Abstract:Objective To analyze current situation of HIV/AIDS case detection and factors associated with late diagnosis among the newly diagnosed cases from 2013 to 2018 in Hangzhou, so as to provide basis for improving the detection capacity of HIV. Methods The data of HIV testing and newly diagnosed HIV/AIDS cases in Hangzhou from 2013 to 2018 were collected through the China AIDS Prevention and Control Information System. The proportion of HIV antibody detection and positive cases in different regions, detection ways and high-risk groups were analyzed. The influencing factors for late diagnosis were analyzed by multivariate logistic regression model. Results The proportions of cases with HIV detected, HIV positive and late diagnosis increased from 2013 to 2018, and the annual ones were 24.99%, 6.95 per ten thousand and 30.07%, respectively. The results of the multivariate logistic regression analysis showed that people who were male ( OR=1.656, 95%CI: 1.351-2.030 ) and aged older ( OR: 1.912-5.117, 95%CI: 1.250-7.904 ) had higher risks of late diagnosis; who detected HIV through pre-test of receiving blood ( OR=4.429, 95%CI:2.217-9.225 ) , other inpatient detection ( OR=2.137, 95%CI: 1.615-2.826 ) , preoperative testing ( OR=2.137, 95%CI: 1.615-2.826 ) and testing of STD clinic attendants ( OR=1.359, 95%CI: 1.007-1.834 ) had higher risks of late diagnosis compared to those diagnosed at VCT clinics; who diagnosed at CDCs ( OR=0.714,95%CI: 0.558-0.915 ) and community health centers ( OR=0.645, 95%CI: 0.441-0.943 ) had lower risks of late diagnosis than those diagnosed in hospitals; who were infected by heterosexual contact ( OR=1.299, 95%CI: 1.130-1.493 ) had a higher risk of late diagnosis than MSM; who had history of STD ( OR=0.818, 95%CI: 0.706-0.948 ) had a lower risk of late diagnosis than who did not.Conclusions HIV testing and case detection had been expanded, but late diagnosis had not been improved in Hangzhou from 2013 to 2018. Age, sex, route and institution of diagnosis, transmission route and history of STD were influencing factors of late diagnosis.
罗艳, 赵刚, 黄思超, 罗文杰, 李西婷, 丁建明. 2013—2018年杭州市HIV/AIDS病例检测发现与晚发现影响因素研究[J]. 预防医学, 2020, 32(8): 757-761.
LUO Yan, ZHAO Gang, HUANG Sichao, LUO Wenjie, LI Xiting, DING Jianming. HIV/AIDS case detection and influencing factors for late diagnosisin Hangzhou from 2013 to 2018. Preventive Medicine, 2020, 32(8): 757-761.
[1] ZHAO Y,HAN M J,MA Y,et al.Progress towards the 90-90-90 targets for controlling HIV—China,2018[J].CCDC Weekly,2019,1(1):5-7. [2] TANG H L,MAO Y R,SHI C X,et al.Baseline CD4 cell counts of newly diagnosed HIV cases in China:2006-2012[J/OL].PLoS One,2014,9(6)[2020-05-18].https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0096098. [3] VALDISERRI R O.Late HIV diagnosis:bad medicine and worse public health[J].PLoS Med,2007,4(6):875-976. [4] BISSET L R,CONE R W,HUBER W,et al.Highly active antiretroviral therapy during early HIV infection reverses T-cell activation and maturation abnormalities,Swiss HIV Cohort Study[J].AIDS,1998,12(16):2115-2123. [5] 袁月荣,唐倩如,陈冰冰,等.海曙区新报告HIV/AIDS病例晚发现情况分析[J].预防医学,2018,30(11):1136-1141. [6] MORENO S,MOCROFT A,MONFORTE A.Medical and societal consequences of late presentation[J].Antivir Ther,2010,15(1):9-15. [7] CHKHARTISHVILI N,CHOKOSHVILI O,BOLOKADZE N,et al.Late presentation of HIV infection in the country of Georgia:2012-2015[J/OL].PLoS One,2017,12(10)[2020-05-18].https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186835. [8] DELPIERRE C,DRAY-SPIRA R,CUZIN L,et al.Correlates of late HIV diagnosis:implications for testing policy[J].Int J STD AIDS,2007,18(5):312-317. [9] 金霞,熊燃,王丽艳,等.2010—2014年我国HIV感染病例的晚发现情况分析[J].中华流行病学杂志,2016,37(2):218-221. [10] 周崇兴,胡茜,沈智勇,等.2015年广西壮族自治区新报告HIV感染者/AIDS患者晚发现的影响因素[J].中华疾病控制杂志,2017,21(9):888-899. [11] 葛锐,张倩倩,徐文贤,等.2011—2016年嘉兴市新报告HIV/AIDS病人的晚发现情况分析[J].中国艾滋病性病,2017,23(11):1078-1079. [12] 何冰. 江山市HIV/AIDS晚发现情况分析[J].预防医学,2016,28(12):1259-1261. [13] REIF L K,RIVERA V,LOUIS B,et al.Community-based HIV and health testing for high-risk adolescents and youth[J].AIDS Patient Care STDS,2016,30(8):371-378. [14] HE X,FENG X,LIU P,et al.An innovative vending machine-based HIV testing and intervention service in China:anonymous urine collection kits distributed at universities[J].AIDS Care,2019,31(22):1-4. [15] HU X,LIANG B Y,ZHOU C X,et al.HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China:a large-scale cross-sectional study[J/OL].AIDS Res Ther,2019,16(1)[2020-05-18].https:// aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-019-0221-7. [16] 潘晓红,陈琳,徐云,等.2012年浙江省HIV感染者和艾滋病患者检测发现特征及影响因素[J].中华预防医学杂志,2014,48(5):380-385. [17] CELESIA B M,CASTRONUOVO D,PINZONE M R,et al.Late presentation of HIV infection:predictors of delayed diagnosis and survival in Eastern Sicily[J].Eur Rev Med Pharmacol Sci,2013,17(16):2218-2224. [18] DRAIN P K,LOSINA E,PARKER G,et al.Risk factors for late-stage HIV disease presentation at initial HIV diagnosis in Durban,South Africa[J/OL].PLoS One,2013,8(1)[2020-05-18].https://pubmed.ncbi.nlm.nih.gov/23383147. [19] KIGOZI I M,DOBKIN L M,MARTIN J N,et al.Late-disease stage at presentation to an HIV clinic in the era of free antiretroviral therapy in Sub-Saharan Africa[J].J Acquir Immune Defic Syndr,2009,52(2):280-289. [20] GULLÓN A,VERDEJO J,MIGUEL R,et al.Factors associated with late diagnosis of HIV infection and missed opportunities for earlier testing[J].AIDS Care,2016,28(10):1296-1300.