Increasing uptake of HIV testing and counseling among the poorest in sub-Saharan countries through home-based service provision.
Increasing uptake of HIV testing and counseling among the poorest in sub-Saharan countries through home-based service provision.
复制标题
通过基于家庭的服务提供，撒哈拉以南国家最贫穷的艾滋病毒测试和咨询的吸收增加。
DOI：
10.1097/qai.0b013e31819c1726
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发表时间：
2009-06-01
期刊：
影响因子：
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通讯作者：
Mkandawire J
中科院分区：
文献类型：
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作者：
Helleringer S;Kohler HP;Frimpong JA;Mkandawire J
撒哈拉以南国家最贫困家庭成员对艾滋病毒检测和咨询 (HTC) 的接受率较低，因此在获得 HTC 和可能的抗逆转录病毒治疗方面造成了严重的不平等。衡量家庭 HTC 的使用情况并估计撒哈拉以南地区最贫困家庭成员的艾滋病毒感染率。利科马岛（马拉维）6 个村庄的 18-35 岁居民及其配偶获得了家庭 HTC 服务。评估了社会经济状况、艾滋病毒检测史和艾滋病毒危险因素。使用逻辑回归估计了最低收入四分位数家庭成员与其他人口之间 HTC 吸收率和 HIV 感染率的差异。收入最低四分位数的家庭成员使用基于设施的 HTC 服务的可能性明显低于其他人口（OR = 0.60，95% CI：0.36-0.97）。相比之下，他们更有可能使用研究期间提供的家庭 HTC 服务（aOR = 1.70，95% CI：1.04–2.79）。家庭 HTC 吸收的社会经济差异并不是由于社会经济特征或艾滋病毒危险因素的根本差异造成的。在家庭 HTC 测试中，最贫困家庭成员的艾滋病毒感染率明显低于其他人群（aOR=0.37，95% CI：0.14-0.96）。在利科马岛举办的家庭 HTC 活动期间，HTC 的使用率很高，尤其是在最贫困的人群中。以家庭为基础的 HTC 有可能显着降低 HTC 吸收中现有的社会经济梯度，并有助于减轻艾滋病对最脆弱家庭的影响。
Uptake of HIV testing and counseling (HTC) is lower among members of the poorest households in sub-Saharan countries, thereby creating significant inequalities in access to HTC and possibly ARV treatment. To measure uptake of home-based HTC and estimate HIV prevalence among members of the poorest households in a sub-Saharan population. Residents of 6 villages of Likoma Island (Malawi) aged 18–35 and their spouses were offered home-based HTC services. Socioeconomic status, HIV testing history and HIV risk factors were assessed. Differences in HTC uptake and HIV infection rates between members of households in the lowest income quartile and the rest of the population were estimated using logistic regression. Members of households in the lowest income quartile were significantly less likely to have ever used facility-based HTC services than the rest of the population (OR = 0.60, 95% CI: 0.36–0.97). In contrast, they were significantly more likely to use home-based HTC services provided during the study (aOR = 1.70, 95% CI: 1.04–2.79). Socioeconomic differences in uptake of home-based HTC were not due to underlying differences in socioeconomic characteristics or HIV risk factors. The prevalence of HIV was significantly lower among members of the poorest households tested during home-based HTC than among the rest of the population (aOR=0.37, 95% CI: 0.14–0.96). HTC uptake was high during a home-based HTC campaign on Likoma Island, particularly among the poorest. Home-based HTC has the potential to significantly reduce existing socioeconomic gradients in HTC uptake, and help mitigate the impact of AIDS on the most vulnerable households.