目的 探讨人类免疫缺陷病毒（human immunodeficiency virus,HIV）暴露后预防（post-exposure prophylaxis，PEP）就诊者疾病进展恐惧（fear of progression，FoP）变化轨迹及其影响因素，为改善该类人群的恐惧心理提供参考。方法 2023年5-10月，采用便利抽样选取江苏省南京市某传染病专科医院的PEP就诊者204例为研究对象，在就诊的第1、14、30天采用疾病进展恐惧量表、领悟社会支持量表等对其调查，应用潜类别增长模型识别其FoP轨迹类别，采用单因素分析及多元Logistic回归分析其影响因素。结果 第1、14、30天时就诊者FoP得分分别为47.00(37.25,56.00)分、42.00(33.00,49.00)分和31.50(22.25,45.00)分，其FoP轨迹分为高恐惧缓慢下降组、中恐惧显著下降组和低恐惧组3种类别，其社会支持得分分别为38.00(41.00,47.00)分、47.00(37.00,66.00)分和54.00(38.50,59.00)分；3个类别的PEP就诊者在性别、教育水平、职业和社会支持得分等方面差异均有统计学意义（均P＜0.05）。性别、职业、社会支持是PEP就诊者FoP轨迹类别的影响因素（均P＜0.05）。结论 发生HIV暴露后就诊者在就诊1个月内，FoP水平变化程度不同，其FoP轨迹存在群体异质性。

Objective To explore the trajectory of changes in fear of progression(FoP) and its influencing factors in attendees with HIV post-exposure prophylaxis(PEP) and to provide reference for improving the fear psychology of the population.Methods From May to October 2023,204 PEP attendees from an infectious disease hospital in Nanjing,Jiangsu Province were selected by the convenience sampling method.The Fear of Progression Scale and Perceptive Social Support Scale were used to investigate them at the 1st,14th and 30th day of treatment,and the latent category growth model was used to identify their FoP trajectory categories.Single factor analysis and multiple logistic regression were used to analyze the influencing factors.Results The FoP scores were 47.00(37.25,56.00),42.00(33.00,49.00) and 31.50(22.25,45.00) at day 1,14 and 30,respectively.Their FoP tracks were divided into three categories:high fear slow decline group,medium fear significant decline group and low fear group.Their social support scores were 38.00(41.00,47.00)， 47.00(37.00,66.00) and 54.00(38.50,59.00),respectively.Three categories of PEP patients had statistically significant differences in gender,education level,occupation and social support scores(all P＜0.05).Gender,occupation and social support were the factors influencing the FoP trajectory category of PEP patients(all P＜0.05).Conclusions The degree of change in FoP levels among attendees seeking medical attention after HIV exposure varies within one month of their visit,and there is heterogeneity in their FoP trajectories.

R473.51

南京市卫生科技发展专项资金项目（ykk21123）；江苏省研究生培养创新工程研究生科研与实践创新项目（sjcx23_0838）