Assisted partner services for HIV in Kenya: a cluster randomised controlled trial.
Assisted partner services for HIV in Kenya: a cluster randomised controlled trial.
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DOI：
10.1016/s2352-3018(16)30214-4
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
aPS Study Group
中科院分区：
文献类型：
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作者：
Cherutich P;Golden MR;Wamuti B;Richardson BA;Ásbjörnsdóttir KH;Otieno FA;Ng'ang'a A;Mutiti PM;Macharia P;Sambai B;Dunbar M;Bukusi D;Farquhar C;aPS Study Group
为艾滋病毒感染患者提供的辅助伴侣服务包括了解性伴侣的信息并与他们联系，以确保他们进行艾滋病毒检测并与护理联系起来。援助伙伴服务在非洲没有广泛提供。我们的目的是确定辅助伴侣服务是否增加了肯尼亚艾滋病毒感染者的性伴侣之间的艾滋病毒检测、诊断和护理联系。在这个集群随机对照试验中，我们招募了年龄在18岁以上的未怀孕的成年人，这些成年人新近或最近被诊断为艾滋病毒，最近没有亲密伴侣暴力史，尚未或最近才与肯尼亚18个艾滋病毒检测服务诊所的艾滋病毒护理有关。肯尼亚的同意地点由研究统计学家随机分配（1:1）（限制随机化；根据县和城市邻近程度平衡分配），以立即或延迟辅助伙伴服务。主要结果是在随访6周时接受采访的伴侣中接受艾滋病毒检测的人数、艾滋病毒检测呈阳性的人数和参加艾滋病毒护理的人数。每个组内的参与者都不知道治疗分配，因为每个组内的参与者都接受了相同的干预。该试验已在ClinicalTrials.gov注册，编号NCT01616420。在2013年8月12日至2015年8月31日期间，我们随机分配了18组立即和延迟艾滋病毒辅助伴侣服务（每组9组），招募了1305名参与者：立即组625人（48%），延迟组680人（52%）。指标患者入组6周后，586名伴侣中立即组有392名（67%）进行了HIV检测，延迟组有680名伴侣中有85名（13%）进行了HIV检测（发病率比为4.8,95% CI为3.7 - 6.4）。即时治疗组有136名（23%）伴侣新诊断出艾滋病毒，而延迟治疗组有28名（4%）伴侣新诊断出艾滋病毒（5.0,3.2 - 7.9），88名（15%）伴侣新登记参加治疗的伴侣为19名（3%）伴侣（4.4,2.6 - 7.4）。辅助伴侣服务没有增加亲密伴侣暴力（每组发生一次与伴侣通知或研究程序有关的亲密伴侣暴力事件）。协助的伙伴服务是安全的，并增加艾滋病毒检测和病例发现；在人口层面的实施可以加强与护理和开始抗逆转录病毒治疗的联系，并大大减少艾滋病毒传播。国立卫生研究院。
Assisted partner services for index patients with HIV infections involves elicitation of information about sex partners and contacting them to ensure that they test for HIV and link to care. Assisted partner services are not widely available in Africa. We aimed to establish whether or not assisted partner services increase HIV testing, diagnoses, and linkage to care among sex partners of people with HIV infections in Kenya. In this cluster randomised controlled trial, we recruited non-pregnant adults aged at least 18 years with newly or recently diagnosed HIV without a recent history of intimate partner violence who had not yet or had only recently linked to HIV care from 18 HIV testing services clinics in Kenya. Consenting sites in Kenya were randomly assigned (1:1) by the study statistician (restricted randomisation; balanced distribution in terms of county and proximity to a city) to immediate versus delayed assisted partner services. Primary outcomes were the number of partners tested for HIV, the number who tested HIV positive, and the number enrolled in HIV care, in those who were interviewed at 6 week follow-up. Participants within each cluster were masked to treatment allocation because participants within each cluster received the same intervention. This trial is registered with ClinicalTrials.gov, number NCT01616420. Between Aug 12, 2013, and Aug 31, 2015, we randomly allocated 18 clusters to immediate and delayed HIV assisted partner services (nine in each group), enrolling 1305 participants: 625 (48%) in the immediate group and 680 (52%) in the delayed group. 6 weeks after enrolment of index patients, 392 (67%) of 586 partners had tested for HIV in the immediate group and 85 (13%) of 680 had tested in the delayed group (incidence rate ratio 4·8, 95% CI 3·7–6·4). 136 (23%) partners had new HIV diagnoses in the immediate group compared with 28 (4%) in the delayed group (5·0, 3·2–7·9) and 88 (15%) versus 19 (3%) were newly enrolled in care (4·4, 2·6–7·4). Assisted partner services did not increase intimate partner violence (one intimate partner violence event related to partner notification or study procedures occurred in each group). Assisted partner services are safe and increase HIV testing and case-finding; implementation at the population level could enhance linkage to care and antiretroviral therapy initiation and substantially decrease HIV transmission. National Institutes of Health.