Routine voluntary HIV testing in Durban, South Africa - The experience from an outpatient department
Routine voluntary HIV testing in Durban, South Africa - The experience from an outpatient department
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DOI：
10.1097/qai.0b013e31814277c8
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发表时间：
2007-10-01
影响因子：
3.6
通讯作者：
Walensky, Rochelle P.
中科院分区：
文献类型：
--
作者：
Bassett, Ingrid V.;Giddy, Janet;Walensky, Rochelle P.
目的：在南非德班的一家医院附属门诊部（OPD）评价常规自愿HIV检测项目与传统提供者推荐的自愿咨询和检测（VCT）相比的效果。设计和方法：在未来14周的“标准护理”期间，我们比较了门诊医生记录患者转诊到医院VCT站点的日志和HIV检测登记簿，以衡量患者完成HIV检测的情况转诊。护理期间的标准，随后是一个为期12周的干预，在此期间，所有在OPD登记的患者都得到了教育干预，并提供了一个快速的艾滋病毒检测，免费作为常规care.Results的一部分：在护理期间的标准，OPD医生提到435名患者年龄≥ 18岁的艾滋病毒检测; 137名（31.5%）转诊患者在4周内完成了VCT现场的检测。在接受检测的人中，102人（74.5%）感染了艾滋病毒。在干预期间，1414名成年人接受了艾滋病毒检测，1498人拒绝。在这些测试中，463（32.7%，95%置信区间：30.3至35.3）是艾滋病毒感染者。常规艾滋病毒检测在门诊确定每周39例新的艾滋病毒病例，每周8例新的情况下，护理标准的基础上，医生转诊到VCT网站（P < 0.0001）。结论：常规自愿艾滋病毒检测在南非的门诊导致显着更高的艾滋病毒疾病的检测率。这一战略应在艾滋病毒流行率高、可提供治疗的地区更广泛地实施。
Objective: To evaluate the yield of a routine voluntary HIV testing program compared with traditional provider-referred voluntary counseling and testing (VCT) in a hospital-affiliated outpatient department (OPD) in Durban, South Africa.Design and Methods: In a prospective 14-week "standard of care" period, we compared OPD physician logs documenting patient referrals to the hospital VCT site with HIV test registers to measure patient completion of HIV test referral. The standard of care period was followed by a 12-week intervention during which all patients who registered at the OPD were given an educational intervention and offered a rapid HIV test at no charge as part of routine care.Results: During the standard of care period, OPD physicians referred 435 patients aged >= 18 years for HIV testing; 137 (31.5%) of the referred patients completed testing at the VCT site within 4 weeks. Among those tested, 102 (74.5%) were HIV infected. During the intervention period, 1414 adults accepted HIV testing and 1498 declined. Of those tested, 463 (32.7%, 95% confidence interval: 30.3 to 35.3) were HIV infected. Routine HIV testing in the OPD identified 39 new HIV cases per week compared with 8 new cases per week with standard of care testing based on physician referral to a VCT site (P < 0.0001).Conclusions: Routine voluntary HIV testing in an OPD in South Africa leads to significantly higher rates of detection of HIV disease. This strategy should be implemented more widely in high HIV prevalence areas where treatment is available.