Voluntary counseling and testing (VCT) services and their contribution to access to HIV diagnosis in Brazil
Voluntary counseling and testing (VCT) services and their contribution to access to HIV diagnosis in Brazil
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DOI：
10.1590/s0102-311x2009000900019
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发表时间：
2009-09-01
期刊：
影响因子：
--
通讯作者：
Kayano, Jorge
中科院分区：
文献类型：
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作者：
Grangeiro, Alexandre;Escuder, Maria Mercedes;Kayano, Jorge
自愿咨询和检测网络于1980年代在巴西实施，以促进匿名和保密的艾滋病毒诊断。作为人口和当地疫情规模的一项功能，这项研究使用了自填问卷的数据和来自统一国家卫生系统(SUS)信息技术部、联合国开发计划署和国家性病/艾滋病计划的数据，评估了该网络的覆盖范围。均数比较采用学生t检验，比例比较采用卡方检验。巴西有383个VCT中心，覆盖48.9%的人口和69.2%的艾滋病病例。该网络主要在疫情显示存在的地区实施，但85.3%的艾滋病毒高发城市缺乏VCT中心；缺乏VCT与更有限的卫生基础设施和更差的社会指标有关。该网络的扩展速度有所放缓，在该市发现首例艾滋病病例后，VCT中心的平均实施时间为16年。在设有VCT中心的城市，根据SUS进行的艾滋病毒检测数量是后者的2.3倍。该网络的范围有限，因此将这些服务对巴西艾滋病毒诊断的贡献降至最低。
The Voluntary Counseling and Testing (VCT) Network was implemented in Brazil in the 1980s to promote anonymous and confidential access to HIV diagnosis. As a function of the population and dimensions of the local epidemic, the study assessed the network's coverage, using data from a self-applied questionnaire and data from the Information Technology Department of the Unified National Health System (SUS), UNDP, and National STD/AIDS Program. The Student t test was used for comparison of means and the chi-square test for proportions. Brazil has 383 VCT centers, covering 48.9% of the population and 69.2% of the AIDS cases. The network has been implemented predominantly in regions where the epidemic shows a relevant presence, but 85.3% of the cities with high HIV incidence lack VCT centers; absence of VCT was associated with more limited health infrastructure and worse social indicators. A slowdown in expansion of the network was observed, with VCT Centers implemented on average 16 years after the first AIDS case in the given municipality. The number of HIV tests performed under the SUS is 2.3 times higher in cities with VCT centers. The network's scope is limited, thus minimizing the contribution by these services to the supply of HIV diagnosis in Brazil.