Using surveillance data to monitor entry into care of newly diagnosed HIV-infected persons: San Francisco, 2006-2007.
Using surveillance data to monitor entry into care of newly diagnosed HIV-infected persons: San Francisco, 2006-2007.
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DOI：
10.1186/1471-2458-9-17
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发表时间：
2009-01-14
影响因子：
4.5
通讯作者：
Klausner, Jeffrey D.
中科院分区：
文献类型：
--
作者：
Zetola, Nicola M.;Bernstein, Kyle;Ahrens, Katherine;Marcus, Julia L.;Philip, Susan;Nieri, Giuliano;Jones, Diane;Hare, C. Bradley;Hsu, Ling;Scheer, Susan;Klausner, Jeffrey D.
艾滋病毒诊断后与护理的联系与临床和公共卫生效益有关。然而，确保和监测公共卫生部门与护理的联系已证明是一项艰巨的任务。在这里，我们报告的有用性，常规监测CD 4 T细胞计数和血浆HIV病毒载量的措施进入护理后，艾滋病毒诊断。自2006年7月1日起，旧金山弗朗西斯科公共卫生部（SFDPH）将监测初始初级保健访问纳入标准的艾滋病毒公共卫生调查，用于选择诊所的新诊断艾滋病毒感染患者。进入护理定义为在初步诊断艾滋病毒感染后至少有一次访问艾滋病毒初级保健提供者。研究人员收集了来自患者、医疗服务提供者、实验室的报告，并审查了医疗记录，以确定艾滋病毒诊断后首次医疗保健访问的日期。我们确定了与艾滋病毒诊断后进入护理的可能性增加相关的因素。2006年7月1日至2007年6月30日期间，诊断出160例新的艾滋病毒感染病例。常规监测方法发现，这些病例中有101例进入艾滋病毒医疗护理，对CD 4 T细胞计数和血浆艾滋病毒载量的监测证实，又有25例进入护理，比常规数据收集方法增加了25%。我们发现，与未接受采访的病例相比，接受公共卫生调查人员采访与艾滋病毒诊断后进入护理的几率较高（OR 18.86 [1.83-194.80]，p = .001）。此外，在旧金山弗朗西斯科县医院的HIV诊断与在县市性病诊所的诊断相比，进入护理的几率更高（OR 101.71 [5.29-1952.05]，p < .001）。从HIV诊断到初始CD 4 T细胞计数、CD 4 T细胞值和HIV病毒载量检测的时间可能是评估进入护理的适当监测措施，以及地方公共卫生部门HIV检测计划的绩效结果。由公共卫生部门进行的病例调查或由诊所工作人员进行的病例管理与进入艾滋病毒医疗保健的时间增加和缩短相关。
Linkage to care after HIV diagnosis is associated with both clinical and public health benefits. However, ensuring and monitoring linkage to care by public health departments has proved to be a difficult task. Here, we report the usefulness of routine monitoring of CD4 T cell counts and plasma HIV viral load as measures of entry into care after HIV diagnosis. Since July 1, 2006, the San Francisco Department of Public Health (SFDPH) incorporated monitoring initial primary care visit into standard HIV public health investigation for newly diagnosed HIV-infected patients in select clinics. Entry into care was defined as having at least one visit to a primary HIV care provider after the initial diagnosis of HIV infection. Investigators collected reports from patients, medical providers, laboratories and reviewed medical records to determine the date of the initial health care visit after HIV diagnosis. We identified factors associated with increased likelihood of entering care after HIV diagnosis. One -hundred and sixty new HIV-infected cases were diagnosed between July 1, 2006 and June 30, 2007. Routine surveillance methods found that 101 of those cases entered HIV medical care and monitoring of CD4 T cell counts and plasma HIV viral load confirmed entry to care of 25 more cases, representing a 25% increase over routine data collection methods. We found that being interviewed by a public health investigator was associated with higher odds of entry into care after HIV diagnosis (OR 18.86 [1.83–194.80], p = .001) compared to cases not interviewed. Also, HIV diagnosis at the San Francisco county hospital versus diagnosis at the county municipal STD clinic was associated with higher odds of entry into care (OR 101.71 [5.29–1952.05], p < .001). The time from HIV diagnosis to initial CD4 T cell count, CD4 T cell value and HIV viral load testing may be appropriate surveillance measures for evaluating entry into care, as well as performance outcomes for local public health departments' HIV testing programs. Case investigation performed by the public health department or case management by clinic staff was associated with increased and shorter time to entry into HIV medical care.
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影响因子：
--
作者：
Turner, BJ;Cunningham, WE;Zierler, S
通讯作者：
Zierler, S
DOI：
10.1080/09540120600966182
发表时间：
2007-02-01
影响因子：
1.7
作者：
Anthony, M. N.;Gardner, L.;Loughlin, A. M.
通讯作者：
Loughlin, A. M.
影响因子：
4.9
作者：
Bradford, Judith B.
通讯作者：
Bradford, Judith B.
影响因子：
4.4
作者：
Brewer, Toye H.;Zhao, Wei;Metsch, Lisa R.
通讯作者：
Metsch, Lisa R.
DOI：
10.7326/0003-4819-135-8_part_1-200110160-00006
发表时间：
2001-10-16
影响因子：
39.2
作者：
Katz, MH;Cunningham, WE;Shapiro, MF
通讯作者：
Shapiro, MF