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目的调查新疆伊犁哈萨克自治州(伊犁州)艾滋病报告病例中传播途径误报的发生原因,为首次随访工作提出针对性改进建议。方法现场核查自2011年以来伊犁州六县(市)报告的所有HIV/AIDS病例传播途径,对经调查发现的传播途径误报者(298例)及其随访员进行深入访谈了解具体误报原因。结果传播途径误报者主要为将注射吸毒(141例)及其他与不详(96例)误报为异性传播、占79.5%(237/298),误报原因主要为担心公安部门知道自己吸毒后实施抓捕,或害怕他人知道自己吸毒后影响家人、歧视自己,选择隐瞒;调查对象否认有高危行为,认为是通过拔牙、剃须等途径感染,而工作人员由于网络直报指标限制,不能填报过多的其他,加之怀疑调查对象言语的真实性,选择填报为异性传播;经住院、门诊或大筛查等途径发现的感染者,首次随访人员询问技巧不够专业,内容不够仔细,发生误报。结论针对各种误报原因制定符合新疆伊犁州的首次随访建议,包括事前制定各类易发生误报情况的应对措施;尊重调查对象的问询回答结果,不做个人主观判断;对医生、护士等非疾病预防控制部门首次随访工作者需加强首次随访培训,以及首次随访后应继续了解感染者的个人信息,尤其是那些工作人员怀疑其信息真实性及传播途径判断为其他或不详者。
Objective To investigate the causes of false positives of transmission in HIV / AIDS cases in Yili Kazakh Autonomous Prefecture (Ili Prefecture) in Xinjiang Uygur Autonomous Region (Ili Prefecture), and to put forward suggestions for improving the first follow-up. Methods On-site verification of all HIV / AIDS cases reported by the six counties in Yili Prefecture since 2011 Misinterpreted patients (298 cases) and their follow-up interviewed were investigated in depth to find out the causes of specific false alarms . Results The main causes of false positives were transmission of injecting drug abuse (141 cases) and other misidentifications (96 cases), accounting for 79.5% (237/298). The main reasons for false positives were the public security departments’ knowledge that they were drug addicts Those who were interviewed denied having high-risk behavior and believed that they were infected by means of tooth extraction and shaving, while staff members could not fill in due to the limitation of direct online reporting Too many others, together with the suspicion of the authenticity of the respondent’s speech, choose to report as heterosexual transmission. Those infected by inpatient, outpatient or large screening found that the skills of the first follow-up staff were not professional enough, the content was not careful enough and false positives occurred . Conclusion The first follow-up recommendations in line with the causes of false positives were formulated in accordance with the first follow-up of Yili Prefecture in Xinjiang, including various measures to deal with false positives in advance. Respecting the respondents’ answers to the inquiries did not make personal subjective judgments; Other first-time follow-up workers in non-CDM departments need to strengthen first-time follow-up training and should continue to understand the personal information of PLWHA after the first follow-up, especially if the staff suspects the authenticity of the information and the route of transmission is judged as other or unknown.