Study Of Follow-up Management For People Living With HIV In Linhai City

Part 1 Study of Follow-up Management for People Living with HIV in Linhai City[Objective] To evaluate the follow-up management of people living with HIV in Linhai city; and further determine a better suitable method of follow-up management.[Methods] All people living with HIV in Linhai city was invited to participate in this cross-sectional survey. Information included their sexual behaviors, antiretroviral treatment (ART) and its side effects, etc., as well as HIV testing history and HIV status of their spouse (or partner) were collected by trained interviewers. Excel was used for data entry and descriptive analysis, SPSS was used for explorative analysis.[Results] A total of 184 HIV-infected persons were included. (1) Most of them are Han (96.7%), local resident (79.3%), married (63.6%), with an education level of junior middle school (51.6%). The average age was 38.6 years with a standard deviation of 11.8 years, ranging from 20 to 49 years (82.6%). Career has no obvious characteri sti-cs. housekeepers and unemployerd.95.1% were infected through sexual transmission, including 26.9% homosexual transmission and 73.1% heterosexual transmission. (2)The rate of Follow-up Management for People Living with HIV is a trend of increase-ing. Beginning in 2007, increase the size of the increase, the proportion of the current year report follow-up from 2003 to 2013 of 10 years is showed from low to high, then stay above 90%. The rate of follow-up management was significant different before and after 2007 (x2=21.3, P=0.000).(3)There is one side has HIV-positive in Couples, on the part of the follow-up management found that spouses HIV antibody positive rate of 0.11 HIV-positive pregnant women received HIV medicine to prevent mother to child transmission, the rate reached 90.9%. Management of condom use among people infected with HIV follow-up showed a rising trend year by year, by the statistical test, the difference was statistically significant between each year(x2=51.6, P=0.000).(4) 1998-2013 at the beginning of the survival of HIV infections increased year by year, when the disease than a downward trend in the composition of the death, since 2007, the composition of live in die earlier than also showed a trend of decline.(5) AIDS antiviral treatment, drug resistance and no drug resistance, both compliance difference was statistically significant. (x2=62.2, P=0.000).106 after receiving AIDS antiviral treatment,82 after a year of disease treatment load are 0 CPS/ml,77.4%. Using the optimal scale regression model analysis the treatment of AIDS patients of CD4+T cell growth factor, before the treatment compliance, treatment showedCD4+[Conclusion] Our findings indicate that the current follow-up management was effective, which highlight the importance of importance of standard-ization of follow-up management for people living with HIV With the increa-seing number of people living longer with HIV, the sustainability and feasibility of current CDC management model will face a big challenge, highlighting a need of ex-tending management from CDC to the hospital and the community. The CDC-hospital community management model may be more effective in integrating all aspects of resources and meeting the needs in the future outbreak development and management.Part 2 Linhai city qualitative interview survey among people infected with HIV[Objective] Understanding of linhai city people living with HIV is the survival of the status quo, psychological state, so as to more fully understand their understanding of AIDS, the opinions and Suggestions for the work of the follow-up management and its requirements, etc., to provide supplementary information for quantitative study.[Methods] Choose different profession and different ages, different gender, different sources of linhai city people living with HIV infection, in the form of a chat to open group interview. As far as possible to the recording, and record the language information notes, late into the interview transcript document. In the qualitative investigation section, after the participants willing to ask for written informed consent, questionnaire survey was conducted by the investigators.[Results] An interview five problems, (1)People living with HIV AIDS knowledge awareness, investigation of 15 awareness of HIV/AIDS knowledge among people infected with HIV are reaching a higher level, the witting rate was 93.3%, but in their life and family contact there are concerns, so still have considerable pressure on the mental and psychological.(2) Learned that the changes of the psychological state of the infection, the most concerned about. Interview people living with HIV will be mixed in various emotions, including fear, regret, remorse, inferiority, anxiety pessimistic psychology, psychology of the lonely and obstinate rebellious attitude, etc. But at the same time has a very strong desire to survive. (3) Their infection status inform way, survival present situation and the demand.73.3% of the people, are more willing to inform his family, the spouse/partner,26.7% of people are willing to the medical staff to help him or her. Living conditions and requirements, Is the first AIDS related social discrimination and social demands on the people living with HIV, 93.7% of the population, are in strict confidentiality under the infection status of life, in addition to their family and spouse, not willing to tell anyone, very worried about their illness leaked, social discrimination against HIV/AIDS in them is very obvious. The psychological needs of people living with HIV:HIV infected people’s heart has continued his own life, is an urgent need to family, society gives them more understanding and care. Survive in the absence of discrimination and exclusion of environment, moral encouragement and hope to get around the crowd psychological comfort. It is vital for their later life. Medical demand status quo of the third people living with HIV:when was confirmed after HIV infection to overcome the psychological fear period, people living with HIV began family counseling about the treatment of AIDS and how to prevent infection and related knowledge. With the progress of the disease, the emergence of AIDS related disease, more and more demand for healthcare, into the AIDS issue, antiviral treatment, prevention and treatment of opportunistic infection, the patient hospitalization prolonged, has increased the demand for medical institutions and family care.(4) Perceptions of HIV/AIDS antiviral treatment, the influence factors of treatment adherence. AIDS antiviral treatment was 90%, but their hearts more hope can be completely cured, because I can no longer be so discrimination, can be relaxed to a good life. (5) Eager to take the medicine treatment. Can accept the trinity management mode.[Conclusion] Look from infected the result of the interview, people living with HIV to understand AIDS knowledge of prevention and cure are, and know the dangers of AIDS, laid the foundation of its change original risk behavior, are not to be ignored, but the psychological changes and demand for people living with HIV in addition to the expensive drugs and treatment technology, the most can not be ignored and "emotional therapy", on the follow-up management is a main way to realize the emotional therapy, for HIV infection itself and control outbreaks can have a good effect. Face at present, the AIDS epidemic situation of HIV infection by the unilateral management, will be unable to withstand, adverse to contain the outbreak, and it needs to consider the strengths of all parties, the management of people living with HIV, there are both centralized and decentralized treatment at the hospital, follow-up in the community, epidemiological investigation and technical guidance and daily management in CDC model of trinity. So the management of patients can do more detailed comprehensive.