本文選題：艾滋病病毒 + 發(fā)現(xiàn)滯后�。� 參考：《復(fù)旦大學(xué)》2014年碩士論文

【摘要】：目的(1)通過橫斷面調(diào)查,了解浙江省HIV感染者檢測(cè)發(fā)現(xiàn)滯后的狀況和流行病學(xué)特征；(2)通過單因素和多因素Logistic回歸分析,識(shí)別影響HIV發(fā)現(xiàn)滯后的獨(dú)立危險(xiǎn)因素和保護(hù)因素；(3)通過定性研究,了解HIV發(fā)現(xiàn)滯后的原因及對(duì)策；(4)結(jié)合定量和定性研究結(jié)果,探討促進(jìn)HIV感染者早期發(fā)現(xiàn)的對(duì)策與措施。方法(1)收集、整理并分析浙江省2010-2012年通過國(guó)家艾滋病綜合防治信息系統(tǒng)上報(bào)的HIV感染者。并對(duì)浙江省2012年新報(bào)告的HIV感染者采用隨機(jī)抽樣的方法開展橫斷面調(diào)查,調(diào)查內(nèi)容包括艾滋病知識(shí)知曉情況、HIV感染的風(fēng)險(xiǎn)意識(shí)、HIV檢測(cè)可及性、就醫(yī)情況、社會(huì)歧視、對(duì)當(dāng)?shù)匕滩×餍行蝿?shì)的知曉情況、檢測(cè)后進(jìn)一步救治政策和服務(wù)的知曉情況等。(2)采用定性訪談方法,對(duì)市縣疾控中心艾滋病防治工作人員就HIV發(fā)現(xiàn)滯后的原因及對(duì)策進(jìn)行個(gè)人深入訪談。(3)定量調(diào)查資料采用EpiData31軟件進(jìn)行數(shù)據(jù)錄入和SPSS19.0軟件進(jìn)行單因素和多因素非條件Logistic回歸分析。(4)定性訪談資料分析則先把錄音轉(zhuǎn)錄成文字,再根據(jù)訪談提綱的條目進(jìn)行歸納總結(jié)。結(jié)果(1)浙江省2010-2012年新報(bào)告的HIV感染者中,發(fā)現(xiàn)滯后的比例在30%左右。調(diào)查的1223例HIV感染者中,385例存在發(fā)現(xiàn)滯后,占31.5%。發(fā)現(xiàn)滯后病例的平均年齡為(41.8±13.6)歲,男性占79.2%,已婚有配偶占60.3%,初中及以下文化程度占66.5%,本省戶籍占76.6%。感染途徑以異性傳播為主,占67.5%,檢測(cè)類別以臨床就診者檢測(cè)為主,占59.2%。(2)385例發(fā)現(xiàn)滯后的病例,有71.4%在確診陽(yáng)性之前聽說過艾滋病,其中有55.6%知道正確使用安全套可以減少艾滋病的傳播；60.5%的發(fā)現(xiàn)滯后病例從未想過自己會(huì)感染HIV;確診陽(yáng)性前是否知道哪里可以檢測(cè)HIV的比例分別為49.9%、46.5%；只有27.3%的發(fā)現(xiàn)滯后病例確診陽(yáng)性之前出現(xiàn)艾滋病相關(guān)癥狀,出現(xiàn)癥狀后及時(shí)就醫(yī)的占21.0%；75.3%的發(fā)現(xiàn)滯后病例確診陽(yáng)性之前擔(dān)心檢測(cè)陽(yáng)性會(huì)受到歧視；確診陽(yáng)性之前估計(jì)當(dāng)?shù)孛?萬(wàn)個(gè)人當(dāng)中感染HIV的人數(shù)不到1人的占48.1%,1-10人的占36.4%；有67.0%的病例在確診陽(yáng)性之前沒有聽說過“四免一關(guān)懷”政策。(3)確診陽(yáng)性之前出現(xiàn)艾滋病相關(guān)癥狀、年齡在40歲及以上、婚姻狀況為已婚有配偶、本省戶籍是HIV發(fā)現(xiàn)滯后的危險(xiǎn)因素；檢測(cè)類別為自愿咨詢檢測(cè)、專題調(diào)查的病例發(fā)現(xiàn)滯后的可能性較低。結(jié)論(1)浙江省存在HIV感染者檢測(cè)發(fā)現(xiàn)滯后的狀況,但低于全國(guó)水平。確診陽(yáng)性前出現(xiàn)艾滋病相關(guān)癥狀,年齡在40歲及以上、婚姻狀況為已婚有配偶、本省戶籍是病例發(fā)現(xiàn)滯后的危險(xiǎn)因素,應(yīng)該作為HIV感染者發(fā)現(xiàn)滯后的預(yù)防和干預(yù)因素。樣本來源于自愿咨詢檢測(cè)、專題調(diào)查發(fā)現(xiàn)滯后的風(fēng)險(xiǎn)較小,提示開展自愿咨詢檢測(cè)和專題調(diào)查有利于早期發(fā)現(xiàn)感染者。(2)建議采取以下措施以利于早期發(fā)現(xiàn)HIV感染者：加大艾滋病宣傳力度,促進(jìn)普通人群對(duì)艾滋病相關(guān)知識(shí)和流行形勢(shì)的了解,提高HIV感染的風(fēng)險(xiǎn)意識(shí)和主動(dòng)檢測(cè)意識(shí)；擴(kuò)大艾滋病自愿咨詢檢測(cè)覆蓋面,鼓勵(lì)醫(yī)院門診的醫(yī)務(wù)人員主動(dòng)提供HIV檢測(cè)咨詢,提高檢測(cè)服務(wù)的可及性；各級(jí)疾控中心針對(duì)高危人群積極開展專題調(diào)查；推進(jìn)陽(yáng)性者配偶/固定性伴的告知和檢測(cè)工作。
[Abstract]:Objective (1) through cross-sectional investigation, the status and epidemiological characteristics of detection and discovery of HIV infected persons in Zhejiang province were investigated. (2) independent risk factors and protective factors affecting HIV discovery were identified by single factor and multiple factor Logistic regression analysis. (3) the reasons and Countermeasures of the lag of HIV discovery were understood through the definite study. (4) combination of the factors and countermeasures. The quantitative and qualitative results were used to explore the countermeasures and measures to promote the early detection of HIV infection. Methods (1) collect, collate and analyze the HIV infected persons reported by the National AIDS comprehensive prevention and control information system for 2010-2012 years in Zhejiang Province, and carry out a cross-sectional survey on the new reported HIV infected persons in Zhejiang Province in 2012 by random sampling method. The investigation included the knowledge of AIDS knowledge, the awareness of the risk of HIV infection, the accessibility of HIV detection, the medical situation, social discrimination, the awareness of the local AIDS epidemic situation, the awareness of the further treatment policy and service after testing. (2) the method of qualitative interview was adopted to the AIDS prevention and control workers in the CDC. HIV found the reasons for the lag and the personal in-depth interview. (3) the quantitative survey data used EpiData31 software for data entry and SPSS19.0 software for single factor and multi factor non conditional Logistic regression analysis. (4) qualitative interview data analysis was first transcribed to text words, and then summed up according to the items of the interview outline. Results (1) among the HIV infected people in 2010-2012 years in Zhejiang Province, the rate of lag was found to be around 30%. Among the 1223 cases of HIV infection, 385 cases were found lagging, the average age of the 31.5%. discovery lagging cases was (41.8 + 13.6), men accounted for 79.2%, married couples accounted for 60.3%, junior middle school and below were 66.5%, and the provincial domicile. The main route of 76.6%. infection was heterosexual transmission, accounting for 67.5%. The detection category was mainly detected by clinical patients, accounting for 59.2%. (2), 385 cases were found lags, and 71.4% had heard of AIDS before the diagnosis was positive. 55.6% of them knew that the correct use of condoms could reduce the spread of AIDS; 60.5% of the delayed cases had never thought of self. It would be infected with HIV; whether the proportion of HIV could be detected before the diagnosis was 49.9%, 46.5%; only 27.3% of the cases of delayed cases were found to have AIDS related symptoms before the diagnosis was positive, and 21% were found in timely medical treatment, and 75.3% of the cases with delayed diagnosis were discriminated against before they were positive. Before the diagnosis was positive, less than 1 of the local 10 thousand people were estimated to be infected with HIV and 1-10 were 36.4%. 67% of the cases had not heard of the "four - one - one care" policy before the diagnosis was positive. (3) there were AIDS related symptoms before the diagnosis was positive. The age was 40 years old and above, marriage was married and spouses were in the province. The household registration is the risk factor of HIV discovery lag; the detection category is voluntary counseling and testing, the possibility of the case finding lag is low. Conclusion (1) there is a delay in detection of HIV infected persons in Zhejiang Province, but it is lower than the national level. Marriage has spouses, the provincial household registration is a dangerous factor in case discovery lag. It should be found as a lagging prevention and intervention factor for HIV infected people. The samples are derived from voluntary counseling and testing, and the special survey found that the lag is less risk. It suggests that voluntary counseling and testing and special investigation are beneficial to the early detection of infected people. (2) the following measures are suggested. To facilitate the early detection of HIV infection: increase the publicity of AIDS, promote the knowledge of AIDS related knowledge and epidemic situation, improve the risk awareness and active detection consciousness of HIV infection, expand the coverage of AIDS voluntary counseling and testing, and encourage the medical staff in the hospital outpatient to provide HIV examination and consultation, and improve The accessibility of testing services, CDC at all levels, actively carry out thematic surveys for high-risk groups, and promote the notification and testing of spouses / fixed partners of positive persons.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R512.91

【共引文獻(xiàn)】

相關(guān)期刊論文 前2條

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相關(guān)博士學(xué)位論文 前1條

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本文編號(hào)：1989021