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目的:探讨影响艾滋病病毒(HIV)感染孕产妇所生儿童失访的因素。方法:以2005~2010年云南省结束保健随访管理的2 238例HIV感染孕产妇所生儿童为研究对象,收集其母亲孕期、产时、产后至儿童满18个月的个案调查资料,采用单因素χ2检验和多因素Logistic回归分析,揭示儿童失访的影响因素。结果:2 238例HIV感染孕产妇所生儿童,失访493例,失访占22.03%;儿童出生6个月内失访占49.09%。儿童失访的影响因素是复杂的,医务人员预防艾滋病母婴传播工作(PMTCT)咨询质量,家庭流动,母亲文化程度、职业,母亲孕产期是否服用抗病毒药物可能是主要因素。结论:降低HIV感染孕产妇所生儿童失访是一个系统工程,需要全社会参与,提高医务人员责任心,规范PMTCT服务,关注重点人群,是减少儿童失访的重要措施。
Objective: To investigate the factors that affect the loss of follow-up of children born to pregnant women with HIV infection. Methods: A total of 2 238 pregnant women with HIV-infected mothers were enrolled in this study. Their mothers were collected during the period of pregnancy, pregnancy, childbirth and children from 18 months to 18 months after the end of health care follow-up in Yunnan Province. Factors χ2 test and multivariate Logistic regression analysis revealed the factors that influence the children’s follow-up. Results: There were 498 cases of HIV-infected pregnant women born with maternal infection, accounting for 22.03% of the total missing children; 49.09% of the children lost their mothers within 6 months of birth. The factors that influence child lay-up are complex. The quality of counseling for PMTCT, family mobility, mother’s education level, occupation, and mother’s motherhood may be the main factors for the loss of follow-up. Conclusion: To reduce the number of HIV-infected pregnant women born to children lost to follow-up is a systematic project, which requires the whole society to participate in, improve medical staff’s sense of responsibility, standardize PMTCT services and focus on key populations. It is an important measure to reduce the number of children lost to follow-up.