【摘要】 目的 了解2014—2023年攀枝花市医疗卫生机构不同样本来源艾滋病病毒（HIV）抗体检测及筛查阳性、确证阳性情况，为进一步优化HIV抗体检测发现策略，逐步推广全人群筛查策略提供科学依据。方法 通过中国疾病预防控制系统艾滋病防治基本信息系统，收集2014—2023年攀枝花市医疗卫生机构HIV抗体检测数据，通过描述性统计分析和χ2检验分析不同医疗卫生机构、不同样本来源的HIV抗体检测情况。结果 2014—2023年攀枝花市医疗卫生机构每年HIV抗体检测量从2014年的194 426人次上升至2023年的659 360人次，年平均增长14.53%。每年检测量主要来源于一般就诊者且逐年上升，年平均增长10.50%；每年筛查阳性数和确证阳性数主要来源于一般就诊者、自愿咨询检测（以下简称“VCT”）、重点人群（包括阳性者配偶或性伴检测、女性阳性者子女检测、职业暴露检测、娱乐场所人员体检，以下简称“重点人群”）和其他类人群。每年HIV抗体筛查阳性率和确证阳性率均是来源于监管场所样本最高且逐年下降，分别由2014年的61.935‰、48.825‰下降至2023年的14.226‰、5.858‰，其次为来源于VCT和性病门诊就诊者样本。每年来源疾控机构的样本HIV抗体筛查阳性率和确证阳性率均最高，但筛查阳性率呈先升后降，2015年最高51.258‰，2021年最低3.834‰（χ~2=1 285.782,P<0.001）；确证阳性率波动较大，且差异具有统计学意义（χ~2=1 107.903,P<0.001）。结论 攀枝花市今后应继续加强医疗机构一般就诊者HIV抗体检测；持续强化线上和线下相结合VCT服务；加强性病门诊就诊者和重点人群检测；最大限度检测发现病例，及早摸清我市疫情基数，采取有效措施遏制我市疫情的蔓延。更多还原

【Abstract】 Objective To understand the HIV antibody detection, and screening positive, confirmed positive status of medical and health institutions in Panzhihua City from 2014 to 2023, and to provide scientific basis for further optimizing the strategy of HIV antibody detection and gradually promoting the whole population screening strategy. Methods HIV antibody detection data of medical and health institutions in Panzhihua City from 2014 to 2023 were collected through the AIDS Prevention and Control Basic information system in the Chinese Disease Prevention and Control system, and the HIV detection of different medical institutions and different sample sources were analyzed by descriptive statistical analysis and Chi-square test. Results The number of HIV antibody detection of medical and health institutions in Panzhihua increased from 194 426 in 2014 to 659 360in 2023, and the average annual growth rate was 14.53%. The annual detection volume mainly came from general patients and increased year by year, and the average annual growth rate was10.50%, the annual number of positive screening and confirmed positive were mainly from the general patient, voluntary Consultation and Testing(VCT), key population(including testing for spouses or sexual partners of positive individuals、 testing for children of female positive individuals、 occupational exposure testing and physical examinations for personnel in entertainment venues), and other groups of people. The annual HIV antibody screening positive rate and confirmed positive rate were the highest in regulatory sites and decreased year by year from61.935‰, 48.825‰ in 2014 to 14.226‰ and 5.858‰ in 2023, the second were VCT and STD outpatient patients. Each year, the positive rate of HIV antibody screening and confirmed positive rate in CDC were the highest,but the positive rate of screening increased first and then decreased,with the highest rate of 51.258‰ in 2015 and the lowest rate of 3.834‰ in 2021（χ~2=1285.782,P<0.001）.The positive rate of confirmation fluctuated greatly and the difference was statistically significant（χ~2=1107.903,P<0.001）. Conclusions From now on,we should continue to strengthen the HIV antibody detection of general patients in medical institutions in Panzhihua City,the combination of online and offline VCT services should be continued to strengthen. The detection of STD outpatient and key population should be strengthen;We should maximize the detection of cases,find out the epidemic base of our city as early as possible, and finally take effective measures to curb the spread of the epidemic in our city.更多还原