2013-2017年广西贵港市孕产妇人类免疫缺陷病毒感染现状调查
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摘要
目的了解广西贵港市孕产妇人类免疫缺陷病毒(HIV)检测情况、流行趋势及其影响因素。方法于2013年1月-2017年9月对贵港市五个县(市、区)371 394例调查对象进行横断面连续监测调查,采用Logistic回归模型分析其HIV晚检测和新确认的影响因素。结果 2013-2017年贵港市孕产妇HIV检测率为99.99%,其中孕27周末前早期检测占59.14%,孕27周末后晚期检测占40.86%,晚期检测比例逐年下降(Z=-55.91,P<0.001),但孕早期检测比例变化趋势不明显(Z=1.41,P=0.159);Logistic回归分析显示,孕产妇HIV晚检测与民族、文化程度和职业3个因素有关联。共533例孕产妇确认HIV阳性,确认阳性率1.44‰,其中既往确认占66.4%,新确认占33.6%,确认阳性率逐年下降(Z=-1.42,P=0.045),但新确认的比例在逐年上升(Z=2.15,P=0.032)。Logistic回归分析显示,新确认与年龄、职业、咨询检测史、配偶检测史、传播途径、夫妻长期分居和高危性行为7个因素有关联。结论广西贵港市孕产妇HIV检测率较高,但早期检测的比例有待提高;孕产妇HIV确认阳性率在逐年下降,但新确认的比例在逐年上升。
OBJECTIVE To understand the prevalence of human immunodeficiency virus(HIV)infection among puerpera in Guigang City and analyze the influencing factors.METHODS A cross-sectional survey was conducted for 371 394 objects in five counties of Guigang city from Jan 2013 to Sep 2017,and the logistic regression model analysis was performed for the influencing factors for the late detection and new validation of HIV.RESULTS The detection rate of HIV of the puerpera was 99.99%in Guigang Cicy from 2013 to 2017,the puerpera who received the early test of HIV before gestational age of 27 accounted for 59.14%,the puerpera who received the late test after gestational age of 27 accounted for 40.86%,and the proportion of the puerpera who received the late test was decreased year by year(Z=-55.91,P<0.001),while the proportion of the puerpera who received the early test did not change significantly(Z=1.41,P=0.159).The logistic regression analysis showed that the late test of HIV of the puerpera was associated with nationality,education level and occupation.Totally 533 puerpera were confirmed positive for HIV,with the confirmed positive rate 1.44%,66.4% of whom were previously confirmed,33.6% were newly confirmed,and the confirmed positive rate was decreased year by year(Z=-1.42,P=0.045),however,the proportion of the newly confirmed cases was increased year by year(Z=2.15,P=0.032).The logistic regression analysis indicated that the newly confirmed cases of HIV infection was associated with age,occupation,history of consulting test,history of spouse testing,route of transmission,long-term separation of husband and wife and high-risk sexual behavior.CONCLUSIONThe detection rate of HIV of the puerpera is high in Guigang City,however,the proportion of the puerpera who received the earl test needs to be improved;the confirmed positive rate of HIV of the puerpera is decreased year by year,but the proportion of the newly confirmed cases is increased year by year.
OBJECTIVE To understand the prevalence of human immunodeficiency virus(HIV)infection among puerpera in Guigang City and analyze the influencing factors.METHODS A cross-sectional survey was conducted for 371 394 objects in five counties of Guigang city from Jan 2013 to Sep 2017,and the logistic regression model analysis was performed for the influencing factors for the late detection and new validation of HIV.RESULTS The detection rate of HIV of the puerpera was 99.99%in Guigang Cicy from 2013 to 2017,the puerpera who received the early test of HIV before gestational age of 27 accounted for 59.14%,the puerpera who received the late test after gestational age of 27 accounted for 40.86%,and the proportion of the puerpera who received the late test was decreased year by year(Z=-55.91,P<0.001),while the proportion of the puerpera who received the early test did not change significantly(Z=1.41,P=0.159).The logistic regression analysis showed that the late test of HIV of the puerpera was associated with nationality,education level and occupation.Totally 533 puerpera were confirmed positive for HIV,with the confirmed positive rate 1.44%,66.4% of whom were previously confirmed,33.6% were newly confirmed,and the confirmed positive rate was decreased year by year(Z=-1.42,P=0.045),however,the proportion of the newly confirmed cases was increased year by year(Z=2.15,P=0.032).The logistic regression analysis indicated that the newly confirmed cases of HIV infection was associated with age,occupation,history of consulting test,history of spouse testing,route of transmission,long-term separation of husband and wife and high-risk sexual behavior.CONCLUSIONThe detection rate of HIV of the puerpera is high in Guigang City,however,the proportion of the puerpera who received the earl test needs to be improved;the confirmed positive rate of HIV of the puerpera is decreased year by year,but the proportion of the newly confirmed cases is increased year by year.
引文
[1]覃寿学,谭燕萍,农燕丽,等.艾滋病母婴传播的三级预防理论架构[J].中国皮肤性病学杂志,2017,31(7):795-799.
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[9]黄春明,林桂芳.2011~2013年广西北海市艾滋病母婴传播阻断现状及效果分析[J].中国妇幼保健,2015,30(21):3580-3582.
[10]葛宪民,唐振柱,朱秋映,等.广西2010-2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[11]王爱华,肖亚洲,熊黎黎,等.湖南省2011-2015年孕产妇艾滋病、梅毒与乙肝检测结果分析[J].实用预防医学,2017,24(7):833-835.
[12]何丹,吴方银,熊庆,等.四川省HIV感染孕产妇的流行情况与对策[J].中国艾滋病性病,2012,18(11):751-753.
[13]R Garg,S Singh,S Singh,et al.Antenatal HIV voluntary counseling and testing:acceptance in government centre of north India[J].A ABS,2016,3(1):a82-a87.
[14]Horino T,Sato F,Kato T,et al.Associations of HIV testing and late diagnosis at a Japanese university hospital[J].Clinics(SaoPaulo),2016,71(2):73-77.
[15]Technau KG,Kalk E,Coovadia A,et al.Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg,South Africa[J].J Acquir Immune Defic Syndr,2014,65(5):e170-e178.
[16]Azwa I,Khong SY.Human immunodeficiency virus(HIV)in pregnancy:a review of the guidelines for preventing motherto-child transmission in Malaysia[J].Ann Acad Med Singapore,2012,41(12):587-594.
[17]陈栏心,董柏青,陈怡,等.广西孕产妇艾滋病相关流行病学横断面调查研究[J].中国热带医学,2013,13(11):1323-1326.
[18]张弛,张玉琼,张爱华,等.贵州省2009-2012年孕产妇HIV感染流行病学特征[J].贵阳医学院学报,2013,38(6):604-606.
[19]奚静,俄木阿呷,周海群,等.2008-2014年四川省凉山州某高流行县预防艾滋病母婴传播效果分析[J].现代预防医学,2016,43(16):3020-3023.
[20]王潇滟,王爱玲,王前,等.2012-2014年我国预防艾滋病母婴传播月报数据报告与管理现状分析[J].中国妇幼卫生杂志,2015,6(3):34-37.
[21]Dinh TH,Delaney KP,Goga A,et al.Impact of maternal HIV seroconversion during pregnancy on early mother to child transmission of HIV(MTCT)measured at 4-8weeks postpartum in South Africa 2011-2012:a national population-based evaluation[J].PLoS One.2015,10(5):e0125525.
[22]姜颖颖,王前,乔亚萍,等.我国4省区HIV感染孕产妇流行病学特征差异分析[J].中国健康教育,2017,33(7):592-595.
[23]乔亚萍,王爱玲,王潇滟,等.艾滋病高发地区HIV感染孕产妇感染途径和危险行为分析[J].中国妇幼保健,2013,28(26):4285-4287.
[24]覃雄林,朱刚劲,徐志良,等.贵港市艾滋病综合防治措施的效果评价[J].应用预防医学,2017,23(1):23-26.
[25]胡海洋,刘晓燕,张之,等.江苏省2011-2013年新报告HIV感染者/艾滋病患者新发感染状况分析[J].中华流行病学杂志,2014,35(10):1115-1118.
[2]Zou H,Dai X,Meng X.HIV/AIDS related knowledge,attitudes,and sexual practices among migrant wives in rural Anhui province,China[J].J AIDS Clin Res,2014,5(7):319-324.
[3]Ministry of Health,People′s Republic of China,Joint United Nations Programme on HIV/AIDS World Health Organization.2011Estimates for the HIV/AIDS epidemic in China[R].Beijing,China:2011.
[4]王潇滟,方利文,王芳,等.中国部分地区2011-2012年孕产妇接受HIV梅毒和HBV检测服务现状[J].中国艾滋病性病,2013,19(12):880-885.
[5]Bao YG,Jing J,Zhang YH,et al.Effects of HIV status notification on reducing the risk of sexual transmission of HIV in China[J].Chin Med J(Engl),2014,127(24):4177-4183.
[6]UNAIDS/WHO working group on global HIV/AIDS and STIsurveillance.Guidelines for conducting HIV surveillance among pregnant women attending antenatal clinics based on routine programme data[R].Geneva:WHO,2015.
[7]刘丽芬,张远旺,赵彦成,等.2006-2012年贺州市预防艾滋病母婴传播干预措施状况分析[J].中国健康教育,2015,31(3):270-272.
[8]农胜日,肖琼,陈世新,等.来宾市2010-2014年艾滋病母婴阻断技术应用效果评价[J].中国艾滋病性病,2015,21(9):826-826.
[9]黄春明,林桂芳.2011~2013年广西北海市艾滋病母婴传播阻断现状及效果分析[J].中国妇幼保健,2015,30(21):3580-3582.
[10]葛宪民,唐振柱,朱秋映,等.广西2010-2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[11]王爱华,肖亚洲,熊黎黎,等.湖南省2011-2015年孕产妇艾滋病、梅毒与乙肝检测结果分析[J].实用预防医学,2017,24(7):833-835.
[12]何丹,吴方银,熊庆,等.四川省HIV感染孕产妇的流行情况与对策[J].中国艾滋病性病,2012,18(11):751-753.
[13]R Garg,S Singh,S Singh,et al.Antenatal HIV voluntary counseling and testing:acceptance in government centre of north India[J].A ABS,2016,3(1):a82-a87.
[14]Horino T,Sato F,Kato T,et al.Associations of HIV testing and late diagnosis at a Japanese university hospital[J].Clinics(SaoPaulo),2016,71(2):73-77.
[15]Technau KG,Kalk E,Coovadia A,et al.Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg,South Africa[J].J Acquir Immune Defic Syndr,2014,65(5):e170-e178.
[16]Azwa I,Khong SY.Human immunodeficiency virus(HIV)in pregnancy:a review of the guidelines for preventing motherto-child transmission in Malaysia[J].Ann Acad Med Singapore,2012,41(12):587-594.
[17]陈栏心,董柏青,陈怡,等.广西孕产妇艾滋病相关流行病学横断面调查研究[J].中国热带医学,2013,13(11):1323-1326.
[18]张弛,张玉琼,张爱华,等.贵州省2009-2012年孕产妇HIV感染流行病学特征[J].贵阳医学院学报,2013,38(6):604-606.
[19]奚静,俄木阿呷,周海群,等.2008-2014年四川省凉山州某高流行县预防艾滋病母婴传播效果分析[J].现代预防医学,2016,43(16):3020-3023.
[20]王潇滟,王爱玲,王前,等.2012-2014年我国预防艾滋病母婴传播月报数据报告与管理现状分析[J].中国妇幼卫生杂志,2015,6(3):34-37.
[21]Dinh TH,Delaney KP,Goga A,et al.Impact of maternal HIV seroconversion during pregnancy on early mother to child transmission of HIV(MTCT)measured at 4-8weeks postpartum in South Africa 2011-2012:a national population-based evaluation[J].PLoS One.2015,10(5):e0125525.
[22]姜颖颖,王前,乔亚萍,等.我国4省区HIV感染孕产妇流行病学特征差异分析[J].中国健康教育,2017,33(7):592-595.
[23]乔亚萍,王爱玲,王潇滟,等.艾滋病高发地区HIV感染孕产妇感染途径和危险行为分析[J].中国妇幼保健,2013,28(26):4285-4287.
[24]覃雄林,朱刚劲,徐志良,等.贵港市艾滋病综合防治措施的效果评价[J].应用预防医学,2017,23(1):23-26.
[25]胡海洋,刘晓燕,张之,等.江苏省2011-2013年新报告HIV感染者/艾滋病患者新发感染状况分析[J].中华流行病学杂志,2014,35(10):1115-1118.