背景:气候变化,以全球气温稳步上升和气候模式不断升级的不可预测性为特征,全球公共卫生面临多方面的挑战。然而,弱势群体,特别是受艾滋病毒/艾滋病影响的人群,很少受到关注。
目的:我们旨在研究温度变化对艾滋病相关死亡率的影响。
方法:从2013年至2019年的HIV/AIDS综合反应信息管理系统中收集了有关HIV/AIDS患者的数据。温度变化指标由昼夜温度范围(DTR)构成,相邻天之间的温度变化(TCN),和温度变异性(TV0-t)。使用条件逻辑回归模型的时间分层病例交叉设计来研究环境温度变化与AIDS相关死亡率之间的关系。
结果:DTR每升高1°C,在0-6天的滞后时间内,AIDS相关死亡率增加5.28%[95%置信区间(CIs):1.61,9.08]。与单身人士相比,已婚人士的DTR与艾滋病相关死亡率之间的关联更强。在1°C下,相应的过量OR(%)为5.33(95%CIs:0.29,10.62)与4.79(95%CIs:-0.50,10.36)在DTR滞后0-6天增加。此外,我们注意到DTR的影响在温暖的季节更加明显,导致在滞后0-6天的DTR升高1°C时,艾滋病相关死亡率的风险升高7.32%(95%CIs:0.57,14.51),而在寒冷季节,效应值降至5.16%(95%CIs:0.71,9.81)。
结论:我们的研究结果表明,在环境温度变化指标中,DTR可能是艾滋病相关死亡的重要危险因素,并强调在旨在降低艾滋病相关死亡率风险的公共卫生干预措施中考虑温度变化的重要性。
BACKGROUND: Climate change, characterized by the steady ascent of global temperatures and the escalating unpredictability of climate patterns, poses multifaceted challenges to public health worldwide. However, vulnerable groups, particularly the population affected by HIV/AIDS, have received little attention.
OBJECTIVE: We aimed to examine the impacts of temperature variations on AIDS-related mortality.
METHODS: Data on individuals with HIV/AIDS were collected from the HIV/AIDS Comprehensive Response Information Management System between 2013 and 2019. Temperature variation metrics were constructed by diurnal temperature range (DTR), temperature changes between neighboring days (TCN), and temperature variability (TV0-t). Time-stratified case-crossover design with conditional logistic regression models was used to investigate the associations between ambient temperature variations and AIDS-related mortality.
RESULTS: Each 1 °C elevated in DTR was linked with a 5.28 % [95 % confidence intervals (CIs): 1.61, 9.08] increment in AIDS-related mortality at a lag of 0-6 days. Stronger associations between DTR and AIDS-related mortality were observed in the married than in single, with corresponding excess ORs (%) of 5.33 (95 % CIs: 0.29, 10.62) versus 4.79 (95 % CIs: -0.50, 10.36) for 1 °C increased in DTR at lag 0-6 days. Additionally, we noticed the impact of DTR was more pronounced in the warm season, leading to a 7.32 % (95 % CIs: 0.57, 14.51) elevation in the risks of AIDS-related mortality for 1 °C increase in DTR at lag 0-6 days, while the effect value decreased to 5.16 % (95 % CIs: 0.71, 9.81) in the cold season.
CONCLUSIONS: Our findings indicated that DTR might be a significant risk factor for AIDS-related deaths among ambient temperature variation indicators, and underscored the importance of considering temperature variability in public health interventions aimed at mitigating this risk of AIDS-related mortality.