CAJ | 학술논문

目的分析我国某艾滋病高流行地区医务人员主动提供艾滋病检测与咨询(PITC)服务情况,及其对早期发现感染者的影响.方法于2013年1-12月,以我国某艾滋病高流行地区所辖县(区)级37家医疗机构为研究场所,其中公共医疗机构19家,民营医院18家.按照医务人员主动提供艾滋病检测咨询工作规范、流程及相关工作内容要求,以其间到医疗机构就诊/住院的患者为调查对象,对其提供PITC服务.通过个案调查表记录调查对象的基本信息和艾滋病高危因素,并采集其静脉血5～10 ml,以进行HIV抗体初筛和确认检测.对新发现HIV-1感染者的血清样本用BED HIV-1发病率捕获酶联(BED-CEIA)法进行检测以区分长期感染者和早期感染者.采用x2检验比较不同特征早期感染者发现比例的差异.结果共有55 164人次接受HIV筛查,初筛阳性658例,确诊阳性598例.598例HIV感染者均提供了转介服务.不同年龄、婚姻状况、文化程度、可能的感染途径和不同检测机构的HIV感染者早期发现比例差异有统计学意义(x2值分别为23.54,10.50,17.96,21.22和4.80,P值分别为＜0.001,0.005,＜0.004,＜0.003和0.029),其中20～29和50～84岁感染者早期发现比例较高,分别为47.1％(114/242)和42.1％ (24/57);未婚和已婚感染者早期发现比例均较高,分别为37.8％(56/148)和38.9％(143/368);高中以上文化程度者早期发现比例较高,为42.6％(26/61);固定异性传播者早期发现比例较高,为46.0％(86/187);来自民营医院者早期发现比例较高,为40.3％(58/144).结论该地区通过开展PITC服务早期发现了一定比例的HIV感染者,重点年龄段、固定异性传播者等人群被早期发现的比例相对较高.
목적 분석아국모애자병고류행지구의무인원주동제공애자병검측여자순(PITC)복무정황,급기대조기발현감염자적영향.방법 우2013년1-12월,이아국모애자병고류행지구소할현(구)급37가의료궤구위연구장소,기중공공의료궤구19가,민영의원18가.안조의무인원주동제공애자병검측자순공작규범、류정급상관공작내용요구,이기간도의료궤구취진/주원적환자위조사대상,대기제공PITC복무.통과개안조사표기록조사대상적기본신식화애자병고위인소,병채집기정맥혈5～10 ml,이진행HIV항체초사화학인검측.대신발현HIV-1감염자적혈청양본용BED HIV-1발병솔포획매련(BED-CEIA)법진행검측이구분장기감염자화조기감염자.채용x2검험비교불동특정조기감염자발현비례적차이.결과 공유55 164인차접수HIV사사,초사양성658례,학진양성598례.598례HIV감염자균제공료전개복무.불동년령、혼인상황、문화정도、가능적감염도경화불동검측궤구적HIV감염자조기발현비례차이유통계학의의(x2치분별위23.54,10.50,17.96,21.22화4.80,P치분별위＜0.001,0.005,＜0.004,＜0.003화0.029),기중20～29화50～84세감염자조기발현비례교고,분별위47.1％(114/242)화42.1％ (24/57);미혼화이혼감염자조기발현비례균교고,분별위37.8％(56/148)화38.9％(143/368);고중이상문화정도자조기발현비례교고,위42.6％(26/61);고정이성전파자조기발현비례교고,위46.0％(86/187);래자민영의원자조기발현비례교고,위40.3％(58/144).결론 해지구통과개전PITC복무조기발현료일정비례적HIV감염자,중점년령단、고정이성전파자등인군피조기발현적비례상대교고.
Objective To understand provider initiated HIV testing and counselling(PITC) in a region with high HIV/AIDS epidemic in China, and analyze its effect to early detection of HIV infections.Methods Between January and December, 2013, 37 county level medical institutions were selected as the study sites, among which, 19 were public medical institutions and 18 were private institutions.According to the related regulation, procedures and contents of PITC, the study was implemented among outpatients and inpatients who seek for doctors in these medical institutions and PITC were provided for them.The ‘Individual Investigation Form’ was used to record the information and high-risky factors, and the respondents were taken venous blood and given HIV screening and confirmation.All available serum samples of newly found HIV/AIDS cases were tested using the BED HIV Incidence Capture Enzyme Immunoassay (BED-CEIA) to differentiate the long-term infections and new infections (early detected infections).Chi-square analysis was used to compare the differences of characteristics of newly infected patients.Results Between January and December,2013, a total of 37 medical institutions provided PITC.55 164 person times were received HIV screening, among which 658 were HIV positive, and 598 were confirmed to be HIV positive.The 598 cases were all provided transferring service.The differences of age, marital status, education levels, transmission routes and testing institutions had statistical significance to early detection (x2 equals to 23.54, 10.50, 17.96, 21.22 and 4.80;P equals to＜0.001, 0.005,＜0.001,＜0.001and 0.029, respectively).And the early detection proportions among patients aged from 20 to 29 and from 50 to 84 were 47.1％ (114/242) and 42.1％ (24/57), respectively;the proportions among single and married patients were 37.8％ (56/148) and 38.9％ (143/368), respectively;the proportion among patients with high school education levels were 42.6％ (26/61);the proportion among patients transmitted by fixed heterosexual sexual partners was 46.0％ (86/187);the proportion among private hospitals was 40.3％ (58/144).Conclusion A certain proportion of HIV infections were early detected by PITC in this region.The HIV early detection proportions among specific age group and population with spouse/fixed sexual partners were relatively high.