Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment
Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment
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DOI：
10.1111/j.1365-3156.2008.02005.x
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发表时间：
2008-03-01
影响因子：
3.3
通讯作者：
Zaba, Basia
中科院分区：
文献类型：
--
作者：
Wringe, Alison;Isingo, Raphael;Zaba, Basia
目的描述社会人口统计学，行为和临床特征之间的关联和使用艾滋病毒自愿咨询和检测（VCT）服务的居民在农村病房在Tanzani.METHODS八千九百七十名参与者从一个以社区为基础的队列进行了采访，提供血液研究艾滋病毒检测，并提供VCT。单因素和多因素Logistic回归分析，以确定社会人口，临床和行为因素与VCT use.RESULTS虽然31%（1246/3980）的男性和24%（1195/4990）的女性表示有兴趣的服务，只有12%的男性和7%的女性随后完成VCT。社会人口学因素，如婚姻状况，居住地区，宗教和种族影响VCT完成男性和女性在不同的方式，而自我感知的艾滋病毒的风险，事先的VCT知识，以及与高风险的合作伙伴的性出现作为重要的预测VCT完成男性和女性。仅在男性中，与HIV阴性者相比，HIV感染5年或5年以下者倾向于自我选择VCT（调整后比值比= 1.43; 95%CI：0.99-2.14）。这有助于更高比例的HIV阳性男性知道自己的地位相比，HIV阳性feminals.CONCLUSIONS在这种情况下，不成比例的HIV阳性的妇女没有学习自己的地位，这对公平获得转介护理和治疗服务的影响。有证据表明，一些高风险行为可能促使人们使用自愿咨询和检测，这是令人鼓舞的，尽管需要采取进一步的干预措施，以提高人们对艾滋病毒风险和自愿咨询和检测益处的认识。还需要采取有针对性的干预措施，促进已婚妇女和农村居民接受VCT。
OBJECTIVE To describe the associations between socio-demographic, behavioural and clinical characteristics and the use of HIV voluntary counselling and testing (VCT) services among residents in a rural ward in Tanzania.METHODS Eight thousand nine hundred and seventy participants from a community-based cohort were interviewed, provided blood for research HIV testing, and were offered VCT. Univariate and multivariate logistic regression was used to identify socio-demographic, clinical and behavioural factors associated with VCT use.RESULTS Although 31% (1246/3980) of men and 24% (1195/4990) of women expressed an interest in the service, only 12% of men and 7% of women subsequently completed VCT. Socio-demographic factors, such as marital status, area of residence, religion and ethnicity influenced VCT completion among males and females in different ways, while self-perceived risk of HIV, prior knowledge of VCT, and sex with a high-risk partner emerged as important predictors of VCT completion among both sexes. Among males only, those infected with HIV for 5 years or less tended to self-select for VCT compared to HIV-negatives (adjusted odds ratio = 1.43; 95% CI: 0.99-2.14). This contributed to a higher proportion of HIV-positive males knowing their status compared to HIV-positive females.CONCLUSIONS In this setting, a disproportionate number of HIV-positive women are failing to learn their status, which has implications for equitable access to onward referral for care and treatment services. Evidence that some high-risk behaviours may prompt VCT use is encouraging, although further interventions are required to improve knowledge about HIV risk and the benefits of VCT. Targeted interventions are also needed to promote VCT uptake among married women and rural residents.