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目的了解2013年云南省德宏州乡镇卫生院经医务人员主动提供艾滋病检测咨询(provider-initiated HIV testing and counselling,PITC)发现的HIV感染者特征及卫生服务利用状况。方法对PITC新发现HIV感染者与既往感染者特点及艾滋病卫生服务利用状况分析,应用Logistic回归分析HIV早发现影响因素。结果经PITC发现HIV感染者179例,76例(42.5%)为新发现感染者。相对于既往感染者,新发现感染者较年轻、外籍比例较高、AIDS患者比例较低。新发现感染者抗病毒治疗率及咨询服务接受率均低于既往感染者。但两者在是否坚持使用安全套以及是否受到抗机会感染药物支持、经济支持、结核病检查等艾滋病相关卫生服务的比例均无统计学差异(均有P>0.05)。58.8%(97/165)为早发现感染者。多因素回归分析显示,女性早发现率高于男性,具有统计学意义(OR=2.40,P=0.006);≥45岁年龄组早发现率小于<35岁年龄组,差异有统计学意义(OR=0.25,P<0.001);外籍人口早发现率低于中国籍,具有统计学意义(OR=0.46,P=0.044)。结论德宏州乡镇卫生院实施免费PITC可发现一定数量的HIV感染者,但对PITC新发现感染者的咨询服务和抗病毒治疗工作有待加强。
Objective To understand the characteristics of HIV-infected persons and utilization of health services found by provider-initiated HIV testing and counseling (PITC) in 2013 in Dehong Prefecture Township Health Center in Yunnan Province. Methods The characteristics of HIV-infected and previously-infected people in PITC newly diagnosed and the utilization of HIV / AIDS health services were analyzed. Logistic regression was used to analyze the influencing factors of HIV early detection. Results 179 cases of HIV-infected persons were found by PITC, and 76 cases (42.5%) were found newly infected. Relative to the previous PLWHA, newly discovered PLHs were younger, with a higher proportion of expatriates, and a lower percentage of AIDS patients. The rates of antiviral treatment and counseling services for new-onset infections were lower than those of previous infections. However, there was no significant difference (both P> 0.05) in the proportion of HIV / AIDS-related health services between the two, whether they insisted on using condoms and whether they were infected with anti-opportunistic drugs, financial support, and tuberculosis tests. 58.8% (97/165) were found early. Multivariate regression analysis showed that the early detection rate of women was higher than that of males (OR = 2.40, P = 0.006). The early detection rate of ≥45 years old group was less than <35 years old group, the difference was statistically significant = 0.25, P <0.001). The early detection rate of foreign population was lower than that of Chinese nationality (OR = 0.46, P = 0.044). Conclusions Dehong Prefecture township hospitals can find out a certain number of HIV-infected persons by implementing free PITC. However, consulting services and antiviral treatment of newly discovered patients with PITC need to be strengthened.