Rapid point-of-care CD4 testing at mobile HIV testing sites to increase linkage to care: an evaluation of a pilot program in South Africa.
Rapid point-of-care CD4 testing at mobile HIV testing sites to increase linkage to care: an evaluation of a pilot program in South Africa.
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DOI：
10.1097/qai.0b013e31825eec60
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发表时间：
2012-10-01
期刊：
影响因子：
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通讯作者：
Rosen S
中科院分区：
文献类型：
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作者：
Larson BA;Schnippel K;Ndibongo B;Xulu T;Brennan A;Long L;Fox MP;Rosen S
约翰内斯堡周围的一个移动的艾滋病毒咨询和检测（HCT）项目使用Pima™分析仪试行了护理点CD 4检测的整合，以改善与艾滋病毒护理的联系。我们报告了2010年5月至10月检测阳性患者（n=508）的试验项目结果。我们分析了三个主要结果：分配到检测组（提供POC CD 4或没有）;成功随访（通过电话）;如果成功随访，则在HIV检测后8周内完成HIV护理的转诊访视。计算每种结局的比例，并使用改良泊松法估计相对风险。311例患者接受了POC CD 4检测，197例患者未接受检测。两组患者特征无差异。大约62.7%的患者在HIV检测后8周成功随访，检测组之间没有观察到差异。在接受随访的人中，54.4%报告完成了转诊。接受POC CD 4检测的患者更有可能完成转诊访视，接受进一步的HIV治疗（RR 1.25，95% CI：1.00-1.57）。在这种移动的HCT环境中，作为HCT服务的一部分提供POC CD 4检测的患者更有可能在检测后前往转诊诊所，这表明快速CD 4检测技术可能会改善与艾滋病毒护理的联系。未来的研究可以评估调整HCT服务的选择，如果POC CD 4检测被永久包括在内，以及POC CD 4检测与其他改善护理联系的方法相比的成本效益。
A mobile HIV counseling and testing (HCT) program around Johannesburg piloted the integration of point-of-care CD4 testing, using the Pima™ Analyzer, to improve linkages to HIV care. We report results from this pilot program for patients testing positive (n=508) from May–October 2010. We analyzed three primary outcomes: assignment to testing group (offered POC CD4 or not; successful follow up (by phone); and completed the referral visit for HIV care within 8 weeks after HIV testing if successfully followed up. Proportions for each outcome were calculated and relative risks estimated using a modified Poisson approach. 311 patients were offered the POC CD4 test, and 197 patients were not offered the test. No differences in patient characteristics were observed between the two groups. Approximately 62.7% of patients were successfully followed up 8 weeks after HIV testing, with no differences observed between testing groups. Among those followed up, 54.4% reported completing their referral visit. Patients offered the POC CD4 test were more likely to complete the referral visit for further HIV care (RR 1.25, 95% CI: 1.00–1.57). In this mobile HCT setting, patients offered POC CD4 testing as part of the HCT services were more likely to visit a referral clinic after testing, suggesting rapid CD4 testing technology may improve linkage to HIV care. Future research can evaluate options for adjusting HCT services if POC CD4 testing were included permanently, as well as the cost-effectiveness of the POC CD4 testing compared to other approaches for improving linkage of care.