Interventions for prevention of mother-to-child HIV transmission in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region: success rate, timeliness and patient compliance

Shouxue QIN; Jiankun TAN; Rongguang SHI; Hongyan WU; Yanli NONG; Yuqing CHENG; Bingyan LU

doi:10.16016/j.1000-5404.201803078

您当前的位置：

首页 >

文章列表页 >

Interventions for prevention of mother-to-child HIV transmission in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region: success rate, timeliness and patient compliance

Public Health and Preventive Medicine | 更新时间：2026-01-09

- Interventions for prevention of mother-to-child HIV transmission in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region: success rate, timeliness and patient compliance
- Journal of Third Military Medical University Vol. 40, Issue 18, Pages: 1704-1710, 封三(2018)
- 作者机构：
  
  1.537100 广西贵港，贵港市妇幼保健院保健部
  2.537200 广西桂平，桂平市妇幼保健院妇产科
  3.537300 广西平南，平南县妇幼保健院保健部
  4.537300 广西平南，平南县人民医院感染科
- 作者简介：
- 基金信息：
  
  the Project of Scientific Research and Technology Development Plan of Guigang(GKC1504041)
- DOI：10.16016/j.1000-5404.201803078
  CLC： R373.9;R725.129.1;R978.7
- Received：11 March 2018，
  
  Revised：2018-05-02，
  
  Published：30 September 2018
- 稿件说明：
移动端阅览
Shouxue QIN, Jiankun TAN, Rongguang SHI, et al. Interventions for prevention of mother-to-child HIV transmission in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region: success rate, timeliness and patient compliance[J]. Journal of Third Military Medical University, 2018, 40(18): 1704-1710, 封三.
DOI：

Shouxue QIN, Jiankun TAN, Rongguang SHI, et al. Interventions for prevention of mother-to-child HIV transmission in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region: success rate, timeliness and patient compliance[J]. Journal of Third Military Medical University, 2018, 40(18): 1704-1710, 封三. DOI： 10.16016/j.1000-5404.201803078.

摘要

目的

系统评价广西部分高流行区人类免疫缺陷病毒(human immunodeficiency virus

HIV)母婴阻断效果及及时性、依从性，探讨相关影响因素。

方法

2011年1月至2017年9月，采取非概率整群抽样和随访观察研究，对广西部分艾滋病高流行区内319例调查对象进行母婴阻断干预，从传播率、及时性和依从性等方面了解HIV母婴阻断效果，采用Logistic回归模型分析接受干预及时性和依从性的相关影响因素。

结果

继续妊娠HIV感染孕产妇用药率为95.92%(306/319)；安全分娩率70.51%(225/319)，呈逐年升高趋势(

=2.03，

=0.042)，累计分娩活婴295例；儿童用药率98.31%(290/295)，人工喂养率98.64%(291/295)，早期诊断率96.20%(152/158)，18月龄抗体检测率93.90%(277/295)，随访率97.97%(289/295)，死亡率1.69%(5/295)，失访率4.1%(12/295)。HIV母婴传播率1.06%(校正1.92%)。HIV母婴阻断及时性好率54.86%(175/319)，其影响因素包括稳定住址、妊娠意愿、确认时间、艾滋病认知、配偶支持和焦虑情绪。HIV母婴阻断依从性好率52.04%(162/319)，其影响因素包括文化程度、稳定住址、产前保健次数、病毒载量、CD4水平、艾滋病认知、配偶支持和焦虑情绪。

结论

广西贵港市等部分艾滋病高流行区HIV母婴阻断成功率比较高，但母婴阻断及时性及依从性差，服务利用质量有待提高。

Abstract

Objective

To systematically evaluate the effect of the interventions for preventing mother-to-child HIV transmission and explore the factors affecting the timeliness of these interventions and the patient compliance in regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region.

Methods

Between January

2011 and September

2017

using a non-probability cluster sampling method with follow-up observation

we conducted interventions for preventing mother-to-child HIV transmission in 319 HIV-infected pregnant women in some regions with a high HIV/AIDS prevalence in Guangxi Zhuang Autonomous Region. The transmission rate

timeliness of administration and compliance with the interventions were assessed to evaluate the effect of these interventions

and a logistic regression model was used to analyze the factors influencing the timeliness of the interventions and the patient compliance.

Results

The rate of antiviral drug administration was 95.92% (306/319) in these HIV-infected pregnant women who chose to continue pregnancy. The overall safe delivery rate was 70.51% (225/319)

and the annual safe delivery rate tended to increase with time (Z=2.03

=0.042). A total of 295 live births were recorded

and 98.31% (290/295) of the children were given antiviral drugs; the artificial feeding rate was 98.64% (291/295) in these children; 96.20% (152/158) of the children received services for early diagnosis and 93.90% (277/295) were detected for HIV antibody at 18 month. The follow-up rate of the children was 97.97% (289/295)

with a mortality rate of 1.69% (5/295) and a loss to follow-up rate of 4.1% (12/295). The mother-to-child HIV transmission rate was 1.06% (1.92% after correction) in these cases. The rate of optimal timing of the transmission-preventing interventions was 54.86% (175/319)

and the factors influencing the timeliness of the interventions included stability of address

pregnancy intention

confirmation time

AIDS awareness

spouse support and anxiety. The good compliance rate with the interventions was 52.04% (162/319)

and was influenced by the factors including the level of education

stability of address

frequency of antenatal care

viral load

CD4 level

AIDS awareness

spouse support and anxiety.

Conclusion

In these selected regions with a high HIV/AIDS prevalence

the interventions for preventing mother-to-child HIV transmission resulted in a relatively high success rate

but the timeliness of administration and compliance with these interventions

along with the quality of service utilization

remain to be improved.

关键词

Keywords

references

KOVAROVA M, SHANMUGASUNDARAM U, BAKER C E, et al . HIV pre-exposure prophylaxis for women and infants prevents vaginal and oral HIV transmissionin a preclinical model of HIV infection[J ] . J Antimicrob Chemother, 2016, 71(11): 3185-3194. DOI: 10.1093/jac/dkw283.

SIDIBÉ M, SINGH P K. Thailand eliminates mother-to-child transmission of HIV and syphilis[J]. Lancet, 2016, 387(10037): 2488-2489. DOI: 10.1016/S0140-6736(16)30787-5.

赵文宇, 俞海亮, 叶少东, 等.中国三省386例HIV感染者和艾滋病患者抗病毒治疗服药依从性及其影响因素分析[J].中华预防医学杂志, 2016, 50(4): 334-338.DOI:10.3760/cma.j.issn.0253-9624.2016.04.010.

ZHAO W Y, YU H L, YE S D, et al . Factors associated with adherence of highly active antiretroviral therapy among 386 HIV/AIDS patients in 3 provinces of China[J ] . Chin J Prev Med, 2016, 50(4): 334-338. DOI:10.3760/cma.j.issn.0253-9624.2016.04.010.

代容, 冯婧, 唐茂芝, 等.中国2004-2010年艾滋病母婴传播率及母婴阻断药物应用状况的系统评价[J].第二军医大学学报, 2014, 35(10): 1094-1102. DOI: 10.3724/SP.J.1008.2014.01094.

DAI R, FENG J, TANG M Z, et al . Mother-to-child transmission rate of HIV and use of drugs to prevent the transmission in China: a systematic review[J ] . Acad J Sec Mil Med Univ, 2014, 35(10): 1094-1102.DOI: 10.3724/SP.J.1008. 2014.01094.

ZOU H, DAI X, MENG X, et al .HIV/AIDS-related know-ledge, attitudes, and sexual practices among migrant wives in rural Anhui province, China[J ] . J AIDS Clin Res, 2014, 5(7): 319-324. DOI: 10.4172/2155-6113.1000319.

WANG A L, QIAO Y P, WANG L H, et al . Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China[J ] . Bull World Health Organ, 2015, 93(1): 52-56. DOI:10.2471/BLT.14.139626.

DINH T H, DELANEY K P, GOGA A, et al . Impact of maternal HIV seroconversion during pregnancy on early mother to child transmission of HIV (MTCT) measured at 4-8 weeks postpartum in South Africa 2011-2012: A National Population-Based Evaluation[J ] . PLoS ONE, 2015, 10(5): e0125525.DOI: 10.1371/journal.pone.0125525.

RUTON H, MUGWANEZA P, SHEMA N, et al . HIV-free survival among nine-to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey[J ] . J Int AIDS Soc, 20 12, 15(1): 1-17. DOI: 10.1186/1758-2652-15-4.

高洁, 王映霞, 吴颖岚, 等.湖南省2010-2013年预防艾滋病母婴传播情况分析[J].实用预防医学, 2015, 22(7): 778-780. DOI: 10.3969/j.issn.1006-3110.2015.07.003.

GAO J, WANG Y X, WU Y L, et al . Analysis on prevention of mother-to-child transmission of HIV (PMTCT) work in hunan province in 2010-2013[J ] . Prac Prev Med, 2015, 22(7): 778-780.DOI: 10.3969/j.issn.1006-3110.2015.07.003.

单多, 王娟, 孙江平, 等.云南省德宏州2011-2013年预防艾滋病、梅毒和乙型肝炎母婴传播效果研究[J].中华预防医学杂志, 2014, 48(11): 942-946. DOI: 10.3760/cma.j.issn.0253-9624.2014.11.005.

SHAN D, WANG J, SUN J P, et al . A study on the effectiveness of prevention of mother-to-child HIV, syphilis, and hepatitis B transmission among pregnant women in Dehong prefecture, Yunnan province, China from 2011 to 2013[J ] . Chin J Prev Med, 2014, 48(11): 942-946. DOI: 10.3760/cma.j.issn.0253-9624.2014.11.005.

SIDIB M, SINGH P K.Thailand eliminates mother-to-child transmission of HIV and syphilis[J].Lancet, 2016, 387(10037): 2488-2489. DOI: 10.1016/S0140-6736(16)30787-5.

WAND H, RAMJEE G. Identifying factors associated with low-adherence and subsequent HIV seroconversions among South African women enrolled in a biomedical intervention trial[J]. AIDS Behavior, 2017, 21(2): 393-401. DOI:10.1007/s10461-016-1471-1.

SOVANNARITH S, SOKLENG S, ROMAING T, et al . Uptake of interventions for preventing mother-to-child HIV transmission in 11 operational districts in Cambodia[J ] . Western Pac Surveill Response J, 2012, 3(3): 22-28. DOI:10.5365/WPSAR.2012.3.2.009.

汤后林, 许娟, 韩晶, 等. 2010-2014年中国新报告HIV感染者和艾滋病患者抗病毒治疗及时性及影响因素分析[J].中华预防医学杂志, 2017, 51(8): 711-717.DOI:10.3760/cma.j.issn.0253-9624.2017.08.010.

TANG H L, XU J, HAN J, et al . An analysis of factors associated with timeliness of antiretroviral therapy initiation among newly diagnosed HIV/AIDS from 2010 to 2014 in China[J ] . Chin J Prev Med, 2017, 51(8): 711- 717.DOI: 10.3760/cma.j.issn.0253-9624.2017.08.010.

AUERBACH J D, KINSKY S, BROWN G, et al . Know-ledge, attitudes, and likelihood of pre-exposure prophylaxis (PrEP) use among US women at risk of acquiring HIV[J ] . AIDS Patient Care STDS, 2015, 29(2): 102-110. DOI:10.1089/apc.2014.0142.

PARK J, NACHMAN S. The link between religion and HAART adherence in pediatric HIV patients[J]. AIDS Care, 2010, 22(5): 556-561.DOI: 10.1080/0954012090 3254013.

SHETH S S, COLEMAN J, CANNON T, et al . Association between depression and nonadherence to antiretroviral therapy in pregnant women with perinatally acquired HIV[J ] . AIDS Care, 2015, 27(3): 350-354. DOI: 10.1080/09540121. 2014.998610.

GLASHEEN C, COLPE L, HOFFMAN V, et al . Prevalence of serious psychological distress and mental health treatment in a national sample of pregnant and postpartum women[J ] . Matern Child Health J, 2015, 19(1): 204-216. DOI:10.1007/s10995-014-1511-2.

SCHNACK A, REMPIS E, DECKER S, et al . Prevention of mother-to-child transmission of HIV in option B+era: uptake and adherence during pregnancy in western uganda[J ] . AIDS Patient Care STDs, 2016, 30(3): 110-118. DOI: 10.1089/apc.2015.0318.

TREISMAN K, JONES F W, SHAW E. The experiences and coping strategies of united kingdom-based african women following an HIV diagnosis during pregnancy[J]. J Assoc Nurses AIDS Care, 2014, 25(2): 145-157. DOI:10.1016/j.jana.2013.01.008.

MATTHEWS L T, RIBAUDO H B, KAIDA A, et al .HIV-infected ugandan women on antiretroviral therapy maintain HIV-1 RNA suppression across periconception, pregnancy, and postpartum periods[J ] .J Acquir Immune Defic Syndr, 2016, 71(4): 399-406. DOI: 10.1097/QAI.0000000000 000874.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Compliance and influencing factors for endoscopic surveillance in patients with chronic atrophic gastritis: An analysis of 1 196 cases

Establishment of a risk prediction for tuberculosis infection model in HIV-infected/AIDS patients

Establishment and validation of a prediction model for liver injury in HIV/AIDS patients

Plateaued CD4+ T count and its influencing factors in HIV infected patients after long-term antiviral treatment

Prediction of new cases of HIV infection and AIDS in Chongqing: data fitting and comparative analysis of 3 prediction models

Related Author

WU Meng

CHEN Lei

GAO Zhi

蒋红

蒋秋

陈瑞华

郑小燕

陈倩立

Related Institution

Department of Gastroenterology， First Affiliated Hospital（Southwest Hospital）， Army Medical University （Third Military Medical University）

Department of Military Epidemiology, College of Military Preventive Medicine, Third Military Medical University

⁰