Study On HIV/AIDS Epidemic Characteristics And Determinants Of Death In Elderly People In A City

Objective:To study HIV/AIDS epidemic characteristics, the death and its determinants in elderly people in Zhangjiajie city, so as to provide scientific evidence for the government prevention and care measures.Methods:The information of elderly HIV/AIDS people who lived in Zhangjiajie and held local residency during1995-2012were downloaded from China Information System For Disease Control And Prevention. Descriptive study was used to explain social demography, route of transmission and so on. Survival time and cause of death were analyzed. The trend Chi-squre test was implemented for the infection rate of newly reported HIV cases and the mortality rate every year. Proportional hazards regression model was conducted to analyze the risk factors of deaths. Statistical software is SPSS18.0.Results:(1) The cumulative number of elderly HIV/AIDS people during1995-2012was333, including194AIDS patients and182deaths. Of all,78.08%live in Yongding district,233cases were male, the ratio of male with female was2.33:1, the average age was (65.33±0.63), the age ranged from50to88,90.09%was peasants,92.79%was lower than junior high school level,70.27%was Tujia,65.17%had been married and had a spouse. The main infection route was heterosexual transmission(96.70%),2.70%were blood transfusion, and0.30%were male same-sexual transmission.(2) Of182death,140cases were male,75were live in urban area,162were peasants,129had been married and had a spouse,127were Tujia,166were lower than junior high school level,6had STDs,173were heterosexual transmission,76were tested CD4+T cell。49had received antiretroviral-treated(ART).(3) The average annual mortality rate of older HIV-positive adults in Zhangjiajie was2.56/100,000and annual mortality rate was increasing with years (Χtrend2=164.38, P<0.001). The median survival time was25.00months overall. The results from multiple regression analysis indicated that antiretroviral-treated(ART)(RR=0.141,95%CI:0.073～0.271), the baseline CD4+T cell count (RR=0.271,95%CI:0.162～0.454)and the time length of diagnosis of AIDS(RR=0.468,95%CI:0.297～0.738) were significantly associated with death among elderly HIV/AIDS people.Conclusion:(1) It is important to prevent and intervene the elderly from HIV infection.(2) The mortality rate of elderly HIV/AIDS people is increasing. The ART, the baseline CD4+T cell count and the time length of diagnosis of AIDS are main factors for deaths.