Abstract:Objective To understand the status and influencing factors of loss to follow-up among HIV/AIDS cases in Gulou District, Nanjing City, so as to provide evidence for optimizing the follow-up management of HIV/AIDS cases. Methods Reporting information and follow-up data of HIV/AIDS cases in Gulou District from January 1, 1994, to July 31, 2025, were collected through the HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. The confirmed date of HIV/AIDS diagnosis was defined as the start of follow-up observation, and July 31, 2025, as the end of observation , with loss to follow-up as the outcome event. Factors affecting loss to follow-up among HIV/AIDS cases were analyzed using a multivariable Cox proportional risk regression model. Results A total of 1 279 HIV/AIDS cases were observed from January 1, 1994, to July 31, 2025, with a total observation period of 8 834.23 person-years. There were 1 198 males (93.67%) and 81 females (6.33%). The median age was 32.00 (interquartile range, 20.00) years. There were 848 HIV-infected individuals (66.30%) and 431 AIDS patients (33.70%). As of July 31, 2025, 152 cases were lost to follow-up, with a loss to follow-up density of 17.21 thousand person-years and a cumulative loss to follow-up rate of 11.88%. Multivariable Cox proportional risk regression analysis showed that HIV/AIDS cases with non-Jiangsu household registration (HR=1.721, 95%CI: 1.212-2.444), passive testing (HR=2.031, 95%CI: 1.346-3.065), and heterosexual transmission (HR=2.542, 95%CI: 1.669-3.872) had a higher risk of loss to follow-up, whereas those who were married/with a spouse (HR=0.432, 95%CI: 0.283-0.661), AIDS patients (HR=0.152, 95%CI: 0.085-0.271), reported by general hospitals (HR=0.382, 95%CI: 0.226-0.645) or Centers for Disease Control and Prevention (HR=0.505, 95%CI: 0.323-0.790) had a lower risk of loss to follow-up. Conclusions The risk of loss to follow-up among HIV/AIDS cases was mainly associated with residence, marital status, HIV/AIDS stage, reporting institution, case detection method, and route of infection. Cases at high risk of loss to follow-up should be prioritized, and follow-up mana gement should be strengthened to reduce the occurrence of loss to follow-up.
徐芬, 张丽, 王凌, 汪靖, 张行. 1994—2025年鼓楼区HIV/AIDS病例失访的影响因素研究[J]. 预防医学, 2026, 38(5): 468-472.
XU Fen, ZHANG Li, WANG Ling, WANG Jing, ZHANG Hang. Factors affecting loss to follow-up among HIV/AIDS cases in Gulou District from 1994 to 2025. Preventive Medicine, 2026, 38(5): 468-472.
[1] 刘宇婧,韩孟杰,陈清峰.我国HIV/AIDS病人随访工作现况分析[J].中国艾滋病性病,2015,21(9):807-809. [2] 中国疾病预防控制中心,性病艾滋病预防控制中心.艾滋病病毒感染者随访工作指南(2026年版)[Z].2026. [3] 沈银忠,李太生.《中国艾滋病诊疗指南(2024版)》解读[J].中国预防医学杂志,2025,26(2):129-132. [4] GARDNER E M,MCLEES M P,STEINER J F,et al.The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection[J].Clin Infect Dis,2011,52(6):793-800. [5] 伍蓉,徐园园,吴苏姝,等.江苏省南京市新报告HIV/AIDS感染及影响因素调查分析[J].疾病监测,2023,38(6):664-669. [6] 徐菁佩,代珍,施雅莹,等.成都市HIV/AIDS患者失访率及影响因素研究[J].现代预防医学,2022,49(14):2666-2671. [7] 陶连弟.兰州市城关区“三位一体”HIV/AIDS随访管理模式的探索与思考[J].疾病预防控制通报,2019,34(5):35-37. [8] 辅海平,沈毅,王国华.艾滋病非流行地区“三位一体”随访管理模式探讨[J].中国卫生检验杂志,2013,23(7):1776-1778,1784. [9] 画伟,吕诗韵,白若靖,等.“三位一体”个案干预模式对北京地区HIV/AIDS患者ART启动时间和治疗依从性影响[J].传染病信息,2021,34(3):242-245. [10] 黄金萍,胡雁,董文逸,等.个案管理在HIV感染者/AIDS病人中的应用效果研究进展[J].护理研究,2020,34(5):863-866. [11] YUAN B C,LI J N,WANG Z G,et al.Household registration system,migration,and inequity in healthcare access[J/OL].Healthcare,2019,7(2)[2026-01-29].https://doi.org/10.3390/healthcare7020061. [12] 周芳,陈晶,纪颖.流动人口健康状况公平性及影响因素研究[J].中国农村卫生事业管理,2023,43(4):235-241. [13] LI W T,WANG X L,YANG Y H,et al.The associations of population mobility in HIV disease severity and mortality rate in China[J/OL].Ann Transl Med,2021,9(4)[2026-01-29].https://doi.org/10.21037/atm-20-4514. [14] KALINJUMA A V,GLASS T R,WEISSER M,et al.Prospective assessment of loss to follow-up:incidence and associated factors in a cohort of HIV-positive adults in rural Tanzania[J/OL].J Int AIDS Soc,2020,23(3)[2026-01-29].https://doi.org/10.1002/jia2.25460. [15] 卓玛拉措,曾亚莉,李菊梅,等.2018年四川省HIV/AIDS病人随访检测的影响因素[J].中国艾滋病性病,2020,26(10):1072-1075. [16] 徐志良,覃雄林,覃春伟,等.贵港市1996—2015年HIV/AIDS患者失访影响因素分析[J].应用预防医学,2017,23(3):187-191. [17] 罗超,颜玉涛,杨璧璘,等.2020年哈尔滨市存活HIV感染者/AIDS患者随访情况及影响因素分析[J].中国公共卫生管理,2022,38(6):824-827. [18] 谭芷敏,黎静,陈晓滨,等.广州市男男性行为者的异性性行为现状及其影响因素[J].中国艾滋病性病,2021,27(3):242-246. [19] SU R,LIU Y,LI P L,et al.Utilization of post-exposure prophylaxis potentially contributed to the changes of risk behaviors among men who have sex with men in China[J/OL].Front Public Health,2024,12[2026-01-29].https://doi.org/10.3389/fpubh.2024.1364913. [20] 潘玲,张大鹏,蔡凌萍,等.我国15~24岁有网约性行为青少年寻求性病艾滋病医疗服务意愿及相关因素分析[J].中国公共卫生,2023,39(2):196-200.