构建一类具有VCT(voluntary counseling and testing)意识及媒体报道影响的HIV/AIDS感染动力学模型.首先得到模型解的适定性,并给出模型的基本再生数.其次,借助Hurwitz判别法及Lyapunov函数分析模型的阈值动力学,当R_(0)<1时无病平衡点局部渐近稳定且当R_(0)≤1时全局渐近稳定;当R_(0)>1时,地方病平衡点局部渐近稳定.进一步,结合持续生存理论给出疾病的一致持续性.最后,数值模拟表明随着VCT意识比例的提高,艾滋病患者人数的峰值逐渐降低,而随着信息失效率的增大,艾滋病患者人数的峰值将有所提高.
Introduction:Human immunodeficiency virus(HIV)voluntary counseling and testing(VCT)clinics play a critical role in identifying and diagnosing HIV cases.This study aimed to describe the trend of HIV positivity rate(HPR)among Chinese VCT clinics between 2015 and 2022.Methods:This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022.The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests,multiplied by 100%.To identify temporal and spatial trends in the HPR,we employed joinpoint regression analysis and the Getis-Ord hotspot analysis.Results:From 2015 to 2022,VCT clinics in China performed a total of 22,075,386 HIV tests,leading to the identification of 260,353 HIV cases,resulting in a HPR of 1.18%.The HPR consistently declined over the study period,with an average annual percent change(AAPC)of−7.5%(95%confidence interval:−12.6%,−2.2%,P<0.05).The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022.These HPR hotspots were primarily located in Yunnan,Sichuan,Guangdong,and Guangxi provincial-level administrative divisions(PLADs).Among the 31 PLADs,16 showed a significant decrease in HPR during the study period(AAPC<0,PAAPC<0.05).Conclusions:VCT clinics in China have played a significant role in identifying HIV cases.The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations.Therefore,it is crucial to further improving the utilization of VCT clinics for HIV testing.
目的研究深圳市坪山区2019—2022年自愿咨询检测(voluntary counseling and testing,VCT)人群中血液传染病病原构成及变迁,为VCT人群中血液传染病的精准防控提供科学依据。方法对VCT人群参照《中国艾滋病诊疗指南(2018版)》检测人类免疫缺陷病毒(HIV)抗体,采用酶联免疫吸附法(ELISA)检测梅毒螺旋体(TP)、丙肝病毒(HCV)抗体及乙肝病毒表面抗原(HBsAg),统计上述4种病原构成及变化特征。结果共检测VCT标本533份,病原阳性率为21.76%,各年间差异无统计学意义(χ^(2)=4.166,P=0.244)。阳性人群主要是有性行为相关危险史的中青年男性,但不同人口学特征人群阳性率差异均无统计学意义。感染类型包括单独感染、双重感染和三重感染,HIV单重感染(8.44%)、TP单重感染(9.01%)及HBsAg单独携带(7.88%)、HCV感染(0.56%)、HIV+TP感染(2.81%)、HIV+HBsAg感染(1.31%)、TP+HBsAg感染(0.38%)及HIV+TP+HBsAg三重感染(0.38%)的阳性率差异有统计学意义(χ^(2)=153.311,P<0.001);单重感染阳性率差异无统计学意义(χ^(2)=0.208,P=0.901)。结论深圳市坪山区2019—2022年VCT人群中存在4种血液传染病病原体感染,不同感染类型阳性率及年度阳性人群构成差异主要集中在危险行为史,可根据以上特征制定血液传染病防控措施。
