西安市2011-2017年新报告HIV/AIDS晚发现及影响因素

目的 分析西安市2011-2017年新报告艾滋病感染者/艾滋病病例（HIV/AIDS）晚发现率及其影响因素,为制定防控措施提供依据。方法 从艾滋病综合防治信息系统中选取西安市2011-2017年新报告的HIV/AIDS,采用趋势χ²检验分析晚发现率及变化趋势,采用Logistic回归模型进行晚发现影响因素分析。结果 西安市2011-2017年新报告HIV/AIDS的晚发现率依次为20.2%、23.1%、28.4%、26.1%、28.7%、32.2%和31.1%,各年度晚发现比例呈上升趋势（P=0.000）。多因素Logistic回归分析显示,女性晚发现比例较男性低（OR=0.740,95%CI：0.607~0.903）; 65岁~组（OR =2.253, 95%CI: 1.564~3.245）、已婚有配偶（OR =1.418, 95%CI: 1.220~1.649）、非本市现住址（OR =1.349, 95%CI: 1.196~1.523）、农民/农民工/工人（OR=1.217, 95%CI: 1.058~1.447）、异性传播（OR =2.513, 95%CI: 1.528~4.133）和医疗机构来源（OR =1.958, 95%CI: 1.678~2.283）的病例晚发现比例较高。结论 西安市2011-2017年新报告HIV/AIDS的晚发现率逐年升高,应加强对老年人口、流动人口和农民工等重点人群的宣传教育,提高防病意识和检测意识,积极推进各级医疗机构全面开展医务人员主动提供艾滋病检测咨询服务（provider initiated HIV testing and counseling,PITC）,促进HIV感染者的早期发现。

Influencing factors of late diagnosis of newly identified HIV/AIDS cases in Xi'an, 2011-2017

Objective To analyze the late diagnosis (LD) status and its influencing factors of the newly reported HIV/AIDS cases in Xi'an City from 2011 to 2017. Methods The newly identified HIV/AIDS cases in Xi'an City from 2011 to 2017 were selected from the National HIV/AIDS Comprehensive Information System, and analyzed with chi-square test for the LD rate and variation trend, and with the multivariate logistic regression to test the factors associated with LD. Results From 2011 to 2017, the yearly LD rate was 20.2%, 23.1%, 28.4%, 26.1%, 28.7%, 32.2%, and 31.1% respectively, and the yearly LD rate was gradually increasing (P=0.000). The multiple logistic regression analysis indicated that the LD proportion was lower in the women compared with that in the men (OR= 0.740, 95%CI: 0.607-0.903). Those who were aged over 65 years (OR=2.253, 95%CI: 1.564-3.245), the married and having spouse group (OR=1.418, 95%CI: 1.220-1.649), the people whose present addresses were not in Xi'an City (OR=1.349, 95%CI: 1.196-1.523), peasantry/peasant-workers/workers (OR=1.237, 95%CI: 1.058-1.447), the people infected via heterosexual transmission (OR=2.513, 95%CI: 1.528-4.133), and the newly identified HIV/AIDS cases found from medical institutions (OR=1.958, 95%CI: 1.678-2.283) were more likely to be diagnosed lately . Conclusions The LD rate of the newly identified HIV/AIDS cases rises year by year in Xi'an City from 2011 to 2017. Therefore, we should promote the health education about HIV/AIDS prevention and control in the aged population, migrant population, peasant-workers and other key groups, strengthen the awareness of prevention and detection of the disease. Meanwhile, we should take a positive attitude to promote medical institutions at all levels to establish the provider initiated HIV testing and counseling (PITC) in full swing, so as to promote the early detection of HIV infection.