Nyblade L C, Menken J, Wawer M J, Sewankambo N K, Serwadda D, Makumbi F, Lutalo T, Gray R H
International Center for Research on Women, Washington, District of Columbia 20037, USA.
J Acquir Immune Defic Syndr. 2001 Dec 15;28(5):463-70. doi: 10.1097/00042560-200112150-00010.
To assess self-selection in a population-based voluntary HIV testing and counseling (VTC) program by comparing the HIV risk characteristics of users and nonusers of VTC in rural Uganda.
A 1994 to 1995 community-randomized trial in the Rakai District of Uganda enrolled adults aged 15 to 59 years and ascertained their HIV status, sociodemographic characteristics, risk behaviors, and AIDS-associated symptoms. All subjects were offered confidential individual VTC at no cost.
We compared users and nonusers of VTC among 10,950 participants (4764 male and 6186 female) enrolled at baseline using multivariate logistic regression.
Women were significantly less likely to receive VTC than men (31.5% vs. 34.8%, p <.001). In multivariate analysis, younger age, HIV-positive status, and having no sexual partners in the past 5 years (and, significant for women only, having 2 or more sexual partners) were associated with lower VTC participation for both men and women. Among women, higher VTC participation was associated with symptoms suggestive of AIDS and other illnesses and shopkeeper occupations.
During the initial phase of a population-based free VTC program in rural Uganda, certain high-risk groups were underrepresented among VTC recipients. There is a need to target VTC to ensure participation by high-risk individuals most in need of services.
通过比较乌干达农村地区自愿接受HIV检测与咨询（VTC）项目的使用者和非使用者的HIV风险特征，评估基于人群的自愿HIV检测与咨询项目中的自我选择情况。
1994年至1995年在乌干达拉凯区进行的一项社区随机试验，纳入了15至59岁的成年人，并确定了他们的HIV感染状况、社会人口学特征、风险行为以及与艾滋病相关的症状。所有受试者均可免费获得保密的个人VTC服务。
我们使用多变量逻辑回归，比较了10950名基线入组参与者（4764名男性和6186名女性）中VTC的使用者和非使用者。
女性接受VTC的可能性显著低于男性（31.5%对34.8%，p<.001）。在多变量分析中，年龄较小、HIV阳性状态以及在过去5年中没有性伴侣（仅对女性而言，有2个或更多性伴侣也具有显著意义）与男性和女性较低的VTC参与率相关。在女性中，较高的VTC参与率与提示艾滋病和其他疾病的症状以及店主职业相关。
在乌干达农村地区基于人群的免费VTC项目的初始阶段，某些高风险群体在VTC接受者中所占比例较低。有必要针对VTC进行针对性宣传，以确保最需要服务的高风险个体能够参与。
