HIV感染者和AIDS病人未接受结核检查的原因分析

目的了解存活的艾滋病病毒（HIV）感染者和艾滋病（AIDS）病人未进行结核病检查的原因。方法选择北京、云南、广东和四川部分地区，对2011年有过随访但未进行结核检查的病例开展问卷调查。结果4个省11地区共调查病例3579例，其中7例为既往已报病例（重卡），实际调查病例3572例，平均年龄为（33．7±11．9）岁，未进行结核检查的主要原因为“自觉无任何不适症状”（26．3％）、“随访时不在本地”（23．6％）和“距离较远去检查单位不便”（10．2％）。吸毒人群因羁押、异性性行为途径感染的病例因担心信息泄露后遭遇歧视，也是未能接受结核检查的重要原因。结论结核病和艾滋病防治机构需建立良好的合作转介机制，强化宣传和病例管理，减少歧视，促进病人主动、及时进行结核检查。

Analysis of reasons for not receiving TB testing among HIV/AIDS patients

Objective To identify reasons associated with failing to receive tuberculosis （TB） testing among peo ple living with HIV/AIDS （PLWHA）. Methods Four epidemic areas were selected： Beijing, Yunnan, Guang dong, and Sichuan. A total of 3579 PLWHA who had at least one documented followup visit in 2011 but did not re ceive TB testing were interviewed with a questionnaire instrument. Results There were 3579 cases enrolled in 11 areas of the four provinces, including 7 previous reported cases （repeat reported）. Among the 3572 cases not receiv ing TB testing, the average age was （33.7 ± 11.9） years. The main reported reasons were ＂not being aware of any symptoms＂ （26.3%）, ＂not residing in the local area＂ （23.6%）, and ＂testing unit is located at a far and inconven ient distance＂ （10.2%）. Other key reasons were being detained for injecting drug use and for cases transmitted through heterosexual contact, fear of discrimination and lack of confidentiality. Conclusion A cooperation mechanism should be established between TB and HIV/AIDS prevention and control institutions to promote active, timely TB testing and to reduce discrimination by strengthening education and case management programs.