2006－2019年云南省预防母婴传播服务效果分析

郑佳瑞; 李四乐; 张燕; 郑敏; 桂小龙; 李鹏斌; 郭光萍

doi:10.3784/j.issn.1003-9961.2020.07.009

2006－2019年云南省预防母婴传播服务效果分析

Effect of mother-to-child HIV transmission prevention service in Yunnan, 2006–2019

摘要

摘要:
目的通过分析评估云南省预防艾滋病母婴传播服务工作效果，找出预防艾滋病母婴传播工作中存在的问题和影响因素，为云南省预防母婴传播工作提供理论指导。
方法从国家《预防艾滋病、梅毒和乙肝母婴传播管理信息系统》中导出2006 — 2019年云南省孕产妇检测、干预措施及随访管理服务等相关信息，采用Excel 2010软件进行数据整理，采用SPSS 20.0软件进行描述性分析、各年度指标变化趋势分析和Q聚类分析。
结果2006 — 2019年云南省孕产妇HIV检测率由63.82%上升到99.97%，孕早期检测率由2014年的39.50%上升到2019年的71.59%；产妇服药率由67.76%上升到99.72%，婴儿服药率由78.31%上升到99.91%。艾滋病母婴传播率由阻断前的34.80%下降到2019年的1.93%。将16州（市）预防艾滋病母婴传播工作效果按照母婴传播率和过程指标进行聚类分析，结果分为4类：第一类为昆明市、保山市、玉溪市、楚雄州、大理州、西双版纳州和德宏州；第二类为昭通市、临沧市、曲靖市、红河州、普洱市和文山州；第三类为怒江州；第四类为丽江市和迪庆州。
结论云南省预防艾滋病服务模式运转效果良好，有效降低了全省的艾滋病母婴传播率，但地区发展不平衡状况突出，需重点关注第二、第三、第四类州（市），结合实际科学研判，制订有针对性的工作策略。

Abstract:
ObjectiveTo analyze and evaluate the effect of the mother-to-child HIV transmission prevention service in Yunnan province, identify exiting problems and related factors and provide the theoretical guidance for the prevention of mother to child HIV transmission.
MethodsThrough “National Mother to Child Transmission Management Information System for the Prevention of AIDS, Syphilis and Hepatitis B”, we collected information about maternal testing, interventions and follow-up management services in pregnant women in Yunnan from 2006 to 2019 for statistical analysis. Excel 2010 was used for data reduction. Besides, SPSS 20.0 was used for the descriptive analysis, analysis on change trend of annual index, and Q clustering analysis.
ResultsFrom 2006 to 2019, the HIV detection rate in pregnant women in Yunnan increased from 63.82% to 99.97%, and the detection rate in early pregnancy increased from 39.50% in 2014 to 71.59% in 2019. Maternal medication rate increased from 67.76% to 99.72%, and infant medication rate increased from 78.31% to 99.91%. The mother to child HIV transmission rate dropped from 34.8% before blocking to 1.93% in 2019. The clustering analysis on the effect of preventing mother to child transmission of HIV by using transmission rate and process index in 16 prefectures (municipality) showed four clusters. The first cluster included Kunming, Baoshan, Yuxi, Chuxiong, Dali, Xishuangbanna, Dehong; the second cluster included Zhaotong, Lincang, Qujing, Honghe, Pu'er, Wenshan; the third cluster included Nujiang and the fourth cluster included Lijiang and Diqing.
ConclusionThe AIDS prevention service model worked well in Yunnan, and it effectively reduced the mother to child transmission rate of HIV. Besides, based on the area specific differences in mother to child HIV transmission prevention, it is necessary to pay close attention to the prefectures which ranked second, third, and fourth in the clustering analysis. Moreover, it is recommended to develop targeted strategies based on the actual situation and scientific research and evaluation.

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