摘要
目的评价云南省德宏州跨境婚姻外籍艾滋病病毒(HIV)感染产妇预防艾滋病母婴传播效果和服务利用状况,为消除艾滋病母婴传播政策制定提供参考。方法利用全国预防艾滋病、梅毒和乙肝母婴传播信息管理系统,收集2004-2016年德宏州报告的所有HIV感染产妇分娩个案及儿童随访卡。抽取HIV感染孕产妇一般人口学特征、预防艾滋病母婴传播服务利用情况、母婴传播发生情况等信息。采用χ^2检验、趋势χ^2检验、t检验比较中国籍和跨境婚姻外籍HIV感染产妇预防母婴传播各项服务措施利用状况及变化趋势、母婴传播率等。结果德宏州2004-2016年报告的1 462例HIV感染产妇中,跨境婚姻外籍HIV感染产妇共370例,且其所占比重呈逐年升高趋势(χ^2=19.28,P<0.001),2016年跨境婚姻外籍孕产妇HIV抗体阳性检出率1.54%(67/4 357),高于中国籍孕产妇0.62%(196/31 818)(χ^2=45.113,P<0.001)。2006-2016年,跨境婚姻外籍HIV感染产妇艾滋病母婴传播率从20.70%下降到2.86%(χ^2=24.08,P<0.001),中国籍从7.49%下降到1.15%(χ^2=15.19,P<0.001)。跨境婚姻外籍HIV感染产妇"孕期保健5次以上""孕早期接受HIV检测""孕早期启动ART治疗"的比例分别为60.27%(223/370)、28.92%(107/370)、22.16%(82/370),低于中国籍HIV感染产妇的66.48%(726/1 092)、42.58%(465/1 092)、31.78%(347/1 092)。结论2004-2016年德宏州跨境婚姻外籍HIV感染产妇所生儿童母婴传播率呈下降趋势,但其预防艾滋病母婴传播干预措施服务利用比例与中国籍HIV感染产妇有差距,需探索更加有效的服务与管理模式促进服务利用。
Objective To analysis and compare the effect of Prevention Mother-to-Child Transmission(PMTCT)of HIV and services utilization among Chinese and foreign HIV infected pregnant women in cross-border marriages.Method Using the National Management and Information System on Prevention Mother-to-Child Transmission of HIV/AIDS,Syphilis and Hepatitis B,we collected all case reporting cards of HIV infected pregnant women and the follow-up cards of their children in Dehong Prefecture during 2004-2016.We analyzed the demographic characteristics of HIV infected pregnant women,PMTCT utilization,and the occurrence of mother-to-child transmission in their children.Result A total of 1462 HIV infected pregnant women were reported in Dehong Prefecture during 2004-2016.Of which,370 HIV infected pregnant women were foreign HIV infected pregnant women in cross-border marriages.The proportion of HIV infected pregnant women increased by year(χ~2=19.28,P<0.001).The proportion of pregnant women tested positive for HIV was significantly higher among foreigners than among Chinese(1.54%vs.0.62%,χ~2=45.113,P<0.001).The rate of mother-to-child transmission in foreign pregnant women infected with HIV droped significantly from 20.70%to 2.86%(χ~2=24.08,P<0.001),while in Chinese pregnant women from 7.49%to 1.15%(χ~2=15.19,P<0.001).The proportions of ANC more than 5 times(χ~2=4.97,P=0.03),HIV testing in early pregnancy,and starting on ART treatment early in the first trimester were significantly lower than that of Chinese(P<0.001).Conclusion The annual rate of mother-to-child transmission in foreign pregnant women infected with HIV decreased in Dehong Prefecture during 2004-2016.Gaps of PMTCT services utilization were found between foreign and Chinese HIV infected pregnant women,with foreign pregnant women much lower.More studies on effective PMTCT services utilization and management strategy for foreign pregnant women infected with HIV in cross-border marriages were needed in future.
作者
郑敏
郭光萍
李燕
唐树萍
乔亚萍
郭云松
ZHENG Min;GUO Guangping;LI Yan;TANG Shuping;QIAO Yaping;GUO Yunsong(Yunnan maternal and child health care hospital,Kunming 650021,China;Kunming Medical University,Kunming 650504;Dehong maternal and chtld health care hospital. Mangsht 678400;National Center for Women’s and children health of China CDC,Beijing 100101)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2019年第6期592-595,605,共5页
Chinese Journal of Aids & STD
基金
国家“十三五”科技重大专项(2018ZX10715006-004)~~
关键词
跨境婚姻
艾滋病病毒感染产妇
母婴传播
服务利用
Cross-border marriages
HIV-infected maternal
mother-to-child transmission
service utilization
