Low engagement in HIV services and progress through the treatment cascade among key populations living with HIV in Mozambique: alarming gaps in knowledge of status.
Low engagement in HIV services and progress through the treatment cascade among key populations living with HIV in Mozambique: alarming gaps in knowledge of status.
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DOI：
10.1186/s12889-020-10039-2
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发表时间：
2021-01-15
影响因子：
4.5
通讯作者：
Raymond HF
中科院分区：
文献类型：
--
作者：
Boothe MAS;Sathane I;Baltazar CS;Chicuecue N;Horth R;Fazito E;Raymond HF
莫桑比克总人口中艾滋病毒流行率为 13.5%。莫桑比克的早期建模工作估计，关键人群（KP），即男男性行为者（MSM）、女性性工作者（FSW）和注射吸毒者（PWID）及其伴侣，约占所有新感染病例的三分之一。描述艾滋病毒感染者 KP 参与检测、护理和治疗服务的数据有限。我们对 2011 年至 2014 年在莫桑比克进行的首次生物行为监测 (BBS) 调查中的 HIV 阳性参与者进行了二次数据分析，以评估 MSM、FSW 和 PWID 之间的 HIV 治疗级联服务的采用情况和进展。计算每个关键人群的未加权汇总估计值。在 HIV 阳性 MSM 中，63.2% 的参与者曾经接受过 HIV 检测，8.8% 的参与者了解自己的状况，6.1% 的参与者报告曾接受过护理，而 3.5% 的参与者开始了 ART 并目前正在接受治疗。在感染 HIV 的 FSW 参与者中，76.5% 的人报告过之前接受过 HIV 检测，22.4% 的人之前知道自己的状况。 20.1% 的人表示与护理有联系，12.7% 的人表示已开始接受 ART，11.8% 的人表示在调查时正在接受治疗。在感染艾滋病毒的注射吸毒者中，79.9% 的人之前接受过艾滋病毒检测，63.2% 的人知道自己的艾滋病毒状况，49.0% 的人报告说与艾滋病毒感染的护理有关。 42.7% 的参与者报告开始接受 ART，而 29.4% 的参与者在调查时正在接受 ART。在莫桑比克的三个高危人群中，服务获取的关键领域都出现了损失，最令人震惊的断点发生在艾滋病毒状况的了解上。应特别注意增加艾滋病毒检测以及与抗逆转录病毒治疗的联系。未来的调查将提供机会根据全球目标监测整个级联的改善情况，并应包括病毒载量测试，以保证更完整地了解治疗级联。
Mozambique has a generalized HIV epidemic of 13.5% among the general population. Early modeling exercises in Mozambique estimate that key populations (KP), defined as men who have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID), along with their partners account for about one third of all new infections. There is limited data describing the engagement of KP living with HIV in testing, care and treatment services. We conducted a secondary data analysis of HIV-positive participants in the first Bio-behavioral Surveillance (BBS) surveys in Mozambique conducted 2011–2014 in order to assess service uptake and progress though the HIV treatment cascade among MSM, FSW, and PWID. Unweighted pooled estimates were calculated for each key population group. Among HIV-positive MSM, 63.2% of participants had ever received an HIV test, 8.8% were aware of their status, 6.1% reported having been linked to care, while 3.5% initiated ART and were currently on treatment. Of the HIV-infected FSW participants, 76.5% reported a previous HIV test and 22.4% were previously aware of their status. Linkage to care was reported by 20.1%, while 12.7% reported having initiated ART and 11.8% reported being on treatment at the time of the survey. Among HIV-infected PWID participants, 79.9% had previously received an HIV test, 63.2% were aware of their HIV status, and 49.0% reported being linked to care for their HIV infection. ART initiation was reported by 42.7% of participants, while 29.4% were on ART at the time of the survey. Among the three high risk populations in Mozambique, losses occurred throughout critical areas of service uptake with the most alarming breakpoint occurring at knowledge of HIV status. Special attention should be given to increasing HIV testing and linkage to ART treatment. Future surveys will provide the opportunity to monitor improvements across the cascade in line with global targets and should include viral load testing to guarantee a more complete picture of the treatment cascade.
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DOI：
10.1097/qai.0000000000000769
发表时间：
2015-12-01
影响因子：
3.6
作者：
Kurth, Ann E.;Cleland, Charles M.;Cherutich, Peter
通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
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作者：
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影响因子：
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DOI：
10.1111/j.1467-9531.2007.00188.x
发表时间：
2007-01-01
期刊：
SOCIOLOGICAL METHODOLOGY 2007, VOL 37
影响因子：
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作者：
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通讯作者：
Heckathorn, Douglas D.