目的 探讨HIV感染产妇所生儿童(HIV暴露儿童)失访的发生情况及影响因素.方法 收集2010-2021年南宁市上报的HIV暴露儿童及其父母个案资料,采用趋势x2检验和Logistic回归模型对儿童失访的变化趋势和影响因素进行分析.结果 2010-2021年南宁市HIV暴露儿童1 269例,发生失访127例,失访率为10.01％.失访率由2010年的30.10％下降至2021年的0,呈下降趋势(x2趋势=70.52,P＜0.001).母亲文化程度小学及以下、未婚/同居、流动人口、新发感染、孕早期未检查、产前检查＜5次、孕期未进行CD4细胞计数检测、孕期未进行病毒载量检测、母亲未cART、父亲未接受HIV抗体检测者的儿童失访率相对较高(P＜0.05).多因素分析显示,流动人口(aOR=1.87,95％CI:1.22～2.85)、新发现感染(aOR=1.83,95％CI:1.19～2.83)、产前检查＜5次(aOR=2.30,95％CI:1.42～3.74)、母亲未抗病毒治疗(aOR=4.47,95％CI:2.62～7.64)、父亲未接受 HIV 抗体检测(aOR=1.92,95％CI:1.23～2.99)是 HIV 暴露儿童发生失访的独立危险因素.结论 南宁市HIV暴露儿童失访率处于较低水平,但父母预防母婴传播服务利用不足时,其所生儿童失访率较高;充分利用失访的影响因素,采取针对性干预措施,尽可能较少失访.
Status and factors related to loss to follow-up among HIV-exposed children in Nanning
Objective This study aimed to explore the status of and factors related to loss to follow-up among children born to HIV-infected mothers(HIV-exposed children)in Nanning.Methods Data on HIV-exposed children and their parents reported during the period of 2010-2021 in Nanning were collected.The chi-square trend test and logistic regression analysis were conducted to investigate the trend and influencing factors of loss to follow-up among these children.Results Between 2010 and 2021,a total of 1 269 HIV-exposed children were reported in Nanning,among whom 127 were lost to follow-up,resulting in an incidence rate of 10.01％.The incidence of loss to follow-up exhibited a decreasing trend,declining from 30.10％in 2010 to 0 in 2021(x2trend=70.52,P＜0.001).Factors associated with a higher incidence of loss to follow-up included mothers with primary school education or below,single or cohabiting status,unsettled residency,recent HIV infection,inadequate prenatal care(less than five visits),lack of CD4+cell count or viral load testing during pregnancy,as well as absence of combination antiretroviral therapy(cART)for the mother and HIV antibody testing for the father(P＜0.05).Multivariate analysis revealed that maternal unsettled residency(aOR=1.87,95％CI:1.22-2.85),new HIV infection(aOR=1.83,95％CI:1.19-2.83),fewer than five prenatal visits(aOR=2.30,95％CI:1.42-3.74),lack of antiviral therapy(for the mother aOR=4.47,95％CI:2.62-7.64),and absence of HIV antibody testing for the father(aOR=1.92,95％CI:1.23-2.99)were independent risk factors for loss to follow-up among HIV-exposed children.Conclusions Although the incidence of loss to follow-up among HIV-exposed children in Nanning is currently low,parental non-participation in prevention of mother-to-child transmission services increases the risk of loss to follow-up in their children.Targeted intervention measures based on these identified risk factors should be implemented to minimize loss to follow-up among HIV-exposed children.
HIV-exposed childrenloss to follow-upinfluencing factorsmother-to-child transmission
NETL
NSTL
万方数据
