| 成都市HIV/AIDS患者失访率及影响因素研究 |
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| 引用本文： | 徐菁佩,代珍,施雅莹,何勤英. 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, 0(14): 2666-2671. DOI: 10.20043/j.cnki.MPM.202107433 |
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| 作者姓名： | 徐菁佩 代珍 施雅莹 何勤英 |
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| 作者单位： | 成都市疾病预防控制中心，四川 成都 610041 |
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| 摘 要： | 目的 了解成都市艾滋病毒感染者/艾滋病病人（HIV/AIDS患者）1992—2019年失访情况及相关影响因素，为针对性提高随访管理质量提供依据。方法 通过“艾滋病综合防治数据信息管理系统”下载历史卡片及定时随访数据库，收集成都市1992—2019年新报告HIV/AIDS患者一般人口学特征、感染HIV途径、病程阶段、病例观察人年和随访状况等信息，对HIV/AIDS患者的一般情况和失访情况进行描述，应用Cox比例风险回归模型分析失访影响因素。结果 1992—2019年现住址为成都市HIV/AIDS患者累计观察12 0617.01人年，失访3 596人，失访率为0.030/人年，1992—2009年间失访率最高，之后一直呈下降趋势。HIV/AIDS患者发生失访的平均时间为开始随访后1.96年。现住址为成都市的HIV/AIDS患者的平均年龄为（49.00±16.50） 岁，男性占比为79.56%,户籍地为成都本地的占比为75.86%，汉族占比为97.70%。Cox比例风险回归模型多因素分析结果显示，与年龄0～14岁的 HIV/AIDS患者相比，其他年龄段发生失访的风险更高（15～24岁HR = 16.71, 95%CI:4.00～69.89；25～49岁HR = 12.02, 95%CI:2.87～50.25；≥50岁HR = 9.93, 95%CI:2.37～41.57）；户籍为外市（HR = 1.42, 95%CI:1.29～1.55）或外省的（HR = 1.67, 95%CI:1.49～1.87）比户籍为本市的发生失访风险更高；从事服务业（HR = 1.10, 95%CI:1.00～1.20）或工人/民工/驾驶员（HR = 1.20, 95%CI:1.04～1.38）相比职业为农民的更易发生失访；病程阶段为HIV感染（HR = 1.27, 95%CI:1.19～1.36）相较艾滋病更易失访；相较异性传播者，注射吸毒者（HR = 2.94, 95%CI:2.63～3.29）发生失访风险更高。而与未婚相比，已婚有配偶（HR = 0.51, 95%CI:0.46～0.57）发生失访的风险相对较低；文化程度为初中及以上（初中HR = 0.79, 95%CI:0.68～0.92；高中或中专HR = 0.62, 95%CI:0.52～0.74；大专及以上HR = 0.45, 95%CI:0.38～0.54）比文盲的失访风险更低；与异性传播者相比，同性传播者（HR = 0.66, 95%CI:0.60～0.72）发生失访的风险更低。结论 现住址为成都市的HIV/AIDS患者失访率总体呈下降趋势，开始随访前两年失访风险较高，＞14岁、户籍为外地、从事服务业或工人/民工/驾驶员、病程阶段为HIV感染、注射吸毒的失访风险较高。针对失访风险较高的人群应当采取相应措施，提高随访工作质量，减少失访的发生。
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| 关 键 词： | 艾滋病 失访 影响因素 |
Study on loss-to-follow-up rate of HIV/AIDS patients and influencing factors in Chengdu |
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| XU Jing-pei,DAI Zhen,SHI Ya-ying,HE Qin-ying. Study on loss-to-follow-up rate of HIV/AIDS patients and influencing factors in Chengdu[J]. Modern Preventive Medicine, 2022, 0(14): 2666-2671. DOI: 10.20043/j.cnki.MPM.202107433 |
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| Authors: | XU Jing-pei DAI Zhen SHI Ya-ying HE Qin-ying |
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| Affiliation: | Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China |
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| Abstract: | Objective To understand the loss to follow-up of HIV/AIDS patients (HIV/AIDS) in Chengdu from 1992 to 2019 and the influencing factors, so as to provide a basis for improving the quality of follow-up management. Methods By downloading historical cards and regular follow-up databases through the “Integrated AIDS Prevention and Control Data Management System”, we collected information on the general demographic characteristics, route of HIV infection, stage of disease, number of years of case observation and follow-up status of newly reported HIV/AIDS patients in Chengdu from 1992 to 2019. AIDS patients’ general conditions and lost visits were described, and the COX proportional risk regression model was applied to analyze the factors influencing the loss to follow-up. Results From 1992 to 2019, a total of 120 617.01 person-years of HIV/AIDS were observed in Chengdu, and 3 596 people were lost to follow-up, with a loss-to-follow-up rate of 0.030/person-year. The mean time to follow-up for HIV/AIDS patients was 1.96 years after the start of follow-up. The loss-to-follow-up rate was the highest between 1992 and 2009 and showed a downward trend since then. On average, the loss to follow-up occurred 1.96 years after the start of follow-up. The mean age of HIV/AIDS patients with current address in Chengdu was 49.00 ± 16.50 years, 79.56% were males, 75.86% had a local household registration in Chengdu, and 97.70% were Han Chinese. The results of the COX proportional risk regression model with multifactorial analysis showed that the risk of lost follow-up was higher in other age groups compared to HIV/AIDS patients aged 0-14 years (HR=16.71, 95%CI: 4.00-69.89 for 15-24 years; HR=12.02, 95%CI: 2.87-50.25 for 25-49 years; HR= 9.93, 95%CI: 2.37-41.57 for above 50 years). Those with household registration in other cities (HR=1.42, 95%CI: 1.29-1.55) or provinces (HR=1.67, 95%CI: 1.49-1.87) were at higher risk of lost follow-up than those with household registration in Chengdu. Those working in the service industry (HR=1.10, 95%CI: 1.00-1.20) or workers/minutemen/drivers (HR=1.20, 95%CI: 1.04-1.38) were more likely to be lost to follow-up than farmers. The risk of loss-to-follow-up was higher among those with HIV infection (HR=1.27, 95%CI: 1.19-1.36) compared to those with AIDS. The risk of loss-to-follow-up was higher among injecting drug users (HR=2.94, 95%CI: 2.63-3.29) compared to those with heterosexual transmission. Compared with unmarried people, married people with spouse (HR=0.51, 95%CI: 0.46-0.57) had a lower risk of loss-to-follow-up. Those with education level of junior high school and above (HR=0.79, 95%CI: 0.68-0.92 for junior high school; HR=0.62, 95%CI: 0.52-0.74 for high school or secondary school; HR=0.45, 95%CI: 0.38-0.54 for college and above) had a lower risk of loss-to-follow-up than illiterates. Same-sex transmitters (HR=0.66, 95%CI: 0.60-0.72) had a lower risk of loss-to-follow-up compared with heterosexual transmitters. Conclusion The loss-to-follow-up rate of HIV/AIDS patients whose current address is in Chengdu generally shows a downward trend. The risk of loss to follow-up is higher in the first two years since the start of follow-up. Those who are older than 14 years old, not with local household registration, working in service industry or as workers/minutemen/drivers, with HIV infection, and injecting drug users are at higher risk of loss-to-follow-up. Measures should be taken to improve the quality of follow-up and reduce the occurrence of lost follow-up. |
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| Keywords: | AIDS Lost to follow-up Influencing factors |
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