Linkage to HIV care from a mobile testing unit in South Africa by different CD4 count strata.
Linkage to HIV care from a mobile testing unit in South Africa by different CD4 count strata.
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DOI：
10.1097/qai.0b013e31822e0c4c
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发表时间：
2011-11-01
期刊：
影响因子：
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通讯作者：
Bekker LG
中科院分区：
文献类型：
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作者：
Govindasamy D;van Schaik N;Kranzer K;Wood R;Mathews C;Bekker LG
以前没有描述过从流动艾滋病毒检测单位到以设施为基础的艾滋病毒护理的联系和障碍。在2008年8月至2009年12月期间，对所有符合条件的、新诊断的艾滋病毒感染者进行了分层随机抽样(N=192)，这些人的实验室CD4计数结果是在移动单元上进行的。所有CD_4计数为≤350 Cells/μ的个体L和30%CD_4计数>；350 Cells/μL个体被抽查。在2010年4月至6月期间，在那些收到CD4计数结果的患者中评估了与护理的联系。在检测后至少一次获得艾滋病毒护理的参与者被视为与护理有关。二项回归模型被用来确定与接受CD4计数结果和与护理相关的临床和社会人口学因素。43人(27%)没有收到他们的CD4计数结果。较低的CD4计数、女性和电话号码的可用性增加了收到这一结果的可能性。对其余145名患者进行了随访。42.4%的人拒绝参加，联系不成功。CD4200细胞/≤L患者的关联性为100%，CD4201-350Cells/μL患者为66.7%，CD4350Cells/μL患者为36.4%。较低的CD4值、披露情况、结核病症状的存在和失业增加了与护理相关联的可能性。与护理的联系在那些有资格接受抗逆转录病毒治疗的人中是最好的。迫切需要旨在改善就业人员之间联系的干预措施。
The linkage and barriers of linkage to facility-based HIV care from a mobile HIV testing unit have not previously been described. A stratified random sample (N=192) was drawn of all eligible, newly-diagnosed HIV-infected individuals with a laboratory CD4 count result on a mobile unit between August 2008 and December 2009. All individuals with CD4 counts ≤ 350 cells/μl and 30% of individuals with CD4 counts > 350 cells/μl were sampled. Linkage to care was assessed during April to June 2010 in those that received their CD4 count result. A participant who accessed HIV care at least once after testing was regarded as having linked to care. Binomial regression models were used to identify clinical and socio-demographic factors associated with receiving a CD4 count result and linking to care. Forty-three (27%) individuals did not receive their CD4 count result. A lower CD4 count, being female and the availability of a phone number increased the likelihood of receiving this result. Follow-up was attempted in the remaining 145 individuals. Ten refused to participate and contact was unsuccessful in 42.4%. Linkage was 100% in patients with CD4 counts ≤ 200 cells/μl, 66.7% in individuals with CD4 counts of 201-350 cells/μl and 36.4% in those with CD4 counts > 350 cells/μl. A lower CD4 count, disclosure, presence of TB symptoms and unemployment increased the likelihood of linking to care. Linkage to care was best among those eligible for ART. Interventions designed at improving linkage among employed individuals are urgently warranted.