因素。结果 4 917例HIV/AIDS中，16.53%（813/4 917）未成功接受ART；接受ART的4 104例HIV/AIDS中，30.63%（1 257/4 104）发生ART延迟，启动时间中位数为27（P₂₅~P₇₅：19~42）d。多因素logistic回归分析显示，由综合性医院报告（相比于ART机构，OR=1.65，95% CI：1.30~2.08）、病程阶段为HIV（相比于AIDS，OR=1.68，95% CI：1.34~2.11）、初中及以下文化程度（相比于大专及以上，OR=1.42，95% CI：1.13~1.79）、无业（相比于干部职员，OR=1.32，95% CI：1.02~1.70）、异性性传播（相比于同性性传播，OR=1.40，95% CI：1.15~1.72）、来源于专题调查和无偿献血（相比于检测咨询，OR=1.87，95% CI：1.34~2.60；OR=3.52，95% CI：1.79~6.92）者ART转介失败比例较高；由CDC（相比于ART机构，OR=1.43，95% CI：1.07~1.92）或综合性医院报告（相比于ART机构，OR=1.62，95% CI：1.32~1.98）、报告机构在郊区（相比于城区，OR=1.24，95% CI：1.01~1.52）、病程阶段为HIV（相比于AIDS，OR=1.42，95% CI：1.19~1.70）、外省户籍（相比于北京市户籍，OR=1.26，95% CI：1.07~1.48）、来源于无偿献血（相比于性病门诊，OR=2.74，95% CI：1.21~6.22）者延迟比例较高。结论不同特征HIV/AIDS的ART转介失败及延迟比例不同，需采取有效措施进一步推进ART工作，减少ART转介失败及延迟。

English Abstract:

Objective To understand the status of antiretroviral treatment (ART) referred by the case reporting institutions among HIV/AIDS cases and influencing factors in Beijing. Methods From June 1, 2017 to April 30, 2019, the data of 4 917 people living with HIV/AIDS (PLWHA) collected from National HIV/AIDS Information System and ART institutions were used to understand the status of ART and influencing factors. No records of ART was defined as referral failure and an interval of more than 15 days between diagnosis of HIV infection and ART initiation was defined as delayed ART. Results Among the 4 917 HIV/AIDS cases, 16.53% (813/4 917) had referral failure. Among the 4 104 PLWHA who received ART, 30.63% (1 257/4 104) had delayed ART, the median of the interval was 27 days (P₂₅-P₇₅:19-42 days). Multivariate logistic regression analysis showed that HIV/AIDS cases who were reported by comprehensive hospitals (compared with ART servicers, OR=1.65, 95%CI:1.30-2.08), in HIV phase (compared with AIDS phase, OR=1.68, 95%CI:1.34-2.11), with educational level of junior middle school or below (compared with colleague graduate or above, OR=1.42, 95%CI:1.13-1.79), unemployed (compared with civil servants or staffs, OR=1.32, 95%CI:1.02-1.70), infected through heterosexual behavior (compared with homosexual behavior, OR=1.40, 95%CI:1.15-1.72), diagnosed in special survey (compared with testing and counseling, OR=1.87, 95%CI:1.34-2.60) or blood donation (OR=3.52, 95%CI:1.79-6.92), were more likely to have referral failures. And the PLWHA who were reported by CDCs (OR=1.43, 95%CI:1.07-1.92) or comprehensive hospitals (compared with ART servicers, OR=1.62, 95%CI:1.32-1.98), reported by rural reporting institutions (compared with urban reporting institutions, OR=1.24, 95%CI:1.01-1.52), in HIV phase (compared with AIDS phase, OR=1.42, 95%CI:1.19-1.70), non-Beijing residence (compared with Beijing residence, OR=1.26, 95%CI:1.07-1.48), diagnosed in blood donation examination (compared with STD clinics, OR=2.74, 95%CI:1.21-6.22) were more likely to have delayed ART. Conclusions The rate of referral failure and delayed ART varied among HIV/AIDS cases with different characteristics. It is still necessary to take effective measures to promote ART in order to reduce referral failure and delayed ART.

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