云南省艾滋病综合管理对相关服务可及性的影响分析

目的了解艾滋病病毒（HIV）感染者和艾滋病（AIDS）病人（HIV/AIDS病人）告知随访管理,对相关服务可及性的影响,为艾滋病防治策略提供依据。方法选择4个县,每县将50例自2008年进入管理并一直随访的〉15岁的HIV/AIDS病人作为管理组,以50例2011年检测发现并至少接受过一次随访的〉15岁HIV/AIDS病人作为对照组。通过＂艾滋病综合防治信息系统＂网路直报数据,对2006-2010年云南省接受相关服务的HIV/AIDS病人的数据进行分析,以P〈0.05为差异有统计学意义。结果共调查403人,其中对照组203人,管理组200人。对照组过去6个月获得AIDS咨询70.0%（142人）、免费安全套42.4%（86人）、民政救助5.4%（11人）、结核病筛查50.7%（103人）、抗病毒治疗12.8%（26人）、美沙酮维持治疗0.5%（1人）。与对照组相比,管理组过去6个月获得AIDS咨询100%（200人）（P〈0.05）、免费安全套69.5%（139人）比值比（OR）=3.1,95%可信区间（CI）：2.0527～4.671,P〈0.05]、民政救助65.0%（130人）（OR=32.416,95%CI：16.529～63.573,P〈0.05）、结核病筛查81.5%（163人）（OR=4.277,95%CI：2.725～6.712,P〈0.05）、抗病毒治疗60.0%（120人）（OR=10.212,95%CI：6.197～16.827,P〈0.05）、美沙酮维持治疗44.0%（88人）（OR=158.714,95%CI：21.814～1154.766,P〈0.05）,均高于对照组,差异有统计学意义。2006-2010年,云南省获得CD4T淋巴细胞计数检测、配偶HIV抗体检测、抗病毒治疗和转介、母婴阻断转介和治疗、美沙酮维持治疗服务的HIV/AIDS病人均呈逐年大幅上升。结论综合管理工作促进HIV/AIDS病人获得相关服务,符合HIV/AIDS病人需求,对艾滋病防控起了重要作用

Analysis of the effects of comprehensive management on the accessibility to HIV/AIDS related services

Objective To understand the effects of notification and follow up management （comprehensive man-agement） for HIV/AIDS patients on the accessibility to related services, and provide evidence for AIDS prevention strategies. Method Four counties were selected. In each county, 50 HIV/AIDS patients who were aged over 15 and had received follow-up since 2008 were defined as a management group, while 50 HIV/AIDS patients who were aged over 15 and received at least one follow-up in 2011 were defined as a control group. The HIV/AIDS services data from 2006 to 2010 in Yunnan were analyzed by using data reported from the Internet ＂AIDS comprehensive prevention and control information system＂. P〈0.01 was considered as statistically significant. Results A total of 403 HIV/AIDS patients were investigated, with 200 in the management group, and 203 in the control group. of the subjects in the control group 70 % （142） received HIV/AIDS counseling in the past six months, 42. 4 % （86） received free condoms service, 5.4 % （11） had access to civil aid service, 50. 7 % （103） received TB screening service, 12.8 % （26） received antiviral treatment, and 0.5% （1） received methadone maintenance treatment services, while of the subjects in the management group, 100 % （200）（P%0.05） received HIV/AIDS counseling in the past six months, 69.5%（139） received free condoms odds ratio（OR） = 3.1,95% confidence interval（CI） ： 2. 0527 -- 4. 671, P〈0.05], 65.0% （130） had access to civil aid service （OR=32. 416, 95% CI： 16. 529 -- 63. 573, P〈 0.05 ）, 81.5% （163） received TB screening service （OR = 4. 277,95%CI：2. 72--6. 712,P〈0.05）, 60.0%（120） received antiviral treatment （OR = 10. 212, 95M CI： 6. 197--16.827,P〈0.05）,and 44.0M（88） received methadone maintenance treatment services （OR = 158. 714,95%CI：21. 814 115 4. 766,P〈0. 05）. From2006 to 2010, the service data in the management group were all higher than those in the control group, and the difference had statistical significance. The proportions of HIV/AIDS patients in Yunnan who received CD4 count detection, spouse HIV test, antiviral treatment referral and treatment, PMTCT and MMT services were increasing year by year. Conclusion Comprehensive management promotes accessibility to related services among HIV/AIDS patients, and meet their needs and demands, thus plays an important role in HIV/ AIDS control and prevention.