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目的:分析2006-2019年台州市HIV/AIDS立即抗病毒治疗（ART）的影响因素，探讨不同ART策略与免疫学效果随时间变化的关联。方法:采用回顾性队列研究和logistic回归模型分析立即ART影响因素，采用n t检验和n χ2检验比较不同ART策略的免疫学效果差异，采用Kaplan-Meier（K-M）法绘制生存曲线。n 结果:2006-2019年台州市2 971例HIV/AIDS中，立即ART组1 786例（占60.1%），其中2016-2019年立即ART的比例为77.8%（1 170/1 504）。2006-2019年立即ART组的成功率（87.4%，1 561/1 786）高于延迟ART组（84.4%，1 000/1 185）。多因素logistic回归分析结果显示，HIV/AIDS立即ART的影响因素中，男性（an OR=1.28，95n %CI：1.03~1.59）、已婚（an OR=1.71，95n %CI：1.33~2.19）、基线CDn 4+T淋巴细胞（CDn 4）计数≤200个/μl（an OR=1.60，95n %CI：1.27~2.02）与立即ART呈正相关；31~40岁（an OR=0.63，95n %CI：0.48~0.84）、感染途径为异性性传播（an OR=0.60，95n %CI：0.49~0.74）、确证时间为2015年及以前（an OR=0.20，95n %CI：0.17~0.23）与立即ART呈负相关。立即ART组各年份CDn 4/CDn 8比值的增幅和ART累积成功率均大于延迟ART组（n P<0.05）。n 结论:2006-2019年台州市HIV/AIDS立即ART策略落实较好，立即ART比例超过60.0%，立即ART组的ART免疫学效果较好。针对HIV/AIDS中31~40岁、女性、未婚和异性性传播者，需加强立即ART的健康教育工作，进一步提高ART效果。“,”Objective:To analyze influencing factors of instant antiretroviral therapy (ART) and explore associution between strategies of ART and immunological effects among HIV/AIDS patients in Taizhou city during 2006-2019.Methods:A retrospective cohort study was conducted on HIV/AIDS patients under ART, and a logistic regression model was used to analyze factors of instant ART. The student n t-test and chi-square test were used to compare immunological effect of different ART strategies while the Kaplan-Meier method was used to generate a survival curve.n Results:A total of 2 971 HIV/AIDS patients were enrolled with 1 786 cases (60.1%) having instant ART strategy. The proportion of instant ART were 77.8% (1 170/1 504) during 2016 to 2019. The treatment success rate of the instant ART group (87.4%, 1 561/1 786) were higher than the delayed ART group (84.4%, 1 000/1 185). The results of multivariate logistic regression model indicated that male (an OR=1.28, 95n %CI: 1.03-1.59), married (an OR=1.71, 95n %CI: 1.33-2.19) and baseline CDn 4+T lymphocyte cells (CDn 4) counts ≤200 cells/μl (an OR=1.60, 95n %CI: 1.27-2.02) were factors positively related to instant ART while 31-40 years old (an OR=0.63, 95n %CI: 0.48-0.84), infected through heterosexual transmission(an OR=0.60, 95n %CI: 0.49-0.74) and diagnosed before 2015 (an OR=0.20, 95n %CI: 0.17-0.23) were inversely related to instant ART. The increase of the CDn 4/CDn 8 ratio was greater, and the cumulative ART success rate was higher each year in the instant ART group than in the delayed ART group (n P<0.05).n Conclusions:The instant ART strategy has been well implemented in Taizhou city during 2006-2019, and the immunological effect was better in instant ART group. The proportion of instant ART were more than 60.0% among HIV/AIDS patients. Instant ART strategy needs to be strengthened for those who are 31-40 years old, women, unmarried, and infected through heterosexual transmission in an attempt to further increase treatment level and improve treatment effect.