论文部分内容阅读
目的:分析2016年7月国家免费抗病毒治疗纳入标准调整后报告的HIV/AIDS首次随访后的跨省流动及其抗病毒治疗和病毒抑制情况，了解其流动特征及对抗病毒治疗效果的影响。方法:利用艾滋病防治基本信息系统的HIV/AIDS报告及治疗数据，采用描述性分析和n χn 2检验探讨HIV/AIDS流动与治疗和病毒抑制的关系。n 结果:首次随访后跨省流动HIV/AIDS占7.8%（22 426/289 218）。男性（8.3%，18 557/223 713）、高中（9.6%，4 317/44 877）和大专及以上文化程度（9.5%，4 792/45 858）、未婚（11.5%，10 538/91 572）、发现方式为羁押人员检测（16.0%，1 268/7 927）、通过同性性传播感染（11.4%，9 069/79 735）的HIV/AIDS跨省流动的比例较高。发生跨省流动的HIV/AIDS诊断1年内接受抗病毒治疗的比例（77.1%，17 296/22 426）和达到病毒抑制的比例（70.7%，15 858/22 426）均低于未发生跨省流动的HIV/AIDS（分别为86.7%，231 293/266 792和78.6%，209 760/266 792）。首次随访为非户籍省份的HIV/AIDS有41.4%（18 887/45 570）发生了跨省流动，其中，流动返回户籍省的占92.9%（17 538/18 887）。首次随访后发生病例流出人数在前5位的省份分别是广东、浙江、上海、北京和四川，病例流入人数在前5位的省份分别是四川、贵州、广东、安徽和湖南。结论:HIV/AIDS跨省流动影响其接受抗病毒治疗及病毒抑制。需要进一步关注户籍地与现住址分离的流动人口中HIV/AIDS的发现和管理，消除政策壁垒，确保抗病毒治疗的及时性和有效性。“,”Objective:To analyze the interprovincial movement of newly reported HIV/AIDS cases after the first follow up in China and understand their movement characteristics and the effect of antiretroviral therapy (ART) after adjustment of ART inclusion criteria.Methods:The data of HIV/AIDS cases, including the effects of ART, were extracted from the information system for HIV/AIDS prevention and control. Descriptive analysis and n χn 2 test was used to explore the characteristics of the movement of HIV/AIDS cases and its relationship with ART effect and viral suppression.n Results:In 289 218 HIV/AIDS cases, 22 426 (7.8%) cases experienced inter-provincial movement after the first follow up. Higher prevalence of inter-provincial movement was found in males (8.3%, 18 557/223 713), those with education level of senior high school (9.6%, 4 317/44 877) and college degree and above (9.5%, 4 792/45 858), the unmarried (11.5%, 10 538/91 572), those diagnosed in detention center (16.0%, 1 268/7 927) and those infected by homosexual behavior (11.4%, 9 069/79 735). The rates of ART initiation within 1 year of diagnosis and viral suppression were lower in HIV/AIDS cases with inter-provincial movement (77.1%, 17 296/22 426 and 70.7%, 15 858/22 426) than in those without inter-provincial movement (86.7%, 231 293/266 792 and 78.6%, 209 760/266 792). After the first follow-up, 41.4% (18 887/45 570) of HIV/AIDS cases diagnosed in non-native provinces experienced inter-provincial movement, of which 92.9% (17 538/18 887) went back to native province. The top five provinces (municipalities) with outflows of HIV/AIDS cases were Guangdong, Zhejiang, Shanghai, Beijing and Sichuan. The top five provinces with inflows of HIV/AIDS cases were Sichuan, Guizhou, Guangdong, Anhui and Hunan.Conclusions:The inter-provincial movement affects ART effect and viral suppression of HIV/AIDS cases. It is necessary to pay more attention to the discovery and management of HIV/AIDS in floating population and eliminate policy barriers to ensure the timeliness and effectiveness of ART.