广东地区预防 HIV母婴传播服务需求与能力分析

  目的  分析广东省各地预防艾滋病母婴传播（mother-to-chlid transmission，MTCT）的服务需求与能力，了解工作的薄弱地区和环节。  方法  收集2014年-2017年广东省感染人类免疫缺陷病毒（human acquired immunodeficiency virus，HIV）的孕产妇及暴露婴儿的服务需求及干预情况，使用SPSS 21.0软件分析各地服务需求与能力差异，以及各地助产机构和母婴保健人员数量与HIV的MTCT之间相关性。  结果  感染HIV孕产妇文化程度不高，以初中为主（54.49%）；各地感染HIV的孕产妇服务需求不同，珠三角区外来少数民族（12.96%）、山区非本地居住（43.75%）、东翼感染途径不详（77.78%）孕产妇占比高；各地服务能力不同，山区和东翼孕产妇多产时/产后确诊（占比41.67%和44.44%）、治疗晚（山区和东翼超过36周治疗或未治疗占比43.75%和55.56%）、孕产妇和婴儿未治疗比例高（山区和东翼为2.08%和33.33%），且东翼母乳喂养比例高（11.11%）；东翼助产服务机构和母婴保健服务人员数量少，覆盖面小；各地助产机构和母婴保健人员数量与MTCT均无相关性（均有P>0.05）。  结论  山区和东翼是广东省预防HIV的MTCT工作薄弱地区，检测晚、干预不规范、信息质量低是薄弱环节。有针对地消除服务能力的地区差异，是实现广东省消除HIV的MTCT目标的关键。

Service demand and capacity of HIV prevention of mother-to-child transmission in Guangdong

  Objective  To analyze the service demand and capacity for preventing mother-to-child transmission(MTCT) of acquired immune deficiency syndrome in Guangdong, as well as to find the weakness in the work.  Methods  The relevant data of service demands and intervention capacity of human acquired immunodeficiency virus(HIV)-infected maternal and their babies from 2014 to 2017 was collected, and SPSS 21.0 software was employed to analyze the differences among the pearl river delta area, western area, mountainous area and eastern area, and to explore the correlation between regional midwifery institutions or personnel numbers and the rate of HIV MTCT.  Results  The education of HIV-infected maternal wasn't high, generally, mainly in middle school (54.49%). The service demand of HIV-infected maternal was different in each area. The ethnic minorities outside the pearl river delta region (12.96%) and non-local living maternal in mountainous area (43.75%) were high. The proportion of maternal in the eastern area who didn't know the route of HIV infection was also high (77.78%). The service capacity varies in each area, and the proportion (mountainous area: 41.67%, eastern area: 44.44%) of the confirmation time in intrapartum/postpartum was high among those from the mountains and eastern areas, which lead to poor intervention (the proportions of starting to antiretroviral treatment time later than 36 weeks or untreated in mountainous and eastern areas were 43.75% and 55.56%, respectively), as well as a high proportion of untreated maternal and exposed-infant (mountainous area: 2.08%, eastern area: 33.33%), and a higher percentage (11.11%) of breastfeeding in eastern area. There was no significant correlation between the number of midwifery institutions or healthcare personnel and the rate of HIV MTCT in different regions.  Conclusions  The mountainous and eastern areas are the weak of HIV MTCT in Guangdong Province, and later detection, less-standard intervention, and lower quality of information management are the weak steps in those areas. Targeted measures should be urgently developed to strengthen the training of the key areas to eliminate the regional differences of service capacity, which is essential to achieve the elimination of HIV MTCT in Guangdong.