Engagement in HIV care among Kenyan adults and adolescents: results from a national population-based survey.
Engagement in HIV care among Kenyan adults and adolescents: results from a national population-based survey.
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DOI：
10.1097/qai.0000000000000119
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发表时间：
2014-05-01
期刊：
影响因子：
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通讯作者：
KAIS Study Group
中科院分区：
文献类型：
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作者：
Wafula R;Masyuko S;Ng'ang'a L;Kim AA;Gichangi A;Mukui I;Batuka J;Ngugi EW;Maina WK;Schwarcz S;KAIS Study Group
增加艾滋病毒感染者获得护理和治疗的机会是肯尼亚应对艾滋病毒流行病的一个目标。利用第二次肯尼亚艾滋病指标调查（KAIS 2012）的数据，我们描述了参加艾滋病毒护理的成年人和青少年所获得服务的覆盖率。KAIS 2012是一项基于人群的调查，收集了15-64岁人群的信息，包括自我报告的艾滋病毒状况，以及报告感染艾滋病毒、使用艾滋病毒护理和抗逆转录病毒治疗（ART）的人群。采集了血样并进行了艾滋病毒检测。对hiv阳性标本进行CD4计数和病毒载量检测。在报告感染艾滋病毒的363人中，93.4%[95%可信区间（CI）： 87.2至99.6]曾接受过艾滋病毒护理。在接受艾滋病毒治疗的患者中，96.3% （95% CI: 94.1至98.4）使用复方新诺明预防，74.6% （95% CI: 69.0至80.2）接受抗逆转录病毒治疗。接受护理和未接受抗逆转录病毒治疗的患者报告使用复方新诺明的比例（89.5%,95% CI: 82.5至96.5,98.6%,95% CI: 97.1至100）和进行CD4计数测量（72.9%,95% CI: 64.0至81.9,90.0%,95% CI: 82.8至97.3）分别低于接受护理和抗逆转录病毒治疗的患者。在接受护理但未接受抗逆转录病毒治疗的患者中，23.2% （95% CI: 6.8至39.7）的CD4细胞计数≤每微升350个细胞。接受抗逆转录病毒治疗的患者中有75.3% （95% CI: 68.7 ~ 81.9）出现病毒抑制。在已知的艾滋病毒感染者中，联系性和护理保留率很高。然而，需要改善对抗逆转录病毒治疗前人群的护理。病毒抑制率与发达环境相当。
Increasing access to care and treatment for HIV-infected persons is a goal in Kenya’s response to the HIV epidemic. Using data from the second Kenya AIDS Indicator Survey (KAIS 2012), we describe coverage of services received among adults and adolescents who were enrolled in HIV care. KAIS 2012 was a population-based survey that collected information from persons aged 15–64 years that included self-reported HIV status, and for persons reporting HIV infection, use of HIV care and antiretroviral therapy (ART). Blood specimens were collected and tested for HIV. HIV-positive specimens were tested for CD4 counts and viral load. Among 363 persons who reported HIV infection, 93.4% [95% confidence interval (CI): 87.2 to 99.6] had ever received HIV care. Among those receiving HIV care, 96.3% (95% CI: 94.1 to 98.4) were using cotrimoxazole prophylaxis, and 74.6% (95% CI: 69.0 to 80.2) were receiving ART. A lower proportion of persons in care and not on ART reported using cotrimoxazole (89.5%, 95% CI: 82.5 to 96.5 compared with 98.6%, 95% CI: 97.1 to 100) and had a CD4 count measurement done (72.9%, 95% CI: 64.0 to 81.9 compared with 90.0%, 95% CI: 82.8 to 97.3) than persons in care and on ART, respectively. Among persons in care and not on ART, 23.2% (95% CI: 6.8 to 39.7) had CD4 counts ≤350 cells per microliter. Viral suppression was observed in 75.3% (95% CI: 68.7 to 81.9) of persons on ART. Linkage and retention in care are high among persons with known HIV infection. However, improvements in care for the pre-ART population are needed. Viral suppression rates were comparable to developed settings.