艾滋病感染者分类管理策略实施前后传播风险的流行病学特征分析

目的了解浙江省宁波市艾滋病病毒感染者/艾滋病患者(HIV/AIDS)分类管理策略实施前后传播风险的流行病学特征。方法2017年11月底,对现住址在宁波市的在访HIV/AIDS进行为期1年的随访研究,定期开展传播风险评估,针对传播风险不同实施分类管理策略,分析人口学特征、风险评估结果、行为学特征、性病感染情况以及抗病毒治疗情况等数据。结果共有2905例HIV/AIDS纳入研究。经过1年的分类管理策略实施,HIV/AIDS高传播风险比例从11.74%降低至5.23%(χ^2=66.786,P<0.05)。除20岁以下年龄组、小学以下文化程度和吸毒传播的HIV/AIDS高传播风险比例无明显下降外(P>0.05),其他人群的高传播风险比例均显著下降(P<0.05)。通过分类管理策略的实施,高传播风险的HIV/AIDS发生性行为比例、多性伴的比例和未使用安全套比例显著降低(P<0.05),梅毒阳性比例显著降低(P<0.05),未接受抗病毒治疗比例和病毒载量≥400拷贝/ml比例显著降低(P<0.05)。结论宁波市分类管理策略能够有效减少高传播风险HIV/AIDS的比例,降低高传播风险HIV/AIDS的多性伴高危性行为和性病感染比例。应进一步加强HIV/AIDS的随访管理工作以及高传播风险的HIV/AIDS抗病毒治疗动员和转介工作,减少传播。

Epidemiological characteristics of people living with HIV/AIDS before and after implementation of classified management

ObjectiveTo understand the epidemiological characteristics of people living with HIV/AIDS before and after the implementation of classified management strategy in Ningbo, China.MethodsA the end of November 2017, a 1-year follow up was conducted in recruited HIV/AIDS who lived in Ningbo. Different management strategy was implemented in HIV/AIDS with different risk of transmission. The information about their socio-demographics, transmission risk, sex behavior, history of sexually transmitted diseases and antiretroviral therapy were analyzed.ResultsA total of 2 905 HIV/AIDS were included. After 1 year classified management, the proportion of HIV/AIDS with high transmission risk declined from 11.74% to 5.23% (χ2＝66.786, P＜0.05). The proportion of HIV/AIDS with high risk transmission significantly decrease (P＜0.05) except those who were aged ＜20 years, with education level blow primary school and drug users (P＞0.05). After classified management, the proportion of HIV/AIDS with sexual behaviors, with multi sex partners, using no condoms significantly decreased (P＜0.05); the proportion of HIV/AIDS who were syphilis positive significantly decreased (P＜0.05); the proportion of HIV/AIDS receiving no antiretroviral therapy and viral load ≥400 significantly decreased (P＜0.05).ConclusionThrough the implementation of classified management strategy, the proportion of HIV/AIDS with high transmission risk in Ningbo significantly decreased, the prevalence of multi sex partners and sexual transmitted diseases in HIV/AIDS A with high transmission risk significantly decreased. In the future, it is necessary to further strengthen the follow up and anti-retroviral therapy in HIV/AIDS with high transmission risk in order to reduce the HIV transmission.