2012-2016年湖南省艾滋病感染孕产妇综合干预措施利用情况分析

高洁; 吴颖岚; 邹颖; 陈霞

2012-2016年湖南省艾滋病感染孕产妇综合干预措施利用情况分析

Analysis of the applications effect of comprehensive PMTCT intervention services for HIV-infected pregnant women in Hunan Province in 2012-2016

摘要

摘要: 目的通过收集2012-2016年湖南省艾滋病感染孕产妇的咨询、检测、分娩、治疗和随访等情况,系统评价近年来湖南省艾滋病母婴阻断(PMTCT)干预服务状况及其变化趋势,为进一步规范和开展PMTCT服务提供参考。方法从预防艾滋病、梅毒和乙肝母婴传播管理系统中收集2012-2016年湖南省孕产妇艾滋病检测情况、艾滋病感染孕产妇和所生儿童的PMTCT干预服务状况进行统计分析。结果 2012-2016年湖南省孕产妇的HIV咨询率分别为97.9%、98.6%、99.21%、99.5%和99.8%(χ_趋势²=17 897.608,P=0.000);HIV检测率分别为96.9%、98.5%、99.2%、99.5%和99.7%(χ_趋势²=27 842.453,P=0.000);艾滋病感染孕产妇用药率分别为56.8%、57.0%、60.2%、67.2%、76.7%(χ_趋势²=11.546,P=0.001);艾滋病感染孕产妇所生儿童预防抗病毒用药率分别为68.2%、76.0%、71.6%、80.0%、87.0%(χ_趋势²=11.860,P=0.001);艾滋病感染孕产妇所生儿童的早期诊断率分别为53.6%、69.5%、80.5%、83.2%、93.5%(χ_趋势²=56.614,P=0.000),满18月龄儿童进行了HIV抗体检测的比例分别为22.5%、22.5%、25.8%、37.0%、43.6%(χ_趋势²=17.090,P=0.000),提供6次以上随访的儿童比例分别为21.1%、21.6%、25.8%、37.0%、43.6%(χ_趋势²=31.992,P=0.000)。结论 2012-2016年,湖南省预防艾滋病母婴传播工作在孕产妇的咨询率、检测率等方面都有较大的进展,但在艾滋病感染孕产妇的用药、感染孕产妇所生儿童的预防抗病毒用药、儿童随访及相关检测的提供、艾滋病母婴传播率等方面距离国家的要求仍有一定的差距,需要进一步落实各项措施,才能更好的规范和开展PMTCT服务,降低艾滋病母婴传播率。

Abstract: Objective This study aims to systematically evaluate the service status and variation trend of PMTCT intervention in Hunan Province in recent years by collecting data on the condition of HIV-infected pregnant women in Hunan Province in 2012-2016, which include consultation, detection, childbirth, treatment and follow-up, in order to provide reference for further normalizing and developing PMTCT services.Methods To analyze the status of PMTCT intervention services for HIV-infected pregnant women and infants born in Hunan province from 2012 to 2016, and got the data from National IPMTCT Surveillances System.Results During 2012 to 2016, the consultation rate of HIV-infected pregnant women in Hunan province was 97. 9%, 98. 6%, 99. 21%, 99. 5% and 99. 8%, respectively (χ_Trend²=17, 897. 608, P=0. 000); the detection rate for HIV was 96. 9%, 98. 5%, 99. 2%, 99. 5% and 99. 7%, respectively (χ_Trend²=27, 842. 453, P=0. 000); the medication rate of HIV-infected pregnant women was 56. 8%, 57. 0%, 60. 2%, 67. 2% and 76. 7%, respectively (χ_Trend²=11. 546, P=0. 001); the medication rate for the antiviral prevention of children born by HIV-infected pregnant women was 68. 2%, 76. 0%, 71. 6%, 80. 0% and 87. 0%, respectively (χ_Trend²=11. 860, P=0. 001); the early diagnosis rate of children born by HIV-infected pregnant women was 53. 6%, 69. 5%, 80. 5%, 83. 2% and 93. 5%, respectively (χ_Trend²=56. 614, P=0. 000); the ratio of children over 18 months old who underwent HIV antibody tests was 22. 5%, 22. 5%, 25. 8%, 37. 0% and 43. 6%, respectively (χ_Trend²=17. 090, P=0. 000); the ratio of children who underwent more than six follow-up was 21. 1%, 21. 6%, 25. 8%, 37. 0% and 43. 6%, respectively (χ_Trend²=31. 992, P=0. 000).Conclusions During 2012 to 2016, great progress has been achieved in the consultation rate and detection rate for preventing the maternal-neonatal transmission of AIDS in Hunan Province, However, a certain gap still remains from national demands in terms of medication for HIVinfected pregnant women, antiviral medication for children born by HIV-infected pregnant women, the supply of follow-up and relevant detection for children, as well as the maternal-neonatal transmission rate of AIDS. Various measures need to be further implemented to better normalize and carry out PMTCT services, and reduce the maternal-neonatal transmission rate of AIDS.

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