High Uptake of Home-Based, District-Wide, HIV Counseling and Testing in Uganda
High Uptake of Home-Based, District-Wide, HIV Counseling and Testing in Uganda
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DOI：
10.1089/apc.2010.0096
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发表时间：
2010-11-01
影响因子：
4.9
通讯作者：
Nuwaha, Fred
中科院分区：
文献类型：
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作者：
Tumwesigye, Elioda;Wana, Goodwill;Nuwaha, Fred
在撒哈拉以南非洲低收入国家，80%以上的艾滋病毒感染者不知道自己的艾滋病毒血清状况。迫切需要采取创新措施，增加获得艾滋病毒咨询和检测的机会，以改善护理和预防工作。2004年9月至2007年3月，我们在乌干达的Bushenyi区实施了一项以家庭为基础的HCT计划，那里大约90%的14岁以上的人从未进行过艾滋病毒检测，以判断是否可以接受HCT并增加HCT的使用。由一名顾问和一名实验室助理组成的29个小组系统地访问了为所有14岁以上的人和高危儿童（母亲死亡或感染艾滋病毒）提供HCT的家庭，使用快速艾滋病毒检测三次检测算法。艾滋病毒感染者接受复方新诺明预防治疗，获得长效驱虫蚊帐和家用饮用水处理设备，并被转诊接受抗逆转录病毒治疗评估。该方案覆盖了该地区所有家庭中的92 984户（63%）。其中，32，3621人符合HCT的条件，28，2857人（87%）在家并接受了测试前咨询。共有264 966人（94%）接受了检测并收到了检测结果，其中11 359人（4.3%）感染了艾滋病毒。这些测试中有90%以前从未测试过。测试成本为每个以前未测试的客户端7.83美元。97%的艾滋病毒感染者开始服用复方新诺明预防剂，74%的人得到蚊帐，70%的人得到水处理设备，11%的人开始接受抗逆转录病毒治疗。44%的人谁是在艾滋病毒不和谐的关系被感染。这些结果表明，以家庭为基础的HCT是公认的，可行的，有效地确定艾滋病毒感染者谁不知道自己的艾滋病毒感染状况在乌干达农村。
More than 80% of the people infected with HIV in low-income countries of sub-Saharan Africa do not know their HIV serostatus. Innovative measures of increasing access to HIV counseling and testing (HCT) are urgently needed so as to improve care and prevention. We implemented a home-based HCT program in Bushenyi District from September 2004 to March 2007, in Uganda where approximately 90% of people aged older than 14 years had never tested for HIV to gauge whether it was acceptable and increased uptake of HCT. Twenty-nine teams comprising a counselor and a laboratory assistant systematically visited homes offering HCT for all people older than 14 years of age and at-risk children (mother deceased or HIV infected) using a rapid HIV testing three-test algorithm. HIV-infected people received cotrimoxazole prophylaxis, were supplied with long-lasting insecticide-treated bed nets and equipment for treatment of drinking water at home, and were referred for assessment for antiretroviral therapy. The program reached 92,984 (63%) of all the homes in the district. Of these, 32,3621 people were eligible for HCT, and 28,2857 (87%) were present at home and were offered pretest counseling. A total of 264,966 (94%) accepted testing and received their results, of whom 11,359 (4.3%) were HIV-infected. Ninety percent of those testing had never tested before. The cost of testing was $7.83 per previously untested client. Ninety-seven percent of HIV-infected people initiated cotrimoxazole prophylaxis, 74% received bed nets, 70% received water treatment equipment, and 11% began antiretroviral therapy. Forty-four percent of people who were in an HIV-discordant relationship were infected. These results demonstrate that home-based HCT was well-accepted, feasible, and effective in identifying HIV-infected individuals who did not know their HIV status in rural Uganda.