Predictors of HIV infection: a prospective HIV screening study in a Ugandan refugee settlement.
Predictors of HIV infection: a prospective HIV screening study in a Ugandan refugee settlement.
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DOI：
10.1186/s12879-016-2021-1
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发表时间：
2016-11-23
影响因子：
3.7
通讯作者：
Bassett IV
中科院分区：
文献类型：
--
作者：
O'Laughlin KN;Rabideau DJ;Kasozi J;Parker RA;Bustamante ND;Faustin ZM;Greenwald KE;Walensky RP;Bassett IV
难民所面临的不稳定可能使他们面临更大的感染艾滋病毒的风险。乌干达西南部的Nakivale难民定居点收容了来自11个国家的68,000名难民，其中许多人的艾滋病毒感染率很高。我们在Nakivale实施了一项HIV筛查计划，并检查了与新HIV诊断相关的因素。从2013年3月至2014年11月，我们在Nakivale健康中心为所有等待门诊就诊的客户提供免费的艾滋病毒筛查。客户包括难民和乌干达国民在定居点获得服务。在收到艾滋病毒检测结果之前，对参与者进行了调查，以获得人口统计信息，包括性别、婚姻状况、到达诊所的旅行时间、难民身份和先前的艾滋病毒检测史。我们使用Pearson卡方检验比较HIV感染和未感染客户的变量，并使用多变量二项回归模型确定HIV感染的预测因子。在艾滋病毒筛查干预期间，接受检测的7766人中有330人（4%）被确定为艾滋病毒感染者。难民感染艾滋病毒的可能性是乌干达国民的四分之一（aRR 0.27 [0.21, 0.34], p < 0.0001）。此外，女性（aRR 1.43 [1.14, 1.80], p = 0.002）和前往诊所超过1小时（aRR 1.39 [1.11, 1.74], p = 0.003）增加了感染艾滋病毒的可能性。与已婚或有稳定关系的人相比，离婚/分居/丧偶增加了感染艾滋病毒的风险（aRR 2.41 [1.88, 3.08], p < 0.0001），而单身降低了风险（aRR 0.60 [0.41, 0.86], p < 0.0001）。以前接受过艾滋病毒检测（aRR 0.59 [0.47, 0.74], p < 0.0001）也降低了感染艾滋病毒的可能性。在乌干达一个难民定居点的艾滋病毒筛查项目中，乌干达国民感染艾滋病毒的风险高于难民。在寻求门诊治疗的病人中，包括乌干达国民和难民，艾滋病毒感染率很高，因此有必要在Nakivale和周边地区加强艾滋病毒筛查服务。这项研究的结果可能与撒哈拉以南非洲其他收容类似人口的难民定居点有关，包括乌干达的其他9个难民定居点。
The instability faced by refugees may place them at increased risk of exposure to HIV infection. Nakivale Refugee Settlement in southwestern Uganda hosts 68,000 refugees from 11 countries, many with high HIV prevalence. We implemented an HIV screening program in Nakivale and examined factors associated with new HIV diagnosis. From March 2013-November 2014, we offered free HIV screening to all clients in the Nakivale Health Center while they waited for their outpatient clinic visit. Clients included refugees and Ugandan nationals accessing services in the settlement. Prior to receiving the HIV test result, participants were surveyed to obtain demographic information including gender, marital status, travel time to reach clinic, refugee status, and history of prior HIV testing. We compared variables for HIV-infected and non-infected clients using Pearson’s chi-square test, and used multivariable binomial regression models to identify predictors of HIV infection. During the HIV screening intervention period, 330 (4%) of 7766 individuals tested were identified as HIV-infected. Refugees were one quarter as likely as Ugandan nationals to be HIV-infected (aRR 0.27 [0.21, 0.34], p < 0.0001). Additionally, being female (aRR 1.43 [1.14, 1.80], p = 0.002) and traveling more than 1 h to the clinic (aRR 1.39 [1.11, 1.74], p = 0.003) increased the likelihood of being HIV-infected. Compared to individuals who were married or in a stable relationship, being divorced/separated/widowed increased the risk of being HIV-infected (aRR 2.41 [1.88, 3.08], p < 0.0001), while being single reduced the risk (aRR 0.60 [0.41, 0.86], p < 0.0001). Having been previously tested for HIV (aRR 0.59 [0.47, 0.74], p < 0.0001) also lowered the likelihood of being HIV-infected. In an HIV screening program in a refugee settlement in Uganda, Ugandan nationals are at higher risk of having HIV than refugees. The high HIV prevalence among clients seeking outpatient care, including Ugandan nationals and refugees, warrants enhanced HIV screening services in Nakivale and in the surrounding region. Findings from this research may be relevant for other refugee settlements in Sub-Saharan Africa hosting populations with similar demographics, including the 9 other refugee settlements in Uganda.
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DOI：
10.1097/qai.0000000000000317
发表时间：
2014-12-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
OʼLaughlin KN;Kasozi J;Walensky RP;Parker RA;Faustin ZM;Doraiswamy S;Owino CO;Bassett IV
通讯作者：
Bassett IV
影响因子：
4.8
作者：
Tanaka, Yasuo;Kunii, Osamu;Wakai, Susumu
通讯作者：
Wakai, Susumu
影响因子：
3.6
作者：
O'Laughlin KN;Rouhani SA;Faustin ZM;Ware NC
通讯作者：
Ware NC
DOI：
10.1080/09540121.2012.748165
发表时间：
2013-08-01
影响因子：
1.7
作者：
Dahab, Maysoon;Spiegel, Paul B.;Schilperoord, Marian
通讯作者：
Schilperoord, Marian
影响因子：
1.4
作者：
Strand, R. T.;Dias, L. Fernandes;Andersson, S.
通讯作者：
Andersson, S.