Patient Attrition Between Diagnosis With HIV in Pregnancy-Related Services and Long-Term HIV Care and Treatment Services in Kenya: A Retrospective Study
Patient Attrition Between Diagnosis With HIV in Pregnancy-Related Services and Long-Term HIV Care and Treatment Services in Kenya: A Retrospective Study
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DOI：
10.1097/qai.0b013e318253258a
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发表时间：
2012-07-01
影响因子：
3.6
通讯作者：
Ross, David A.
中科院分区：
文献类型：
--
作者：
Ferguson, Laura;Lewis, James;Ross, David A.
背景资料：一直很少有人注意，直到最近，连接妇女谁测试艾滋病毒阳性的妊娠相关的服务，长期的艾滋病毒护理和治疗service.Methods：常规医院的数据进行了回顾性分析，在肯尼亚的2家医院。可用的人口统计信息和艾滋病毒相关的服务在妊娠相关服务的艾滋病毒诊断6个月内的摄取之间的关联进行了评估，使用逻辑回归。Kaplan-Meier生存分析用于评估HIV诊断和在HIV诊所登记之间的时间。结果：在奈瓦沙医院，6个月内在艾滋病毒诊所登记的妇女比例为17.2%（153 892）;在Gilgil医院，这是35.4%（84 237）。在奈瓦沙和吉尔吉尔，分别有40%和27%的已知合格妇女开始了高效抗逆转录病毒治疗。观察到艾滋病毒诊所对首次接触的客户进行非系统登记，以及由于费用和开放时间而限制服务的提供。在奈瓦沙，2009年，多次与怀孕有关的就诊和在奈瓦沙医院接受产前护理与在艾滋病毒诊所登记有关。在Gilgil，一年，出席多次妊娠相关的访问，妇女在其第一次怀孕与outcome.Conclusions：只有4%的妇女估计需要HAART为自己的护理启动HAART在6个月内的艾滋病毒诊断。在人口高度流动的背景下，与提供纵向护理相关的挑战尤其明显。需要在提供服务方面进行创新，以提高服务的利用率。
Background: There has been little attention, until recently, to linking women who test HIV positive in pregnancy-related services to long-term HIV care and treatment services.Methods: A retrospective review of routine hospital data was carried out in 2 hospitals in Kenya. Associations between available demographic information and uptake of HIV-related services within 6 months of HIV diagnosis in pregnancy-related services were assessed using logistic regression. Kaplan-Meier survival analysis was used to assess time between HIV diagnosis and registration at the HIV clinic. Referrals between pregnancy-related and HIV-related services were observed.Results: At Naivasha hospital, the proportion of women registering at the HIV clinic within 6 months was 17.2% (153 of 892); at Gilgil hospital, it was 35.4% (84 of 237). Highly active antiretroviral therapy (HAART) was initiated by 40% and 27% of known eligible women in Naivasha and Gilgil, respectively. Non-systematic registration of clients on first contact at the HIV clinic, and restricted availability of services due to costs and opening hours were observed. In Naivasha, year, attendance at multiple pregnancy-related visits, and attendance at antenatal care in Naivasha hospital were associated with registration at the HIV clinic. In Gilgil, year, attendance at multiple pregnancy-related visits, and women being in their first pregnancy were associated with the outcome.Conclusions: Only 4% of women estimated to need HAART for their own care initiated HAART within 6 months of HIV diagnosis. Challenges associated with providing longitudinal care are especially evident in the context of high population mobility. Innovation in service delivery is required to improve uptake of services.