Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic
Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic
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DOI：
10.1097/olq.0000000000000529
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发表时间：
2016-11-01
影响因子：
3.1
通讯作者：
Golden, Matthew R.
中科院分区：
文献类型：
--
作者：
Myers, R. Serene;Feldacker, Caryl;Golden, Matthew R.
背景协助伴侣服务（APS）涉及为人类免疫缺陷病毒（HIV）感染者提供协助，通知和检测他们的性伴侣。在撒哈拉以南非洲，很少有得到援助的伙伴服务。我们制定了一个试点APS计划在马普托，Mozambo.Methods 2014年6月至9月，社区卫生工作者（CHW）提供APS的人与新诊断的艾滋病毒（索引患者[IP]）。社区卫生工作者在基线、第4周和第8周采访了IP。在基线时，社区卫生工作者建议IP通知合作伙伴并鼓励他们进行艾滋病毒检测，但不直接通知合作伙伴。在第4周，CHW直接通知合作伙伴。我们比较了4周和8周的结果，估计APS对合作伙伴的通知，艾滋病毒检测和艾滋病病例finding.Results的影响，社区卫生工作者提供了223个IP APS，其中220（99%）接受; CHW收集完整的后续数据206人，79%是妇女，74%已婚，50%命名>1性伴侣。索引患者在基线时命名了262名HIV阴性伴侣。在APS前4周，IP通知了193名伴侣（74%），但只有82名（31%）进行了HIV检测; 43名（13%）HIV检测呈阳性。由于提供了协助伙伴服务，又通知了22名伙伴，对83名伙伴进行了检测，并有43名新的艾滋病毒诊断。相对而言，APS增加了13%，101%和125%的伴侣通知，检测和艾滋病毒病例发现。在206名执行伙伴中，有72名（35%）正在建立艾滋病毒血清不一致伙伴关系。只有2.5个IP需要接受APS来识别先前未诊断的HIV感染伴侣或正在进行的HIV血清不一致伴侣关系。两个（1%）IP报告APS相关的不良事件。结论协助合作伙伴服务是可以接受的莫桑比克新诊断的艾滋病毒，确定大量的血清不一致的伙伴关系和未确诊的艾滋病毒的人，并构成不良事件的风险低。
Background Assisted partner services (APS) involves offering persons with human immunodeficiency virus (HIV) assistance notifying and testing their sex partners. Assisted partner services is rarely available in sub-Saharan Africa. We instituted a pilot APS program in Maputo, Mozambique.Methods Between June and September 2014, community health workers (CHWs) offered APS to persons with newly diagnosed HIV (index patients [IPs]). Community health workers interviewed IPs at baseline, 4 and 8 weeks. At baseline, CHWs counseled IPs to notify partners and encourage their HIV testing, but did not notify partners directly. At 4 weeks, CHWs notified partners directly. We compared 4- and 8-week outcomes to estimate the impact of APS on partner notification, HIV testing and HIV case finding.Results Community health workers offered 223 IPs APS, of whom 220 (99%) accepted; CHWs collected complete follow-up data on 206 persons; 79% were women, 74% were married, and 50% named >1 sex partner. Index patients named 262 HIV-negative partners at baseline. At 4 weeks, before APS, IPs had notified 193 partners (74%), but only 82 (31%) had HIV tested; 43 (13%) tested HIV positive. Assisted partner services resulted in the notification of 22 additional partners, testing of 83 partners and 43 new HIV diagnoses. In relative terms, APS increased partner notification, testing, and HIV case finding by 13%, 101%, and 125%. Seventy-two (35%) of 206 IPs were in ongoing HIV serodiscordant partnerships. Only 2.5 IPs needed to receive APS to identify a previously undiagnosed HIV-infected partner or an ongoing HIV serodiscordant partnership. Two (1%) IPs reported APS-related adverse events.Conclusions Assisted partner services is acceptable to Mozambicans newly diagnosed with HIV, identifies large numbers of serodiscordant partnerships and persons with undiagnosed HIV, and poses a low risk of adverse events.