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2018—2024年辽宁省医疗机构及自愿咨询检测发现的HIV/AIDS患者特征分析

Characteristics of HIV/AIDS cases identified in medical institutions versus voluntary counseling and testing clinics in Liaoning province, 2018–2024

    摘要
  • 摘要:
    目的  分析2018—2024年辽宁省医疗机构与自愿咨询检测（VCT）发现的HIV/AIDS患者特征差异，为扩大艾滋病检测、促进艾滋病患者早发现提供依据。
    方法  通过中国疾病预防控制信息系统艾滋病综合防治信息系统，收集2018—2024年新报告的HIV/AIDS患者历史卡片、随访数据以及艾滋病检测份数表数据；采用χ2检验比较医疗机构与VCT的HIV/AIDS患者特征差异，运用Joinpoint回归模型分析2种检测途径粗检出率的变化趋势。
    结果  2018—2024年辽宁省医疗机构共检测发现HIV/AIDS患者9 314例，粗检出率呈下降趋势（AAPC= –5.78%，P=0.036）。VCT共检测发现HIV/AIDS患者4 657例，粗检出率呈下降趋势（AAPC= –12.38%，P=0.009）。医疗机构检测发现患者中以男性（89.50%）、20～<40岁年龄组（51.21%）、初中及以下（46.17%）、同性传播（59.30%）为主。VCT检测发现患者中以男性（94.09%）、20～<40岁年龄组（63.62%）、大专及以上（44.56%）、同性传播（78.48%）为主。2018—2024年两种途径发现的HIV/AIDS患者性别、年龄、文化程度、婚姻状况、职业等人口学特征构成比差异均有统计学意义（P<0.001）。医疗机构发现的HIV/AIDS患者首次CD4+T淋巴细胞值<200 cells/μL占比为44.07%，VCT发现的患者≥350 cells/μL占比42.97%，差异均有统计学意义（（P<0.001）。
    结论  辽宁省医疗机构与自愿咨询检测发现的HIV/AIDS患者特征存在差异。医疗机构是发现患者的主要途径，VCT是能够发现早期患者的重要手段。需充分发挥两者优势，促进感染者早检测、早发现。

     

    Abstract:
    Objective  To compare the characteristics of HIV/AIDS cases detected through medical institutions and voluntary counseling and testing (VCT) clinics in Liaoning province, China, from 2018 to 2024.
    Methods Data on newly reported HIV/AIDS cases, follow-up information, and HIV testing volumes from 2018 to 2024 were extracted from the AIDS Comprehensive Prevention and Control Information System of the Chinese Center for Disease Control and Prevention. Demographic and clinical characteristics of cases from the two detection channels were compared using the chi-square test. Trends in crude detection rates were analyzed using Joinpoint regression to calculate the average annual percent change (AAPC).
    Results From 2018 to 2024, 9 314 and 4 657 HIV/AIDS cases were detected through medical institutions and VCT clinics, respectively. Both channels showed significant declining trends in crude detection rates (medical institutions: AAPC = –5.78%, P = 0.036; VCT clinics: AAPC = –12.38%, P = 0.009). Significant differences (P < 0.001) were observed in all demographic characteristics (gender, age, education, marital status, occupation). Cases from medical institutions were predominantly male (89.50%), aged 20–39 years (51.21%), had a junior high school education or below (46.17%), and were infected via male-to-male sexual contact (59.30%). In contrast, cases from VCT clinics had a higher proportion of males (94.09%), were younger (63.62% aged 20–39), had a higher education level (44.56% with college or above), and a greater proportion were infected via male-to-male sexual contact (78.48%). A stark contrast was noted in the initial CD4+ T lymphocyte count: 44.07% of cases from medical institutions had a count < 200 cells/μL, whereas 42.97% from VCT clinics had a count ≥ 350 cells/μL (P < 0.001).
    Conclusion Significant differences exist in the characteristics of HIV/AIDS cases detected through medical institutions and VCT clinics in Liaoning province. Medical institutions serve as the primary case detection channel, while VCT clinics play a crucial role in identifying cases at an earlier disease stage. Public health strategies should leverage the complementary advantages of both approaches to promote early HIV testing and case detection.

     

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