摘要
目的了解1989—2012年云南省德宏州芒市HIV感染者死亡率及其影响因素。方法选择芒市1989—2012年期间报告的所有现住址为本地的HIV感染者为研究对象,收集其死亡相关信息,计算死亡率和累积生存率,并应用COX比例风险回归模型分析死亡的影响因素。结果共有2 944例HIV感染者纳入分析,其中,69.57%为男性,61.24%为农民,54.21%为已婚有配偶,少数民族占51.12%,57.68%为文盲或小学文化程度。研究对象累计观察13 113.67人年,死亡731例,死亡率为5.57/百人年。死亡率在1995—2004年间总体呈上升趋势,自2005年起开始持续下降。研究对象自报告发现HIV感染至观察期末的平均生存时间为11.35年,其中,接受过抗病毒治疗者的平均生存时间为14.47年,而从未接受过抗病毒治疗者的平均生存时间为7.83年。多因素分析显示,抗病毒治疗及年龄、性别、婚姻状况和文化程度等社会人口学因素显著影响HIV感染者的死亡和生存状态。结论包括抗病毒治疗在内的艾滋病综合防治有效地降低了德宏州HIV感染者的死亡率,未来仍需扩大抗病毒治疗覆盖面,并针对HIV感染者的社会人口学特征加强分类管理和随访,以显著减少HIV感染者死亡。
OBJECTIVE To examine mortality and risk factors among HIV-infected patients from 1989 to 2012 in Mangshi, Dehong prefecture in Yunnan Province. METHODS AI! HIV-infected patients reported from 1989 to 2012 in Mangshi who held local residen- cy were included in the analysis. Mortality rates and cumulative survival rates were calculated. Multiple regression analysis using cox proportional hazard model was conducted to examine risk factors for deaths. RESULTS A total of 2 944 HIV-infected patients were in- cluded for the analysis, of whom 69.57% were males, 61.24% were peasants, 54.21% were married at the time of reporting, 51.12% were ethnic minorities, and 57.68% were illiterate or received only primary school education. The patients were followed-up for a total of 13 113.67 person-years in which 731 patients died, with an overall mortality rate 5.57/100 person-years. The mortality rate had been increasing by 2004 but decreasing since 2005. The average survival time since identification of HIV infection was 11.35 years overall, 14.47 years for those with antiretroviral treatment（ART） and 7.83 years for those without ART. Multiple regression analysis indicated that ART and sociodemographic characteristics such as age, gender, marital status and education were significantly associated with death among HIV-infected patients. CONCLUSIONS The comprehensive AIDS campaigns including ART have significantly reduced deaths among HIV-infected patients in Mangshi city. More efforts on ART scaling up as well as enhanced man- agement and follow-up tailored for HIV-infected patients with certainsociodemographic characteristics are needed to further reduce deaths in the future.
出处
《中国初级卫生保健》
2014年第12期63-66,共4页
Chinese Primary Health Care
关键词
HIV感染者
死亡率
影响因素
回顾性队列研究
HIV-infected individuals
mortality rate
risk factors
retrospective cohort study
