成都市2010—2019年新报告HIV/AIDS病例晚发现的影响因素及晚发现病例的生存情况分析

目的 了解成都市艾滋病病毒感染者和艾滋病病人（简称HIV/AIDS）的晚发现情况及主要影响因素，为当地艾滋病防控工作提供建议。方法 收集成都市2010—2019年10年间新报告的HIV/AIDS的数据，采用χ2检验和多因素logistic回归分析，计算比值比，95%可信区间值。分析不同病例生存情况并绘制生存曲线。结果 共纳入39 230例研究对象，总晚发现率为34.4%，多因素logistic回归分析显示，女性出现晚发现的可能性更低（OR = 0.77，95%CI:0.73～0.82），随年龄增加出现晚发现的可能性逐渐增高，家务、家政及待业较农民更易出现晚发现（OR = 1.12，95%CI:1.05～1.19），外地户籍较本地户籍出现晚发现可能性更低（OR = 0.83，95%CI:0.79～0.88），以医院就诊人群为参考，样本来源为重点人群（OR = 0.65，95%CI:0.61～0.68）、羁押人群（OR = 0.25，95%CI:0.20～0.31）、献血人群（OR = 0.31，95%CI:0.25～0.39）和其他（OR = 0.50，95%CI:0.42～0.59）出现晚发现的可能性更低。晚发现病例生存时间为（32.3±30.8）月，非晚发现病例为（42.1±31.6）月。结论 成都市近几年发现的HIV/AIDS晚发率呈下降趋势。性别、年龄、样本来源是晚发现的影响因素，非晚发现病例的平均生存时间远高于晚发现病例的平均生存时间。

Analysis of factors influencing late detection of newly reported HIV/AIDS cases and survival of late detected cases in Chengdu from 2010 to 2019

Objective To understand the late detection of HIV-infected and AIDS patients (referred to as HIV/AIDS) in Chengdu and the main influencing factors, and to provide suggestions for local AIDS prevention and control. Methods Data on newly reported HIV/AIDS in Chengdu city during the 10-year period from 2010 to 2019 were collected, and the odds ratio (OR), 95% confidence interval (CI) values were calculated using Chi-square test and multi-factor logistic regression analysis. Survival of different cases was analyzed and survival curves were plotted. Results A total of 39 230 study subjects were included, with an overall late detection rate of 34.4%. Multifactorial logistic regression analysis showed that women were less likely to have late detection (OR=0.77, 95%CI: 0.73-0.82), with a progressively higher likelihood of late detection with increasing age, people doing housework, domestic work, and waiting for work opportunity were more likely to have late detection than farmers (OR=1.12 , 95%CI: 1.05-1.19), and migrant people from other provinces were less likely to have late detection than locally registered residents (OR=0.83, 95%CI: 0.79-0.88). Using the hospital visit population as a reference, and the sample source of key population (OR=0.65, 95%CI: 0.61-0.68), custodial population (OR=0.25, 95%CI: 0.20-0.31), blood donor population (OR=0.31, 95%CI: 0.25-0.39) and others (OR=0.50, 95%CI: 0.42-0.59) were less likely to have late detection. The survival time was (32.3±30.8) months for late detection cases and (42.1±31.6) months for non-late detection cases. Conclusion The late detection rate of HIV/AIDS in Chengdu has shown a decreasing trend in recent years. Gender, age, and sample source are influencing factors of late detection, and the mean survival time of non-late-detected cases is much higher than the mean survival time of late-detected cases.