Family-Based HIV VCT in Patients at Risk for TB

描述（由申请人提供）：全球呼吁迅速将艾滋病毒抗逆转录病毒疗法引入撒哈拉以南非洲，迫切需要改进艾滋病毒感染者的识别，并成功地与艾滋病毒医疗护理和社会支持联系起来。艾滋病毒自愿咨询和检测（VCT）已被证明是有效的，帮助个人了解他们的艾滋病毒状况，并进入护理。结核病患者是自愿咨询和检测发现艾滋病毒感染并将个人与艾滋病毒专门护理联系起来的最大机会之一。 在发展中国家，艾滋病毒流行与先前存在的结核病流行有很大重叠，新诊断为结核病的个人中艾滋病毒流行率超过50%。 结核病患者的家庭成员，特别是配偶和年幼子女，艾滋病毒感染率也大大高于一般人群。 然而，所有这些群体中自愿咨询和检测的使用率都很低（<10%）。我们建议测试干预的有效性，利用艾滋病毒快速检测和整合艾滋病毒VCT到结核病评估和家庭为基础的VCT的家庭成员，以克服确定的后勤和心理障碍，艾滋病毒VCT在新的结核病患者艾滋病毒及其家庭成员。本研究的具体目的是：1）确定在乌干达国家结核病和麻风病规划署在乌干达坎帕拉老穆拉戈医院结核病门诊提供艾滋病毒咨询和检测的2,000名结核病评估患者的横断面样本中接受VCT和VCT的障碍。2)在600个家庭中进行艾滋病自愿咨询检测的随机试验，比较结核病评估患者家庭和家庭成员在家庭为基础的自愿咨询检测和结核病诊所为基础的自愿咨询检测的接受情况。3)目的探讨以家庭为基础和以结核病门诊为基础的自愿咨询和检测（VCT）对随机抽取的600个家庭中艾滋病病毒感染者获得艾滋病医疗服务和社会支持的有效性。

DESCRIPTION (provided by applicant): The global call for the rapid introduction of HIV antiretroviral therapy to sub-Saharan Africa urgently requires improved identification of HIV infected persons and successful linkage to HIV medical care and social support. Voluntary Counseling and Testing (VCT) for HIV has been shown to be effective in helping individuals learn their HIV status and get into care. Tuberculosis (TB) patients present one of the greatest opportunities for VCT to identify HIV infections and link individuals into HIV specific care. In the developing world, the HIV epidemic overlaps significantly with pre-existing epidemics of TB and the HIV prevalence among individuals newly diagnosed with TB is greater than 50%. Family and household members of TB patients, especially spouses and young children, also have a greatly elevated prevalence of HIV infection compared to that of the general population. However, VCT use among all these groups is low (<10%). We propose to test the efficacy of an intervention utilizing HIV rapid testing and integration of HIV VCT into TB evaluation and home-based VCT for family members, to overcome identified logistical and psychological barriers to HIV VCT among new TB patients HIV and their family members. The specific aims of the study are: 1) To determine the uptake of and barriers to VCT among a cross-sectional sample of 2,000 TB evaluation patients offered same-day results HIV counseling and testing at the Uganda National TB and , Leprosy Programme outpatient TB clinic at Old Mulago Hospital in Kampala, Uganda. 2) To conduct a randomized trial of HIV VCT among 600 households comparing VCT uptake between Home-based VCT and TB Clinic-based VCT for family and household members of TB evaluation patients. 3) To investigate the effectiveness of Home-based and TB Clinic-based VCT in linking HIV infected persons among the 600 randomized households to HIV medical care and social support.