Real-world impact of integrating HIV assisted partner services into 31 facilities in Kenya: a single-arm, hybrid type 2 implementation-effectiveness study.
Real-world impact of integrating HIV assisted partner services into 31 facilities in Kenya: a single-arm, hybrid type 2 implementation-effectiveness study.
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DOI：
10.1016/s2214-109x(23)00153-5
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发表时间：
2023-05
期刊：
影响因子：
--
通讯作者：
Farquhar C
中科院分区：
文献类型：
--
作者：
Sharma M;Naughton B;Lagat H;Otieno G;Katz DA;Wamuti BM;Masyuko S;Bosire R;Mugambi M;Roy Paladhi U;Weiner BJ;Kariithi E;Farquhar C
临床试验表明，辅助伴侣服务（APS），或对被诊断为艾滋病毒感染者（指数客户）的性伴侣进行暴露通知和艾滋病毒检测是安全有效的。我们评估了将APS纳入肯尼亚西部艾滋病诊所后的实际有效性。在这项单组混合2型实施科学研究中，我们通过培训现有的卫生保健人员，促进了肯尼亚31家卫生机构实施APS。我们关注的是男性伴侣的结果，以评估APS对撒哈拉以南非洲男性个体的影响，他们的艾滋病毒检测率低于女性个体。在肯尼亚的参与机构中，艾滋病毒检测呈阳性的女性个体（年龄≥18岁或未受监护的未成年人）被提供APS；同意的女性参与者提供了过去3年内所有男性性伴侣的联系方式。男性伴侣被告知他们可能感染艾滋病毒，并可选择以社区为基础或以设施为基础的艾滋病毒检测服务。女性指标客户和感染艾滋病毒的男性伴侣在入组后6周、6个月和12个月进行随访，以评估与抗逆转录病毒治疗的联系。在12个月时评估病毒载量。2018年5月1日至2020年3月31日期间，32 722名女性接受了HTS；1910人（6%）艾滋病毒检测呈阳性，其中1724人（90%）接受了APS治疗。女性指数客户列出了5137名男性合伙人（每个指数中位数为3名[IQR 2-4]），其中4422名（86%）获得了暴露通知和HTS。接受检测的男性伴侣中有524人（12%）是新诊断出艾滋病毒，1292人（29%）报告以前曾诊断出艾滋病毒。在12个月的随访中，1512名（88%）女性指标客户和1621名（89%）感染艾滋病毒的男性伴侣正在接受抗逆转录病毒治疗，不良事件很少：25名（2%）女性指标客户和7名（<1%）男性伴侣报告亲密伴侣暴力，60名（3%）女性指标客户和10名（<1%）男性伴侣报告关系破裂。来自这个现实世界的APS扩大项目的证据表明，APS是一种安全、可接受和有效的策略，可以识别感染艾滋病毒的男性并对其进行护理。美国国立卫生研究院。
Assisted partner services (APS), or exposure notification and HIV testing for sexual partners of individuals diagnosed with HIV (index clients), have been shown to be safe and effective in clinical trials. We assessed the real-world effectiveness of APS when integrated into HIV clinics in western Kenya. In this single-arm, hybrid type 2 implementation science study, we facilitated APS implementation in 31 health facilities in Kenya by training existing health-care staff. We focused on male partner outcomes to assess the impact of APS in reaching male individuals in sub-Saharan Africa, who have lower rates of HIV testing than female individuals. Female individuals (aged ≥18 years or emancipated minor) who tested positive for HIV at participating facilities in Kenya were offered APS; consenting female participants provided contact information for all male sexual partners in the past 3 years. Male partners were notified of their potential HIV exposure and offered a choice of community-based or facility-based HIV testing services (HTS). Female index clients and male partners with HIV were followed up at 6 weeks, 6 months, and 12 months after enrolment, to assess linkage to antiretroviral treatment. Viral load was assessed at 12 months. Between May 1, 2018, and March 31, 2020, 32 722 female individuals received HTS; 1910 (6%) tested positive for HIV, of whom 1724 (90%) received APS. Female index clients named 5137 male partners (median 3 per index [IQR 2–4]), of whom 4422 (86%) were reached with exposure notification and HTS. 524 (12%) of the male partners tested were newly diagnosed with HIV and 1292 (29%) reported a previous HIV diagnosis. At 12 months follow-up, 1512 (88%) female index clients and 1621 (89%) male partners with HIV were taking ART, with few adverse events: 25 (2%) female index clients and seven (<1%) male partners reported intimate partner violence, and 60 (3%) female index clients and ten (<1%) male partners reported relationship dissolution. Evidence from this real-world APS scale-up project shows that APS is a safe, acceptable, and effective strategy to identify males with HIV and retain them in care. The US National Institutes of Health.
DOI：
10.1371/journal.pgph.0001586
发表时间：
2023
期刊：
PLOS global public health
影响因子：
--
作者：
通讯作者：
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影响因子：
2.8
作者：
Wamuti B;Sharma M;Kariithi E;Lagat H;Otieno G;Bosire R;Masyuko S;Mugambi M;Weiner BJ;Katz DA;Farquhar C;Levin C
通讯作者：
Levin C