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预防医学  2023, Vol. 35 Issue (1): 21-26    DOI: 10.19485/j.cnki.issn2096-5087.2023.01.005
  论著 本期目录 | 过刊浏览 | 高级检索 |
义乌市2016—2020年报告HIV/AIDS病例流动特征分析
蒋均1, 陈军仙2, 楼莲娟2, 朱碧香2, 查琏琦2, 阮建军2
1.浙江省疾病预防控制中心艾滋病与性病预防控制所,浙江 杭州 310051;
2.义乌市疾病预防控制中心,浙江 义乌 322000
Migration characteristics among HIV/AIDS patients reported in Yiwu City from 2016 to 2020
JIANG Jun1, CHEN Junxian2, LOU Lianjuan2, ZHU Bixiang2, ZHA Lianqi2, RUAN Jianjun2
1. Department of HIV/AIDS and STDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China;
2. Yiwu Center for Disease Control and Prevention, Yiwu, Zhejiang 322000, China
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摘要 目的 了解浙江省义乌市2016—2020年报告艾滋病病毒感染者和艾滋病患者(HIV/AIDS)确证后流动及随访治疗情况,为优化流动人口艾滋病防控策略提供依据。方法 通过中国疾病预防控制信息系统艾滋病综合防治信息系统收集义乌市2016—2020年报告HIV/AIDS病例的人口学、随访和治疗资料,分析HIV/AIDS病例确证后流动特征、抗病毒治疗和转归情况,并采用Cox比例风险回归模型分析HIV/AIDS病例确证后流动的影响因素。结果 义乌市2016—2020年报告的1 189例HIV/AIDS病例纳入分析。男性988例,占83.10%;非浙江省户籍806例,占67.79%。流出义乌市441例,占37.09%,流动率为17.73/100人年;其中流出浙江省366例,跨省流动比例为30.78%。非浙江省户籍病例中,流出义乌市395例,占49.01%;其中返回户籍省份337例,占85.32%,以云南省、四川省、贵州省和湖南省为主。少数民族(HR=1.375,95%CI:1.044~1.811)、离退休人员(HR=3.605,95%CI:1.771~7.335)、学生(HR=8.969,95%CI:4.095~19.645)、非浙江省户籍(HR=4.545,95%CI:3.164~6.529)、经流动人口或从业人口体检发现(HR=1.318,95%CI:1.006~1.727)的病例确证后流动的可能性较高;已婚有配偶(HR=0.721,95%CI:0.569~0.913)、初中及以上学历(HR:0.428~0.753,95%CI:0.280~0.952)的病例确证后流动的可能性较低。流动病例中,失访26例,占5.90%;死亡49例,占11.11%。流动病例未接受抗病毒治疗、由HIV感染者进展为AIDS患者和病毒未抑制的比例均高于未流动病例(P<0.05)。结论 义乌市2016—2020年报告的HIV/AIDS病例中,非浙江省户籍、未婚、文化程度较低、离退休人员、学生、经流动人口或从业人员体检发现病例确证后流动风险较高,且流动不利于抗病毒治疗和随访的延续性,可影响疾病转归。
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蒋均
陈军仙
楼莲娟
朱碧香
查琏琦
阮建军
关键词 艾滋病流动人口随访抗病毒治疗    
AbstractObjective To investigate the migration characteristics and follow-up treatment among HIV/AIDS patients after HIV confirmation in Yiwu City, Zhejiang Province from 2016 to 2020, so as to provide insights into the optimization of the HIV/AIDS control strategy among floating populations. Methods The reported HIV/AIDS patients' demographics, follow-up and treatment data in Yiwu City from 2016 to 2020 were captured from the HIV/AIDS Prevention and Control Information System of Chinese Disease Control and Prevention Information System. The migration characteristics, antiretroviral therapy and outcomes of HIV/AIDS patients were analyzed after HIV confirmation, and the factors affecting the migration of HIV/AIDS patients after HIV confirmation were identified using a Cox proportional hazard regression model. Results A total of 1 189 HIV/AIDS patients were enrolled, including 988 men (83.10%) and 806 cases without Zhejiang provincial household registration (67.79%). There were 441 patients (37.09%) migrating out of Yiwu City after HIV confirmation, with a migration rate of 17.73/100 person-years, and there were 366 patients migrating out of Zhejiang Province, with a cross-province migration rate of 30.78%. Among participants without Zhejiang provincial household registration, 395 patients (49.01%) migrated out of Yiwu City, including 337 patients (85.32%) returning to their household registration provinces, which mainly included Yunnan, Sichuan, Guizhou and Hunan. Cox proportional hazard regression analysis showed a high risk of migration among minority ethnic populations (HR=1.375, 95%CI: 1.044-1.811), retires (HR=3.605, 95%CI: 1.771-7.335), students (HR=8.969, 95%CI: 4.095-19.645), patients without Zhejiang provincial household registration (HR=4.545, 95%CI: 3.164-6.529) and patients identified through physical examination of floating populations or employees (HR=1.318, 95%CI: 1.006-1.727), and a low risk among married patients with spouses (HR=0.721, 95%CI: 0.569-0.913) and with an educational level of junior high school and above (HR: 0.428~0.753, 95%CI: 0.280-0.952). Among all floating HIV/AIDS patients, there were 26 cases lost to follow-up (5.90%) and 49 deaths (11.11%). In addition, the proportion of absence of antiretroviral therapy, HIV infection progressing into AIDS patients and failure in HIV inhibition were all greater among floating HIV/AIDS patients than among non-floating patients (P<0.05). Conclusions A high risk of migration was found among HIV/AIDS patients without Zhejiang provincial household registration, unmarried patients, patients with a low education level, retirees, students, and patients identified through physical examination of floating populations or employees in Yiwu City from 2016 to 2020, and migration does not facilitate the sustainability of antiretroviral therapy and follow-up, which may affect the prognosis of HIV/AIDS.
Key wordsAIDS    floating population    follow-up    antiretroviral therapy
收稿日期: 2022-10-20      修回日期: 2022-11-29      出版日期: 2023-01-10
中图分类号:  R512.91  
通信作者: 阮建军,E-mail:464094921@qq.com   
作者简介: 蒋均,硕士,主管医师,主要从事艾滋病预防控制工作
引用本文:   
蒋均, 陈军仙, 楼莲娟, 朱碧香, 查琏琦, 阮建军. 义乌市2016—2020年报告HIV/AIDS病例流动特征分析[J]. 预防医学, 2023, 35(1): 21-26.
JIANG Jun, CHEN Junxian, LOU Lianjuan, ZHU Bixiang, ZHA Lianqi, RUAN Jianjun. Migration characteristics among HIV/AIDS patients reported in Yiwu City from 2016 to 2020. Preventive Medicine, 2023, 35(1): 21-26.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2023.01.005      或      http://www.zjyfyxzz.com/CN/Y2023/V35/I1/21
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