| Objective: To analyze the prevalence and spatial epidemic characteristics of HIV infection among pregnant women in Hunan province from 2010 to 2020,analyze the situation of mother-to-child transmission of AIDS in Hunan Province,explore its influencing factors,and provide a theoretical basis for the prevention and control of HIV infection in pregnant women and prevention of mother-to-child transmission of AIDS.Methods: The data on HIV infection among pregnant women and children born to infected women in Hunan province from 2010 to 2020 were obtained through the information management system of mother-tochild transmission of AIDS,Syphilis and Hepatitis B.Excel 2019 and SPSS 26.0 were used for data collation and traditional epidemiological analysis.Arc GIS 10.7,Geo Da 1.18.0 and Sa Tscan 9.7 were used for spatial autocorrelation analysis,spatiotemporal scanning analysis and spatial regression analysis.The Chi-square test,Fisher’s exact probability and Logistic regression model were used to analyze the influencing factors of mother-to-child transmission of AIDS.Results:(1)From 2010 to 2020,there were 8119401 puerperae in medical institutions at all levels in Hunan Province,among which6,726,915 were tested for HIV antibody,with an average test rate of82.85%.A total of 1,909 pregnant women with HIV infection were reported,with an average positive rate of 255/10,000.The positive rate reached 3.65/10,000 in 2020.There was no obvious seasonal distribution of the monthly positive rate.The high incidence areas were Chenzhou,Hengyang,and Yiyang.The high-risk population was 23 to 35 years old(60.56%),the education background was junior high school(52.44%),the occupation was housework and unemployed(40.65%)and farmer(37.09%).The main route of infection was sexual transmission(49.03%).(2)Global spatial autocorrelation showed that HIV infection in pregnant women in Hunan province was aggregated in 2010 and 2017.Local spatial autocorrelation showed that the incidence hotspots were mainly concentrated in Hengyang,Huaihua,Yongzhou,Chenzhou,Shaoyang,Zhuzhou,Xiangxi Tujia and Miao Autonomous Prefecture and Loudi.The results of spatiotemporal scanning analysis showed that HIV infection in pregnant women in Hunan province in 2010,2011,2012,2014,2015,2016,2017,2019 and 2020 was Spatio-temporal clustering,and the clustering months were From July to December.The main gathering centers are Leiyang City,Yongxing County,Hengnan County,Yanfeng District,New Huang Dong Autonomous County and Yizhang County.The results of spatial regression analysis showed that the urbanization rate in2010 was positively correlated with the HIV-positive rate of pregnant women.(3)From 2011 to 2020,38 children born to HIV-infected mothers were infected with HIV and 584 children were not infected with HIV.The average rate of mother-to-child transmission of AIDS in Hunan province from 2011 to 2020 was 7.40%,of which the rate was 2.40% in 2020.The results of logistic regression analysis showed that women with HIV infection confirmed during pregnancy had a higher risk of mother-to-child transmission than those with HIV infection confirmed before pregnancy(OR=4.71,95%CI: 1.57-14.20).Compared with cesarean section,vaginal delivery had a higher risk of mother-to-child transmission(OR=2.42,95%CI: 1.20-4.89).The use of antiretroviral drugs in infected mothers was a protective factor for mother-to-child transmission of HIV(OR=0.28,95%CI: 0.13-0.58).Conclusion:(1)The average positive rate of HIV tests in pregnant women in Hunan province from 2010 to 2022 was 2.55/10,000,among which the positive rate was 3.65/10,000 in 2022.There was no obvious seasonal or periodic distribution of HIV-positive rate in pregnant women in Hunan Province and the high incidence areas are Chenzhou,Hengyang,Yiyang and other cities.(2)HIV infection in pregnant women in Hunan province was spatially clustered,and the hotspots were mainly concentrated in Hengyang,Huaihua,Yongzhou,etc.The main gathering months of temporal and spatial scanning analysis are From July to December,and the main gathering centers are Leiyang City,Yongxing County,Hengnan County,Yanfeng District,New Huang Dong Autonomous County and Yizhang County.(3)The average rate of motherto-child transmission of AIDS in Hunan province from 2011 to 2020 was7.40%,of which the rate was 2.40% in 2020.Period of HIV infection,delivery mode,and application of anti-HIV drugs in pregnant women were the influencing factors of mother-to-child transmission of AIDS. |
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