德宏傣族景颇族自治州不同年龄跨境婚姻人群艾滋病相关公共卫生服务现况

  目的  了解德宏自治州跨境婚姻人群艾滋病相关公共卫生服务现况及其年龄差异。  方法  采用横断面调查研究，2017年5月-2019年6月，招募德宏州所有跨境婚姻人员开展调查。  结果  共调查并纳入分析32 182人，年龄15~85岁。曾接受过艾滋病检测服务、近1年接受过艾滋病相关干预服务、近1年得到关怀帮助和参加新农合比例分别为57.8%、92.7%、6.5%和94.5%；其中后三项存在年龄差异（P < 0.001）。多因素Logistic回归分析显示，曾接受过艾滋病检测服务的影响因素包括年龄（51~85岁:OR=0.71，95% CI:0.63~0.81）、女性（OR=1.14，95% CI:1.03~1.25）、地区（陇川:OR=6.30，95% CI:5.72~6.93；梁河:OR=1.27，95% CI:1.11~1.44；盈江:OR=0.88，95% CI:0.82~0.94）、傣族（OR=1.60，95% CI:1.50~1.72）、婚姻登记（办理边民通婚登记:OR=0.60，95% CI:0.56~0.65；未办任何手续:OR=0.66，95% CI:0.62~0.70）、结婚年数（4~5年:OR=1.21，95% CI:1.12~1.31；6~60年:OR=1.30，95% CI:1.22~1.39）、近1年未得到关怀帮助（OR=0.64，95% CI:0.58~0.71）、未参加新农合（OR=0.58，95% CI:0.52~0.65）。  结论  德宏州跨境婚姻人群艾滋病相关公共卫生服务总体实施较好。但是，接受艾滋病检测服务比例相对较低，需在个别人群和县市加强检测。

The present situation of access to HIV/AIDS public health services among cross-border couples in Dehong Prefecture

  Objective  To investigate the accessibility of HIV-related public health services among cross-border couples living in Dehong Prefecture and age differences.  Methods  A cross-sectional survey was conducted among cross-border couples in Dehong Prefecture from January 2017 to July 2019.  Results  In total, 32 182 participants were included. The proportion of people who had received HIV testing services, HIV-related intervention services in past year, care and help in the past year, and participated in new rural cooperative medical services (NCMS) were 57.8%, 92.7%, 6.5% and 94.5%, respectively; and the latter three services were significantly different across age groups (P < 0.001). In multivariable Logistic regression model, variables significantly associated with having ever received HIV testing services older age (51-85 years: OR=0.71, 95% CI: 0.63-0.81), women (OR=1.14, 95% CI: 1.03-1.25), county/city (Longchuan: OR=6.30, 95% CI: 5.72-6.93; Lianghe: OR=1.27, 95% CI: 1.11-1.44; Yingjiang: OR=0.88, 95% CI: 0.82-0.94), Dai ethnic minority (OR=1.60, 95% CI: 1.50-1.72), marriage registration (marriage registration for border inhabitants: OR=0.60, 95% CI: 0.56-0.65; non-registration: OR=0.66, 95% CI: 0.62-0.70), years of marriage (4-5 years: OR=1.21, 95% CI: 1.12-1.31; 6-60 years: OR=1.30, 95%CI: 1.22-1.39), having not received care and help in the past year (OR=0.64, 95% CI: 0.58-0.71) and having not participated in NCMS (OR=0.58, 95% CI: 0.52-0.65).  Conclusions  The accessibility to HIV-related public health services are relatively high among cross-border couples in Dehong Prefecture. However, the relatively low proportion of receiving AIDS testing services, particularly among certain groups and counties/cities, need to be strengthened.