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目的对新报告艾滋病病毒(HIV)感染者的高危行为接触者进行追踪调查并检测HIV,以最大程度地发现HIV感染者,探讨其作为新的艾滋病检测策略的费用效果。方法 2008年8月1日至10月31日,对云南省陇川县新发现的本地HIV感染者及其所提供的高危行为接触者,进行追踪调查和HIV检测(以下简称“溯源调查”),对高危行为接触者中原HIV阳性或通过本次检测新发现的HIV阳性者,同样作进一步的溯源调查。结果累计完成了4个层次的溯源调查,共调查109名HIV感染者。共提供高危行为接触者1 293人,其中1 102人(85.2%)因无姓名或详细地址而无法作进一步的追踪调查,62人(4.8%,其中死亡21人)在艾滋病疫情库中已记录为HIV感染者,另有129人(10.0%,其中死亡20人)有姓名和详细地址但HIV感染状况不清者中,65人接受了HIV检测,从中新发现18例HIV阳性,检测阳性率为27.7%。此次调查共耗资7 572元,平均每新发现1例HIV感染者耗资420.67元。结论溯源调查可以有效地发现高危行为接触者和HIV感染者,成本可接受。但未来的溯源调查需要解决严重的拒访和失访问题。
Objective To track the high-risk contacts of newly reported HIV-infected individuals and test HIV to maximize the detection of HIV-infected individuals and to explore their cost-effectiveness as a new HIV testing strategy. Methods From August 1 to October 31, 2008, follow-up surveys and HIV testing were conducted on newly discovered local HIV-infected individuals and their contacts with high-risk behaviors in Longchuan County, Yunnan Province (hereinafter referred to as "), For high-risk behavior of contacts in Central Plains HIV-positive or through this test found that HIV-positive persons, also for further traceability survey. Results A total of 4 levels of traceability surveys were completed and a total of 109 HIV-infected persons were investigated. A total number of 1 293 persons were found to be among the highest risk behaviors. Among them, 1,102 (85.2%) were unable to conduct further follow-up surveys due to lack of names or detailed addresses and 62 (4.8%, of whom 21 died) were recorded in the AIDS epidemic outbreak Among those with HIV infection, 65 (10.0%, 20 deaths) have full name and full address but HIV infection is unclear. Totally 65 HIV-positive patients were tested positive for HIV, 27.7%. The survey cost a total of 7 572 yuan, an average of every new case of HIV infection 420.67 yuan. CONCLUSIONS Traceability surveys can be effective in detecting high-risk behavioral contacts and HIV-infected persons at an acceptable cost. However, the future traceability investigation will need to address the serious problem of refusing to visit and losing.