HIV/AIDS病人生活质量及社会支持调查

目的 了解皖北农村地区人类免疫缺陷病毒（HIV）感染者／艾滋病（AIDS）病人的生活质量和社会支持现状，分析其相关的影响因素。方法 通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷（GQOLI-74）和社会支持评定量表（SSS）对85名HIV感染者／AIDS病人进行调查。采用单因素方差和多元线性回归方法对调查结果进行分析。结果 单因素分析显示，不同性别、不同文化程度的HIV感染者／AIDS病人GQOLI-74总分差异有统计学意义（P〈0．05）；不同乡镇的HIV感染者／AIDS病人SSS总分差异有统计学意义（P〈0．05）。多元线性回归分析结果表明，负性生活事件是影响HIV感染者／AIDS病人社会支持的不利因素。而好的邻里关系、烦恼诉说是影响HIV感染者／AIDS病人生活质量的有利因素。结论 诸多因素影响皖北农村地区HIV感染者／AIDS病人的生活质量和社会支持，农村应加强艾滋病社区关爱、社会支持工作，建立以家庭、邻里为依托的社区关爱模式。     

AIDS病人/HIV感染者孤独现状与相关因素分析

目的了解血源性艾滋病高发乡艾滋病病人（AIDS）／人类免疫缺陷病毒（HIV）感染者（PLWHAS）的孤独现状。探讨其孤独的相关因素。方法整群抽取某血源性AIDS高发乡10个行政村的219名艾滋病病人／HIV感染者。用自制的农村社区艾滋病病人／HIV感染者社会支持模式调查表（包括孤独评定量表（UCLA）、家庭功能量表（APGAR）、社会支持量表（SSS）、日常生活功能状态量表（ADL）等）对目标人群进行调查。结果孤独均分为（47．62±11．52）分。在所调查的项目中，职业为农民、子女不孝顺、无经济来源、与邻居关系差、家庭功能和社会支持差的PLWHAS。孤独评分较高。多元逐步回归分析结果表明。主观生活满意度、社会支持、家庭功能等变量对预测孤独差异有统计学意义（P〈0．05），其中主观生活满意度的作用最强。结论PLWHAS孤独是多因素综合作用的结果，针对家庭功能和社会支持而采取人群干预策略和措施是减轻孤独、提高PLWHAS生活质量从而提高主观生活满意度的一个重要途径。     

艾滋病病毒感染者/艾滋病病人配偶告知工作现状分析

目的：分析和总结我国HIV感染者/病人的配偶告知工作现状。方法：对艾滋病防治工作人员、HIV感染者/病人及其配偶三类人群进行问卷调查和定性访谈。结果：由感染者本人告知其配偶的占58.7%,由医务人员告知的占41.3%;告知后,夫妻关系变差了的占22.0%,没有变化的占73.8%;告知后,配偶做HIV检测的占87.7%;最近3个月与配偶发生性行为时,66.7%的感染者/病人每次都使用安全套,未使用的占6.4%。访谈发现,告知政策能促使感染者本人告知其配偶,能增加工作人员的责任感。结论：明确的配偶告知政策很重要,安全套的可及性还需提高,配偶告知与检测结合作用更大,配偶告知会有一些负面影响。     

艾滋病流行地区艾滋病感染者/艾滋病病人随访模式探讨

目的通过艾滋病感染者/艾滋病病人(以下简称HIV/AIDS)随访服务提供方和接受方的视角,初步了解随访干预的影响因素,探讨在吸毒严重的艾滋病流行地区的随访模式。方法采用半结构化访谈的方法对4名主管艾滋病工作人员,14名随访责任人、40名HIV/AIDS进行个人深入访谈,每人约1~1.5小时。结果政府重视、政策支持、"四免一关怀"政策、社区维持治疗、随访工作人员数量、HIV/AIDS的流动、歧视、家庭支持、违法犯罪被公安抓获、交通不便等是影响HIV/AIDS随访的主要因素。结论社区为基础的随访模式不仅可以充分发挥人力资源优势,降低社会歧视,方便提供心理支持,减少HIV/AIDS暴露的机会,还可以及时地随访到外出流动而失访的HIV/AIDS。社区药物维持治疗门诊(MMT)在HIV/AIDS随访当中也发挥了重要作用。建议在艾滋病流行地区迅速采用以社区为基础的随访模式,发挥MMT的随访管理作用,加强与公安部门的合作,在监管场所随访HIV/AIDS。     

某社区HIV/AIDS社会歧视现状分析

目的通过对HIV/AIDS受到社区相关歧视分析,探讨建立社区关怀和支持体系、减少社会歧视,达到预防和控制艾滋病的目的。方法采用随机抽样的方法,用统一的问卷调查表对社区居民350名、社区居委会干部58名进行调查,分析城市社区对HIV/AIDS相关歧视现状特征。结果城市社区对HIV/AIDS的歧视现象仍然存在:31.1%的人认为感染艾滋病与不良道德品质有关;52.9%的人认为艾滋病感染者或病人应该继续工作或学习;16.7%的人对艾滋病持害怕态度;愿意与艾滋病病毒感染者/病人的亲戚朋友继续交往的为40.0%;愿意与艾滋病病毒感染者/病人共同生活的为15.7%;主张艾滋病感染者/病人应该被隔离的为36.0%。结论应进一步加强社区艾滋病反歧视的宣传,通过减少社会歧视来预防和控制艾滋病。     

艾滋病感染者和患者配偶调查结果分析

目的了解艾滋病感染者和患者配偶的艾滋病感染率和抗体阳转率等,为制定有针对性的防控措施提供依据。方法对409名艾滋病感染者和患者的配偶进行基线调查,收集社会人口学资料、艾滋病相关知识、性行为等信息,采血检测HIV抗体,并进行宣教咨询、发放安全套等干预。半年后对138名基线调查中HIV抗体检测为阴性的配偶进行随访调查。结果基线时调查对象艾滋病知识知晓率为69.9%;80.3%最近半年与配偶发生过性行为,50.2%未每次使用安全套;艾滋病抗体检测阳性率为34.7%。随访时调查对象的艾滋病知识知晓率上升为98.6%;84.1%最近半年与配偶发生过性行为,其中仅有2名随访调查对象未每次使用安全套;138名随访调查对象HIV抗体阳转率为0.7%。结论宣传干预与随访管理,在预防艾滋病经婚内性途径传播起着积极的作用,同时要加强单阳配偶抗病毒治疗,以降低配偶间传播的风险。     

艾滋病病毒感染者配偶艾滋病知识、态度、行为调查及HIV感染状况分析

目的 了解艾滋病病毒（HIV）感染者配偶对艾滋病（AIDS）的认知及其感染状况，为开展有针对性的健康教育提供依据。方法 分别选择一个示范区和非示范区，采取整群抽样的方法，对420名感染者配偶进行问卷调查和HIV抗体检测。结果 感染者配偶的艾滋病知晓率为100％，94.29％正确回答艾滋病的传播途径；HIV抗体检测率为44．76％；91．43％认为应为感染者身份保密，94．05％认为艾滋病病人应该享有平等的工作和劳动的权利；44．52％认为配偶感染HIV后可仍与其有性生活；50％～60％知道病人出现发热、腹泻、头痛等症状时的正确处理方法；感染者配偶HIV感染率为5．71％。非示范区较高。与其性别等因素无关。结论 应继续加大对高危人群的检测力度；要加强对HIV感染者配偶的家庭护理教育；示范区防制措施和方法应向非示范区逐步推行。     

HIV感染者/艾滋病患者的生存质量和社会支持度分析

目的了解HIV感染者/AIDS患者的生存质量和社会支持度,更好地预防和控制艾滋病。方法于2012年4月-2013年4月对229例HIV感染者/AIDS患者使用MOS-HIV生存质量表和社会支持度量表进行面对面调查。结果生存质量得分为（68.64±11.76）分,其中HIV感染者（71.31±10.10）分,已达到服药阶段HIV感染者（65.59±13.49）分,AIDS患者（66.52±12.10）分,HIV感染者、已达到服药阶段HIV感染者和AIDS患者的得分在社会功能、疼痛、精力和情绪功能上差异有统计学意义（P〈0.05）。HIV感染者/AIDS患者的社会支持度得分为（46.32±12.48）分,其中HIV感染者（46.91±12.76）分,已服药HIV感染者（45.12±12.21）分,AIDS患者（46.26±12.32）分。结论随着疾病进展,艾滋病病人的生存质量逐步下降,而社会支持度不因疾病的发展而下降。     

信阳市浉河区农村有偿供血史艾滋病感染者传播艾滋病的危险性评估

目的分析信阳市浉河区农村有既往有偿供血史的艾滋病感染者在人群中传播艾滋病的蜲招浴7椒ā±?2005年全球基金艾滋病项目基线调查和每年艾滋病专题调查的数据库,调取浉河区所有农村既住有偿供血艾滋患者的资料,进行与艾滋病传播有关数据的整理分析。结果共调取调查对象222例,其HIV感染确诊时间在1995年10月20日-2009年3月20日。传播HIV的途径,以夫妻之间性传播的有24例,占10.80%;其次为母婴传播,有7例,占3.20%。结论应加强农村既往有偿供血史的HIV感染者的管理,以减少HIV在人群中的传播。     

艾滋病病毒感染者/艾滋病患者及其家属生活质量和社会支持的研究

目的了解皖北农村地区艾滋病病毒感染者/艾滋病患者(HIV/AIDS)及其家属的生活质量和社会支持现状,分析其相关的影响因素。方法通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷(GQOLI-74)和社会支持评定量表(SSS)对331名HIV/AIDS及其家属148名进行调查。结果单因素分析显示,不同性别、不同乡镇、不同文化程度的HIV/AIDS及其家属的GQOLI-74总分差异有统计学意义(P<0.05);不同年龄、不同乡镇HIV/AIDS的SSS总分差异有统计学意义(P<0.05)。多元线性回归分析结果表明,高年龄、负性生活事件是影响HIV/ AIDS及其家属生活质量的不利因素,而高文化程度、好的邻里关系、烦恼诉说是影响HIV/AIDS及其家属生活质量的有利因素。结论诸多因素在不同层面影响皖北农村地区HIV/AIDS及其家属的生活质量和社会支持,农村现有的艾滋病社区关爱、社会支持工作还亟需加大力度,以家庭、邻里为依托的社区关爱模式有待建立。     

艾滋病相关社会歧视的差序格局研究

目的了解艾滋病毒感染者/艾滋病患者(PLWHA,people living with HIV/AIDS)、PLWHA的家属和普通村民对PLWHA及其家属的社会歧视差序格局,并分析造成艾滋病相关社会歧视的原因。方法自制调查问卷,对乡村艾滋病流行区的117名PLWHA、190名相应的PLWHA的家属、非艾滋病流行区的216名普通村民,进行面对面的问卷调查。结果艾滋病相关社会歧视在艾滋病流行区的PLWHA、PLWHA的家属和非艾滋病流行区的普通村民之间存在统计学差异(F=351.088,P=0.000),且这种差异有一定的格局,基本上随着关系的亲疏而呈递增递显的趋势。多因素Logistic回归分析发现与PLWHA的接触程度(OR=0.268,P=0.000)、艾滋病知晓得分(OR=0.825,P=0.001)、对PLWHA处境的理解(OR=1.102,P=0.000)与艾滋病相关社会歧视存在关联,可能是艾滋病相关社会歧视的影响因素。结论目前我国仍普遍存在对PLWHA及其家属的社会歧视,且这种社会歧视存在差异格局的特点,因此应针对这些特点提出可行的策略和措施。     

HIV感染者/AIDS患者的社会支持状况及影响因素分析

目的了解HIV感染者/AIDS患者(PLWHAS)的社会支持现状,并分析相关影响因素。方法采用社会支持评定量表(SSRS)进行社会支持测量,自制调查表收集相关影响因素,采用多元逐步回归方法分析社会支持的影响因素。结果 294名PLWHAS的社会支持平均总分为(27.16±8.04)分,低于常模。社会支持得分随年龄增加而下降(β=-0.119),随文化程度的增加而增加(β=0.108);家庭人均年收入≥3000元者社会支持得分高于<3000元者(β=0.141);无业(β=-0.166)和独居(β=-0.305)是社会支持的危险因素,而与家里人维持良好的关系(β=0.356)和稳定的婚姻(β=0.252)是社会支持的有利因素。结论 PLWHAS的社会支持水平不高,影响因素包括年龄、就业状况、教育程度、收入水平、居住方式及与家里人的关系等。     

Characteristics of pregnant adolescents receiving prenatal care at school-based or hospital-based clinics

This study examines characteristics of adolescent females in prenatal care in a hospital-based teen clinic compared to a school-based teen clinic. Interviews were conducted during 1991-92 among 189 pregnant adolescents, whose mean age was 16.22 years. 48% were African American, 42% were Hispanic, and 2% were Asian or other. 75% of adolescents were single or without a spouse. 30% lived with siblings, 21% lived with their husband, 9% lived with their boyfriend, 10% lived with in-laws, 4% lived with a friend, and the rest lived with their mothers. 48% of adolescents' mothers helped with child care. 27% did not have any help. 57% were enrolled in school, 41% dropped out, and 4% graduated. 63% planned to continue their education. 75% had a parent who served as a mentor. Over 50% lived with someone who smoked cigarettes or drank alcohol. 75% had friends or relatives who smoked. Almost 25% had a sexual partner who sold drugs, and 25% had a sexual partner who had been in trouble with the law. 14% had a partner who used drugs. 62% of adolescents who had smoked before their pregnancy quit smoking. 79% of adolescents who had consumed alcohol before their pregnancy stopped consuming alcohol. Adolescents in both clinics showed no significant differences in family welfare status, initiation of prenatal care, parity, and number of living children. There were differences by clinic type for adolescent ethnic patterns of clinic use, educational status, financial and social support, and family setting. Hispanics and Whites and school dropouts were more likely to use hospital-based care. The school-based adolescents were more likely to be single; to receive support from parents, relatives, and a job; and to have higher exposure to alcohol and substance abuse. Hospital-based adolescents were more likely to live with relatives, not to have help, and to be Spanish speakers. It is recommended that services match the characteristics and needs of clients in each local setting.     

安徽省艾滋病病毒感染者和病人卫生服务利用及其对生存质量的影响

目的 了解艾滋病病毒感染者和病人(PLWHAS)的卫生服务利用(HSU)现状及其对生存质量(QOL)的影响,为合理分配卫生服务资源,提高其QOL提供依据。方法 采用整群分层抽样方法抽取10个县(市、区)的PLWHAS,使用简明健康调查量表(MOS-HIV)对选定人群的HSU和QOL状况进行问卷调查,通过描述性统计和多重线性回归分析评价PLWHAS的HSU及其对QOL的影响。结果 PLWHAS的CD4免费检测的利用率最高(96.39%),其次为医疗保险(95.36%),而生活保障的利用率最低(71.14%)。PLWHAS的生理健康总分(PHS)为48.29±8.73分,心理健康总分(MHS)为46.67±8.45分,GH、PF、RF、SF、PN、MH、VT、HD共8个维度的得分均低于一般人群(P<0.000 1)。接受免费病毒载量(VL)检测、获得持续固定补贴的PHS差异有统计学意义(P<0.05);享受低保、医保、关爱活动、CD4检测的MHS差异有统计学意义(P<0.05);除GH外,HSU对各维度均产生不同程度的影响(P<0.05)。享有低保和医保的QOL优于无医保的,有低保、新农合、持续固定补贴和每年2次的CD4检测对PHS、MHS及PF、RF、CF、MH、VT、HD、QL的影响均有统计学意义(P<0.05)。结论 安徽省PLWHAS的QOL低于一般人群,HSU较好,医保、低保、固定补贴均能提高其QOL,建议扩大PLWHAS机会性感染、药物副作用报销比例,将新农合、医疗保险、医疗救助有机结合,并逐步开展心理支持、中医调理性治疗以提高其QOL。     

河南省HIV配偶间性传播流行病学调查

目的了解河南省报告的艾滋病配偶间性传播者的流行病学特征,为制定更有针对性的干预措施提供依据。方法采用自行设计的调查问卷,对2011年1月至2012年6月,河南省189个县区通过国家艾滋病网络直报系统报告的感染途径是“异性传播”且接触史是“配偶HIV阳性”的配偶间性传播者进行面对面调查。结果共调查557例HIV配偶间性传播感染者,其中男性占37．7％,女性占62．3％,70．7％的HIV感染者是40岁以上;49．7％的感染者感染前配偶间性生活频次在2～3次／月,得知配偶感染后73．4％的感染者性行为次数减少;46．9％的感染者从未使用过安全套;58．3％的感染者不习惯使用安全套,13．3％的感染者由于不知道配偶感染而没有使用安全套;38．4％的配偶间性传播者其配偶属于异性传播,59．3％的配偶间性传播者的配偶因既往采供血或输血感染HIV;50．3％的感染者是由医务人员告知其配偶感染HIV,73．6％的配偶双方HIV检测确认时间差值在3个月内。结论报告的HIV配偶间性传播者中属于配偶双方同时检测确认的比例较高,应采取定期随访检测、早期抗病毒治疗等综合干预措施预防HIV配偶间性传播。     

Health status and social conditions of the elderly in remote districts. Results of a screening programme

In 1978 a cohort of 1040 individuals aged 65 years or over was screened by public health nurses in Kuusamo. The screening produced basic data about health status and social conditions for an intervention of active medical care of the elderly by means of a mobile unit in rural districts. The response rate of the screening was 90%. 72% of the men and 35% of the women lived with their spouse; 6% of the men and 20% of the women lived alone. Poor health was assessed least commonly (36%) by those living alone, and most commonly by women living with their spouse (51%), even though 87% of them were under 75 years old. A visit to a physician during the past 12 months was more common among younger subjects. 15% of the men and 18% of the women had slightly restricted mobility. Men living alone had better mobility than women living alone.     

人类免疫缺陷病毒夫妻传播的调查

目的　了解夫妻间HIV传播情况。方法　对某艾滋病高发农村有偿供浆员及其配偶作询问调查并采静脉血作HIV检测 ,对其中一方为供浆员且HIV阳性 ,配偶为非供浆员的 5 4对夫妻作分析研究。结果　 5 4对夫妻中 6对发生HIV传播 ,传播率为 11 1% (6 / 5 4 )。HIV由丈夫传给妻子占 8 3% (2 / 2 4 ) ,妻子传给丈夫占 13 3% (4/ 30 ) ,无明显差异 ,P >0 0 5。艾滋病 (AIDS)和艾滋病相关综合征 (ARC)病人HIV传播率 (2 3 8% )显著高于HIV携带者(3 0 % ) ,P <0 0 5。结论　在艾滋病高发地区 ,夫妻间HIV传播是造成AIDS进一步蔓延的重要原因之一。但HIV婚内性传播率比较有多个性伴侣者低 ,提示家庭内一般接触造成HIV传播并不常见     

ADL and actual life styles of all Japanese centenarians as determined by a visitation interview survey

A visiting interview survey was performed on all centenarians living in Japan to investigate their Activities of Daily Life (ADL). 2,851 centenarians, 92.9% of all subjects completed the interview. They were divided into three groups, good ADL (almost independent in daily life), moderate ADL (almost independent in indoor life), and inferior ADL (bed fast) by the condition of ADL. Some factors of health conditions, family size, frequency of use of public welfare services, and life styles were compared among these three groups. Both the good and the moderate ADL groups accounted for about 20% each, and the inferior ADL group was about 60% of the subjects. The condition of ADL of men was better than that of women. The inferior ADL group showed a significantly higher percentage of chronic diseases. High ratios of cerebral vascular disease and dementia were seen in this group, and many had no teeth. While two thirds of all the centenarians lived at home, over 90% of the good ADL group lived at home. The mode of family size was three including the person oneself. An average of 21% of men and 27% of women used public health welfare services. However 40% of the centenarians in the inferior ADL group used those services. Men had better dietary habits for health than women. The good ADL group showed the most desirable dietary habits among the three groups and had the highest percentage of drinkers and smokers. Men practiced a greater number of ideal habits for longevity than women. Of the ADL groups, centenarians in the good ADL group had the highest percentage of ideal habits for longevity. The centenarians who maintained good ADL had the following characteristics: There were fewer people under medical treatment. They had maintained their own teeth. Almost all of them were living at their home with their family. They had continued good dietary habits and daily life for health and longevity. For the maintenance and improvement of ADL of centenarians, adequate social welfare support in a local area for centenarians and their family seemed to be vital in addition to health management and guidance of healthy life style of the aged.     

Human T-cell lymphotropic virus in family members of seropositive blood donors: silent dissemination]

OBJECTIVE: To investigate human T-cell lymphotropic virus transmission among family members of asymptomatic carriers identified through blood donor screening tests; and to determine the most likely direction of transmission in sexual partners having the same (concordant) serological diagnosis. METHODS: Between March 1997 and June 2003 the relatives and steady sexual partners of seropositive, asymptomatic blood donors were investigated for the presence of human T-cell lymphotropic virus type I and II. Diagnosis was based on enzyme-linked immunoassay and Western blot. To determine the direction of transmission, demographic and behavioral data were obtained through questionnaires. All participants lived in the metropolitan region of Belo Horizonte capital of the state of Minas Gerais, Brazil. RESULTS: The overall prevalence of infection with human T-cell lymphotropic virus type was 25.9% among 352 relatives of 343 seropositive patients. The prevalence rates in mothers, sexual partners, and children of seropositive donors were 36.6% (15/41), 35.9% (42/117), and 17.5% (34/194), respectively. The demographic and behavioral data obtained suggest greater efficiency of male-to-female transmission. CONCLUSION: The observed prevalence rates suggest there is familial aggregation of human T-cell lymphotropic virus infection. The main transmission mode was horizontal (sexual). It is important to identify the presence of the virus in family members of infected individuals, even if they are asymptomatic. Doing so may lead to a better understanding of how the virus spreads and more efficient measure for preventing disease transmission.