Low Rates of Repeat HIV Testing Despite Increased Availability of Antiretroviral Therapy in Rural Tanzania: Findings from 2003-2010
Low Rates of Repeat HIV Testing Despite Increased Availability of Antiretroviral Therapy in Rural Tanzania: Findings from 2003-2010
复制标题
DOI：
10.1371/journal.pone.0062212
复制
发表时间：
2013-04-23
期刊：
影响因子：
3.7
通讯作者：
Zaba, Basia
中科院分区：
文献类型：
--
作者：
Cawley, Caoimhe;Wringe, Alison;Zaba, Basia
背景：艾滋病毒咨询和检测（HCT）服务可以通过鼓励安全性行为并将艾滋病毒感染者与抗逆转录病毒治疗（ART）联系起来，在艾滋病毒预防中发挥重要作用。然而，高危 HIV 阴性个体定期重复检测对于及时启动 ART 作为“治疗即预防”方法的一部分非常重要。目的：调查 2010 年坦桑尼亚西北部一轮 HIV 血清学监测期间 HCT 的使用情况，并探讨 2003 年至 2010 年期间重复检测的比率。方法：在 2003-2004 年第四、第五和第六轮血清学监测期间提供了 HCT 服务(Sero-4)、2006-2007 (Sero-5) 和 2010 (Sero-6)。自 2005 年以来，研究地区的政府运营的卫生中心和其他诊所也提供了 HCT 服务。血清调查期间进行的问卷调查收集了有关社会人口特征、性行为的信息，并报告了以前使用 HCT 服务的情况。结果：使用 HCT 的参与者比例从 Sero-4 的 9.4% 增加到 Sero-5 的 16.6% 和 Sero-6 的 25.5%。在参加所有三轮血清调查的参与者中（n = 2,010），使用两次或两次以上 HCT 的比例较低，其中 11.1% 使用两次或两次以上血清调查中提供的 HCT 服务，如果考虑到在血清调查之外使用 HCT 的报告，则有 25.3% 的人进行了两次或两次以上测试。在多变量分析中，与 HIV 阴性测试者相比，HIV 阳性测试者重复测试的可能性较小（aOR 0.17，95% CI 0.006-0.52）。 讨论/结论：虽然 HCT 服务的使用随着时间的推移而增加，但令人失望的是，考虑到研究地区 HCT 和 ART 的可用性不断增加，曾经测试和曾经重复测试的比例并没有更大。有证据表明，具有较高风险性行为的艾滋病毒阴性者最有可能重复检测，这对于发现感染艾滋病毒风险最大的人的潜力而言是令人鼓舞的。
Background: HIV counselling and testing (HCT) services can play an important role in HIV prevention by encouraging safe sexual behaviours and linking HIV-infected clients to antiretroviral therapy (ART). However, regular repeat testing by high-risk HIV-negative individuals is important for timely initiation of ART as part of the 'treatment as prevention' approach.Aim: To investigate HCT use during a round of HIV serological surveillance in northwest Tanzania in 2010, and to explore rates of repeat testing between 2003 and 2010.Methods: HCT services were provided during the fourth, fifth and sixth rounds of serological surveillance in 2003-2004 (Sero-4), 2006-2007 (Sero-5) and 2010 (Sero-6). HCT services have also been available at a government-run health centre and at other clinics in the study area since 2005. Questionnaires administered during sero-surveys collected information on socio-demographic characteristics, sexual behaviour and reported previous use of HCT services.Results: The proportion of participants using HCT increased from 9.4% at Sero-4 to 16.6% at Sero-5 and 25.5% at Sero-6. Among participants attending all three sero-survey rounds (n = 2,010), the proportions using HCT twice or more were low, with 11.1% using the HCT service offered at sero-surveys twice or more, and 25.3% having tested twice or more if reported use of HCT outside of sero-surveys was taken into account. In multivariable analyses, individuals testing HIV-positive were less likely to repeat test than individuals testing HIV-negative (aOR 0.17, 95% CI 0.006-0.52).Discussion/Conclusions: Although HCT service use increased over time, it was disappointing that the proportions ever testing and ever repeat-testing were not even larger, considering the increasing availability of HCT and ART in the study area. There was some evidence that HIV-negative people with higher risk sexual behaviours were most likely to repeat test, which was encouraging in terms of the potential to pick-up those at greatest risk of HIV-infection.