Impact of a Comprehensive Adolescent-Focused Case Finding Intervention on Uptake of HIV Testing and Linkage to Care Among Adolescents in Western Kenya
Impact of a Comprehensive Adolescent-Focused Case Finding Intervention on Uptake of HIV Testing and Linkage to Care Among Adolescents in Western Kenya
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DOI：
10.1097/qai.0000000000001819
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发表时间：
2018-11-01
影响因子：
3.6
通讯作者：
Rakhmanina, Natella
中科院分区：
文献类型：
--
作者：
Kose, Judith;Tiam, Appolinaire;Rakhmanina, Natella
背景：艾滋病毒检测使用率低阻碍了青少年艾滋病毒感染者的识别和与护理和治疗的联系。我们在卫生保健机构实施了一项创新的一揽子服务，以改善肯尼亚西部10-19岁青少年接受艾滋病毒检测和与护理的联系。方法：这项准实验研究使用了139家卫生保健机构（医院、卫生中心和药房）的干预前和干预后数据。一揽子计划包括卫生工作者能力建设、方案绩效监测工具、以青少年为重点的艾滋病毒风险筛查工具和青少年友好工作时间。研究人群分为早期（10-14岁）和晚期（15-19岁）两组。2016年7月开始实施，干预前数据收集于2016年1月至3月，干预后数据收集于2017年1月至3月。描述性统计用于分析接受艾滋病毒检测、艾滋病毒检测呈阳性以及与护理服务相关的青少年人数。采用泊松均值检验比较干预前和干预后人口统计学和检测数据。采用Chi(2)检验比较其与护理率的关联。结果：干预前共有25520名青少年接受检测，其中hiv阳性198人（0.8%）；干预后共有77644名青少年接受检测，其中hiv阳性534人（0.7%）
Background: Low HIV testing uptake prevents identification of adolescents living with HIV and linkage to care and treatment. We implemented an innovative service package at health care facilities to improve HIV testing uptake and linkage to care among adolescents aged 10-19 years in Western Kenya.Methods: This quasi-experimental study used preintervention and postintervention data at 139 health care facilities (hospitals, health centers, and dispensaries). The package included health worker capacity building, program performance monitoring tools, adolescent-focused HIV risk screening tool, and adolescent-friendly hours. The study population was divided into early (10-14 years) and late (15-19 years) age cohorts. Implementation began in July 2016, with preintervention data collected during January-March 2016 and postintervention data collected during January-March 2017. Descriptive statistics were used to analyze the numbers of adolescents tested for HIV, testing HIV-positive, and linked to care services. Preintervention and postintervention demographic and testing data were compared using the Poisson mean test. chi(2) testing was used to compare the linkage to care rates.Results: During the preintervention period, 25,520 adolescents were tested, 198 testing HIV-positive (0.8%) compared with 77,644 adolescents tested with 534 testing HIV-positive (0.7%) during the postintervention period (both P-values