Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda
Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda
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DOI：
10.1097/01.aids.0000162339.43310.33
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发表时间：
2005-03-25
期刊：
影响因子：
3.8
通讯作者：
Nalugoda, F
中科院分区：
文献类型：
--
作者：
Matovu, JKB;Gray, RH;Nalugoda, F
目的：了解乌干达拉凯地区艾滋病毒自愿咨询与检测（VCT）的接受程度及其对性危险行为和艾滋病毒感染的影响。方法：在一个农村队列中，对10694名同意的成年人进行访谈，提供血液进行艾滋病毒检测，并由社区驻院辅导员免费提供VCT。采用对数二项回归估计接受VCT的比例和接受VCT的校正风险比（adj. RR）。前瞻性评估HIV阴性接受者和非接受者的风险行为和每100人年（PY）的HIV发病率。结果：虽然93%的人最初要求HIV检测，但62.2%的人随后接受了VCT检测。无VCT病史者的VCT接受度较低[j. RR = 0.88；95%可信区间（CI）， 0.85-0.90]，小学教育程度（RR = 0.94; 95% CI, 0.90-0.99）或以上（RR = 0.91; 95% CI, 0.87-0.97）， hiv阳性（RR = 0.72; 95% CI, 0.68-0.76），以及报告在过去6个月内使用安全套的人（不一致使用，RR = 0.95; 95% CI, 0.90-0.99；一致使用，RR = 0.88; 95% CI, 0.82-0.95）。已婚人士（RR = 1.14, 95% CI, 1.08-1.20）和已婚人士（RR = 1.11, 95% CI, 1.04-1.18）的VCT接受度较高。接受结果与年龄、性别和对艾滋病毒风险的自我认知没有显著相关性。接受VCT者（1.6/100 PY）和未接受VCT者（1.4/100 PY）在性危险行为和HIV感染率方面无显著差异。结论：在VCT服务免费、可及的农村队列中，接受VCT的个体存在自我选择，VCT对后续危险行为和HIV发病率无影响。(c) 2005年Lippincott Williams & Wilkins。
Objective: To assess the acceptance of voluntary HIV counseling and testing (VCT) and the effects of VCT on sexual risk behavior and HIV acquisition in Rakai, Uganda.Methods: In a rural cohort, 10694 consenting adults were interviewed, provided blood for HIV testing and were offered free VCT by community resident counselors. The proportions receiving VCT and the adjusted risk ratio (adj. RR) of VCT acceptance were estimated by log binomial regression. Risk behaviors and HIV incidence per 100 person-years (PY) in HIV-negative acceptors and non-acceptors of VCT were assessed prospectively.Results: Although 93% initially requested HIV results, 62.2% subsequently accepted VCT. VCT acceptance was lower among persons with no prior VCT [Adj. RR = 0.88; 95% confidence interval (CI), 0.85-0.90], individuals with primary education (adj. RR = 0.94; 95% CI, 0.90-0.99) or higher (adj. RR = 0.91; 95% CI, 0.87-0.97), individuals who were HIV-positive (adj. RR = 0.72; 95% CI, 0.68-0.76), and persons reporting condom use in the past 6 months (inconsistent users, adj. RR = 0.95; 95% Cl, 0.90-0.99; consistent users, adj. RR = 0.88; 95% CI, 0.82-0.95). VCT acceptance was higher among the currently married (adj. RR = 1.14; 95% CI, 1.08-1.20) and previously married (adj. RR = 1.11; 95% CI, 1.04-1.18). Receipt of results was not significantly associated with age, gender, and self-perception of HIV risk. There were no significant differences in sexual risk behaviors, or in HIV incidence between acceptors (1.6/100 PY) and non-acceptors (1.4/100 PY) of VCT.Conclusion: In this rural cohort where VCT services are free and accessible, there is self-selection of individuals accepting VCT, and no impact of VCT on subsequent risk behaviors or HIV incidence. (c) 2005 Lippincott Williams & Wilkins.