Effects And Influencing Factors Of Rapid Antiviral Therapy

Objective To evaluate the effectiveness of rapid initiation of antiviral treatment for newly diagnosed male-to-male HIV/AIDS case in the intervention cities and control cities in the "13th Five-Year Plan" rapid antiviral treatment project.And to explore the influencing factors of the lack of rapid antiviral treatment for HIV/AIDS in the intervention citiesMethods Part 1: Based on the national rapid antiviral treatment project,selecting data from information management system for the prevention and control of HIV/AIDS project for ten cities(including baoding,langfang,yantai,kunshan,jinhua,taizhou,changzhou,yancheng,foshan,fuzhou)intervention and ten cities(including shijiazhuang,jinan,Qingdao,ningbo,jiaxing,wuxi,xuzhou,zhenjiang,zhuhai and xiamen),in July 2019 to December 2019 newly diagnosed infections of the HIV/AIDS transmission by men as the research object.Demographic information(excluding any personal information),time of onset,time of confirmation,first medication date and some other information were collected at the beginning of treatment.The time of initiation of antiviral therapy,the 3-month ART rate and the retention rate were compared between the intervention and control group.Part 2: Among the intervention cities,Ningbo,Jinan,Qingdao,Shijiazhuang,Wuxi and Qingdao,which had more confirmed cases of HIV/AIDS during July 2019 to December2019,were selected to study the newly found HIV/AIDS in MSM during the intervention period.Through the way of online questionnaire survey,understand fast antiviral treatment group,delayed the treatment group and treatment group research object of social demographic characteristics,economic conditions,the cause of the antiviral treatment,not quick to accept antiviral treatment cause,the cause of the untreated and ART cognition,diagnosed with health,family support,etc.Results Part 1: A total of 2110 subjects were included in the study,904 in the control group and1206 in the intervention group.Compared with the control group,more HIV/AIDS in the intervention group initiate ART within 14 days,more HIV/AIDS in the intervention group,and the ART initiate rate within 30 days was higher too(P <0.001).There was no significant difference in the retention rate between the control group and the intervention group.Multivariate Logistic regression analysis showed that subjects with intervention(OR=0.35,95%CI: 0.29~0.42),other counties in the city(OR=0.66,95%CI:0.47~0.93),the county(OR=0.51,95%CI: 0.36~0.70),and those who had been diagnosed with AIDS at the time of discovery(OR=822.34,95%CI: 103.99~6503.10)were more likely to start antiviral treatment within two weeks after confirmation.However,those infected with other ethnic groups(OR=2.17,95%CI: 1.12-4.19)and samples from thematic survey(OR=1.41,95%CI: 1.14-1.75)were more likely to delay antiviral treatment.Part 2: A total of 310 HIV/AIDS who were transmitted by homosexual route were included in the cross-sectional study,194 in the rapid group,85 in the delayed ART group,and 31 in the untreated group.The composition of the most important reasons for starting antiviral therapy was approximately the same in the rapid treatment group and the delayed treatment group.In the delayed treatment group of 85 subjects,the main reasons for delayed antiviral treatment included: "delayed treatment due to work or business trip"(32.9%),"delayed treatment due to other diseases"(18.8%),"fear of exposure of infection status"(15.3%).In the second part,the main reasons for not starting antiviral therapy in the 31 subjects of the untreated group included: "not being ready to take drugs for life"(29.0%),"fear of drug side effects"(22.6%),and "fear of exposure of infection status"(16.1%).The 310 subjects were asked eight questions about antiviral treatment and the question "How long should I take the anti-HIV drugs?" "Was the most accurate(100.0%,310/310),followed by" Should asymptomatic AIDS patients continue to take their medication? " "(92.5%,287/310),while " Do you think you should receive immediate treatment if you are diagnosed with HIV " and " Do you know about rapid antiviral treatment?" The correct rates of the two questions were61.9%(192/310)and 46.6%(144/310),respectively.Conclusions Rapid antiviral treatment intervention measures can shorten the time for the study subjects to start antiviral treatment and improve the coverage rate of antiviral treatment in three months.The promotion of this measure is conducive to promoting the AIDS prevention and control work in China and realizing the "90-90-90" prevention and control goal as soon as possible.Study has found that age,cultural degree,ART knowledge and peer support are factors that influence the intervention project prompt intervention city should be increased to young people and the low level of culture crowd the propaganda,in collaboration with NGOs,peer education,and the cooperation between NGOs,local volunteers on a regular basis with team among MSM backbone training,Better promotion of rapid antiviral interventions in MSM populations.