Analysis of the timeliness and influencing factors of antiretroviral treatment among HIV/AIDS patients in Hubei Province from 2017 to 2023
Objective To analyze the timeliness and influencing factors of antiretroviral treatment (ART) among HIV/AIDS patients in Hubei Province from 2017 to 2023. Methods Data were selected from the National AIDS Comprehensive Prevention and Treatment Information System for HIV-infected individuals and AIDS patients residing in Hubei Province from January 1,2017,to December 31,2023. Timely treatment was defined as the interval between diagnosis and the initiation of ART being ≤30 days,and non-timely treatment as>30 days. The annual timely treatment rates were calculated,and a time trend regression analysis of these rates was conducted using the Joinpoint regression program 4.9.0.0. The annual percentage change (APC) and average annual change percentage (AAPC) were computed to evaluate the global average change trend across intervals. Cox univariate and multivariate analyses were used to assess the impact of the patient's basic characteristics such as gender,age at diagnosis,ethnicity,education level,infection route,etc. Results Among the 21332 HIV/AIDS patients,81.52％ were male,and the median age at diagnosis was 43 years (range:28-56 years). The proportion of patients initiating antiretroviral therapy within 30 days of diagnosis increased from 45.12％ in 2017 to 67.61％ in 2023,showing an upward trend in the timely treatment rate from 2017 to 2023 (AAPC=6.90). Cox multivariate analysis indicated that females were more likely to initiate treatment in a timely manner after diagnosis (HR=1.15,95％CI:1.1-1.21). Compared to cases aged 50 or above,younger age groups had lower treatment timeliness,with HRs (95％CI) of 0.79 (0.76-0.83) for those aged 25～<50,0.67 (0.63-0.72) for those aged 15～<25,and 0.55 (0.33-0.91) for those aged 0～<15. Non-Han ethnicities showed lower timeliness in treatment initiation (HR=0.91,95％CI:0.83-0.99). Individuals with high school or technical secondary school education,and those with college or higher education,had lower treatment timeliness,with HR (95％CI) of 0.92 (0.88-0.97) and 0.97 (0.92-1.02),respectively. Married or partnered,and divorced or widowed individuals had lower treatment timeliness,with HR (95％CI) of 0.89 (0.86-0.94) and 0.8 (0.76-0.85),respectively. Cases in detention facilities had lower treatment timeliness (HR=0.37,95％CI:0.29-0.47). Cases from counseling and testing,and other sources had higher treatment timeliness,with HR (95％CI) of 1.09 (1.04-1.15) and 1.07 (1.0-1.15),respectively. Lower initial CD4+T lymphocyte counts were associated with higher treatment timeliness. Conclusions The timely treatment among HIV-infected individuals and AIDS patients in Hubei Province has improved year by year from 2017 to 2023. Gender,age at diagnosis,education level,marital status,infection route,sample source,and first CD4+T lymphocyte status are all factors that determine the timely treatment of HIV/AIDS.
万方数据
维普
