Missed opportunities for HIV testing among newly diagnosed HIV-infected adults in Abidjan, Cote d'Ivoire
Missed opportunities for HIV testing among newly diagnosed HIV-infected adults in Abidjan, Cote d'Ivoire
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DOI：
10.1371/journal.pone.0185117
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发表时间：
2017-10-04
期刊：
影响因子：
3.7
通讯作者：
Danel, Christine
中科院分区：
文献类型：
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作者：
Inghels, Maxime;Niangoran, Serge;Danel, Christine
背景HIV检测对于HIV感染者早期开始ART至关重要。我们描述错过的机会（MO）为艾滋病毒检测新诊断的艾滋病病毒在阿比让，Cote d 'Ivoire.MethodsBetween四月，2nd 2013年和四月1日2014年，一项横断面研究进行了所有新诊断的成年人（<1年）在阿比让献血者医疗中心与面对面的问卷调查。艾滋病毒检测的MO定义为针对临床指标的医疗咨询（例如症状、住院和妊娠）或非临床指标（例如高风险性行为，HIV感染的伴侣）可能与HIV感染有关，但没有导致健康护理专业人员提出HIV检测建议。273例患者（157例女性和116例男性）被纳入本分析。130人（47.6%）报告在诊断前1个月至5年内至少有一次与检测建议相关的指标的医疗咨询。其中，92例（77.3%）至少经历了一次MO检测。纳入的273例患者共报告了216项指标，其中146项（67.6%）未报告检测方案，因此为MO。住院、体重极度下降、慢性或反复发热、带状疱疹是MO发生最多的指标。虽然66（24.2%）的患者经历了非临床指标相关的HIV感染的风险，只有11（4.0%）提到它的健康professional.ConclusionMO HIV检测是频繁的，即使在测试的情况下，明确建议。更好地培训医疗保健专业人员，创造新的机会，在医疗环境内外进行检测，对改善艾滋病毒控制至关重要。
BackgroundHIV testing is crucial for starting ART earlier in HIV-infected people. We describe Missed Opportunities (MO) for HIV testing among adults newly diagnosed with HIV in Abidjan, Cote d'Ivoire.MethodsBetween april, 2nd 2013 and april 1st 2014, a cross-sectional study was conducted among all adults newly diagnosed (< 1year) for HIV at the Blood Donors Medical Center of Abidjan with face to face questionnaire. An MO for HIV testing was defined as a medical consultation for a clinical indicator (e.g. symptoms, hospitalization, and pregnancy) or a non-clinical indicator (e.g. high-risk sexual behavior, HIV-infected partner) potentially related to an HIV infection but did not lead to HIV test proposal by a health care professional.ResultsOf the 341 patients who attended the center suring this period, 273 (157 women and 116 men) were included in this analysis. 130 (47.6%) reported at least one medical consultation for an indicator relevant for a test proposal between 1 month and five years prior to their diagnosis. Among them, 92 (77.3%) experienced at least one MO for testing. The 273 included patients reported a total of 216 indicators; 146 (67.6%) were reported without test proposal and thus were MO. Hospitalization, extreme lose of weight, chronic or repeat fever and herpes zoster were the indicators with the largest number of MO. While 66 (24.2%) patients experienced non-clinical indicators relevant to risk of HIV infection, only 11 (4.0%) mentioned it to a health professional.ConclusionMO for HIV testing are frequent, even in situations for which testing is clearly recommended. Better train healthcare professionals and creating new opportunities of testing inside and, outside of medical settings are crucial to improve HIV control.