HIV assisted partner services (aPS) to support integrated HIV and hypertension screening in Kenya: a pre-post intervention study.
HIV assisted partner services (aPS) to support integrated HIV and hypertension screening in Kenya: a pre-post intervention study.
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DOI：
10.1186/s12889-023-17205-2
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发表时间：
2023-12-01
影响因子：
4.5
通讯作者：
Bukusi, David
中科院分区：
文献类型：
--
作者：
Wamuti, Beatrice;Sambai, Betsy;Magambo, Christine;Ndegwa, Margaret;Macharia, Paul;Temu, Tecla M.;Farquhar, Carey;Bukusi, David
与未感染艾滋病毒的人相比，艾滋病毒感染者（PLWH）患高血压的风险更高。艾滋病毒辅助性伴侣服务（aPS），即艾滋病毒携带者在医疗保健提供者的协助下向性伴侣和/或注射毒品的伴侣披露其状况，提供了一个综合艾滋病毒和高血压筛查的机会。我们评估了在肯尼亚肯雅塔国家医院支持艾滋病毒和高血压综合筛查的aPS模型的可行性。在2019年8月至2020年12月期间，我们进行了一项干预前后研究。我们招募了接受艾滋病毒检测服务（HTS）并确诊高血压的女性（女性指数客户），并追踪她们的男性亲属进行艾滋病毒和高血压筛查，并在3个月时审查管理情况。高血压定义为收缩压（SBP）≥ 140 mmHg，舒张压（DBP）≥ 90 mmHg和/或使用降压药物。100名女性指数客户（中位年龄：55岁;四分位距（IQR）：47-65）提到了165名男性亲属（中位年龄：49岁; IQR：40-59），其中35%（n = 58/165）已入组。在男性亲属中，29%患有高血压（n = 17/58），34%患有高血压前期（n = 20/58），无HIV阳性（n = 0/58）。在女性指数客户中，SBP在统计学上显著下降（前：156 mmHg，后：133 mmHg，p值：< 0.0001）和DBP（术前：97 mmHg，术后：80 mmHg，p值：< 0.0001），以及抗高血压药物摄取增加（治疗前：91%，n = 84/92;治疗后：98%，n = 90/92; X2：4.3931，p值：0.036）。在男性亲属中，与基线相比，高血压患者的抗高血压药物摄入量在统计学上显著增加（术前：13%，n = 6/46;术后：17%，n = 8/46; X2：32.7750，p值：< 0.0001）。艾滋病毒aPS有望在高危客户及其家人中进行艾滋病毒和高血压综合筛查。29%的男性亲属患有高血压，高于全国患病率（24%），而三分之一患有高血压前期。我们观察到相对较高的参与者保留，血压降低，并增加降压药物的摄入与确诊的高血压。未来的研究需要通过更大规模的研究和更长时间的随访，将aPS模式扩展到其他非传染性疾病，以更好地评估因果关系和优化综合服务的提供。
People living with HIV (PLWH) have a higher risk of developing hypertension compared to HIV uninfected individuals. HIV assisted partner services (aPS), where PLWH are assisted by a healthcare provider to disclose their status to sexual and / or drug injecting partner(s), offers an opportunity for integrated HIV and hypertension screening. We evaluated the feasibility of the aPS model in supporting integrated HIV and hypertension screening at the Kenyatta National Hospital, Kenya. Between August 2019 and December 2020, we conducted a pre-post intervention study. We enrolled women receiving HIV testing services (HTS) with confirmed hypertension (female index clients) and traced their male relatives for HIV and hypertension screening and reviewed management at 3-months. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, and/or use of antihypertensive medication. One hundred female index clients (median age: 55 years; interquartile range (IQR): 47–65) mentioned 165 male relatives (median: 49 years; IQR: 40–59) of whom 35% (n = 58/165) were enrolled. Of the male relatives, 29% had hypertension (n = 17/58), 34% had pre-hypertension (n = 20/58), and none were HIV-positive (n = 0/58). Among the female index clients, there was a statistically significant decline in SBP (pre: 156 mmHg, post: 133 mmHg, p-value: < 0.0001) and DBP (pre: 97 mmHg, post: 80 mmHg, p-value: < 0.0001), and increase in antihypertensive medication uptake (pre: 91%, n = 84/92; post: 98%, n = 90/92; X2: 4.3931, p-value: 0.036) relative to baseline. Among the male relatives, there was a statistically significant increase in antihypertensive medication uptake among those with hypertension (pre: 13%, n = 6/46; post: 17%, n = 8/46; X2: 32.7750, p-value: < 0.0001) relative to baseline. HIV aPS holds promise for integrated HIV and hypertension screening among at-risk clients and their families. Twenty-nine percent of the male relatives had hypertension, higher than the national prevalence (24%), while one-third had pre-hypertension. We observed relatively high participant retention, reductions in blood pressure, and increase in antihypertensive medication uptake among those with confirmed hypertension. Future research expanding the aPS model to other non-communicable diseases through larger studies with longer follow-ups is required to better assess causal relationships and optimize integrated service delivery.
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DOI：
10.1016/s2352-3018(16)30214-4
发表时间：
2017-02
期刊：
The lancet. HIV
影响因子：
--
作者：
Cherutich P;Golden MR;Wamuti B;Richardson BA;Ásbjörnsdóttir KH;Otieno FA;Ng'ang'a A;Mutiti PM;Macharia P;Sambai B;Dunbar M;Bukusi D;Farquhar C;aPS Study Group
通讯作者：
aPS Study Group
使用肯尼亚的常规健康信息系统对HIV辅助合作伙伴服务的监视。
影响因子：
3.5
作者：
Cherutich P;Golden M;Betz B;Wamuti B;Ng'ang'a A;Maingi P;Macharia P;Sambai B;Abuna F;Bukusi D;Dunbar M;Farquhar C
通讯作者：
Farquhar C
影响因子：
2.8
作者：
Ramezankhani, Azra;Guity, Kamran;Hadaegh, Farzad
通讯作者：
Hadaegh, Farzad
影响因子：
3.1
作者：
Henley, Catherine;Forgwei, Gideon;Muffih, Pius Tih
通讯作者：
Muffih, Pius Tih
影响因子：
3.2
作者：
Rutstein, Sarah E.;Brown, Lillian B.;Miller, William C.
通讯作者：
Miller, William C.