柳州市不同途径发现的HIV/AIDS的晚发现状况及其相关因素

目的 了解柳州市不同途径发现的艾滋病病毒（human immunodeficiency virus，HIV）感染者和艾滋病（acquired immune deficiency syndrome，AIDS）病人（简称HIV/AIDS）的晚发现状况及其相关因素。方法 采用横断面调查方法对2009年1月~2010年6月柳州市新报告的HIV/AIDS进行问卷调查。采用Logistic回归方法分别分析不同途径发现的HIV/AIDS晚发现的危险因素。结果 调查的839例研究对象中，通过医院就诊途径和通过其他途径发现的HIV/AIDS的晚发现率分别为83.8%和62.7%，差异有统计学意义（χ2=48.765，P<0.001）。医院就诊途径发现的HIV/AIDS中，年龄在16~39岁、女性、未婚以及注射吸毒传播途径所占比例分别为37.3%、22.8%、15.3%和5.0%，均低于其他途径发现的HIV/AIDS（均有P<0.05）。多因素结果显示，医院就诊途径发现的HIV/AIDS中，异性性接触传播者、查出感染HIV之前有异性固定性伴性行为和非固定异性性行为者发生晚发现的危险性增加，而家庭年收入 ≥ 15 000元发生晚发现的危险性降低；其他途径发现的HIV/AIDS中，年龄越大发生晚发现的危险性越高。结论 医院就诊途径和其他途径发现的HIV/AIDS中晚发现状况均较严重，两者的人口学特征及其晚发现的危险因素不尽相同，提示今后在促进HIV/AIDS早期发现时应根据不同途径发现的HIV/AIDS的人群特点开展针对性干预措施。

Prevalence and associated factors with late HIV diagnosis among HIV/AIDS patients detected via different pathways in Liuzhou City

Objective To understand the status and associated factors with late human immunodeficiency virus (HIV) diagnosis among HIV/acquired immune deficiency syndrome (AIDS) patients detected via HIV testing for persons seeking medical care for illness (HTPSMCI) and HIV testing for other types of person (HTOTP) in Liuzhou City. Methods A cross-sectional survey was conducted to eligible subjects who were newly diagnosed with HIV infection between January 2009 and June 2010 in Liuzhou City. Multivariate Logistic regression analysis was used to identify risk factors associated with late HIV diagnosis among HIV/AIDS patients detected via HTPSMCI and HTOTP respectively. Results The prevalence of late HIV diagnosis among 839 HIV/AIDS patients detected via HTPSMCI and HTOTP were 83.8% and 62.7% respectively and the difference was statistically significant (χ2=48.765, P<0.001). Among HIV/AIDS patients detected via HTPSMCI, the participants at age of 16-39 years, female, unmarried, and injection drug transmission route accounted for 37.3%, 22.8%, 15.3% and 5.0%, which were lower than HIV/AIDS patients detected via HTOTP (all P<0.05). The results of multivariate Logistic regression analysis showed that risk factors of late HIV diagnosis among HIV/AIDS patients detected via HTPSMCI included heterosexual contact, regular heterosexual partner and casual heterosexual partner prior to HIV diagnosis, and annual household income ≥ 15 000 Yuan was a protective factor. The results also showed that risk factors associated with late HIV diagnosis among HIV/AIDS patients detected via HTOTP was older age. Conclusions The prevalence of late HIV diagnosis among HIV/AIDS patients detected via HTPSMCI and HTOTP are both high. Moreover, there are some differences in demographic characteristics and risk factors of late HIV/AIDS diagnosis patients detected via HTPSMCI and HTOTP, which suggested that it is essential to promote appropriate interventions to detect HIV infections earlier targeting the demographic characteristics of HIV/AIDS patients detected via HTPSMCI and HTOTP.