Burns Fiona M, Johnson Anne M, Nazroo James, Ainsworth Jonathan, Anderson Jane, Fakoya Ade, Fakoya Ibidun, Hughes Andy, Jungmann Eva, Sadiq S Tariq, Sullivan Ann K, Fenton Kevin A
Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, London, UK.
AIDS. 2008 Jan 2;22(1):115-22. doi: 10.1097/QAD.0b013e3282f1d4b6.
To identify opportunities for earlier HIV diagnosis within primary and secondary care settings in the UK in Africans with newly diagnosed HIV infection.
A survey of newly diagnosed HIV-positive Africans attending 15 HIV treatment centres across London was conducted between April 2004 and February 2006. The survey consisted of a confidential self-completed questionnaire linked to clinician-completed clinical records.
A total of 263 questionnaires were completed, representing an uptake rate of 79.5% of patients approached and 49.8% (131/263) of participants presented with advanced HIV disease (CD4 cell count < 200 cells/mul at diagnosis). In the year prior to HIV diagnosis 76.4% (181/237) had seen their GP, 38.3% (98/256) had attended outpatient services, and 15.2% (39/257) inpatient services, representing missed opportunities for earlier HIV diagnosis. Of those attending GP services the issue of HIV and/or HIV testing was raised for 17.6% (31/176) and 37.1% (78/210) had a previous negative HIV test, 32.5% of these within the UK. Medical attention was sought for wide ranging reasons, often not obviously connected to underlying HIV status. Despite the population predominantly coming from countries of high HIV prevalence personal appreciation of risk was comparatively low and knowledge of benefits of testing lacking.
Africans are accessing health services but clinicians are failing to use these opportunities effectively for preventive and diagnostic purposes with regards to HIV infection. Comparatively low appreciation of personal risk and lack of perceived ill health within this community means clinicians need to be more proactive in addressing HIV.
确定在英国初级和二级医疗保健机构中，对新诊断出感染艾滋病毒的非洲人进行更早艾滋病毒诊断的机会。
2004年4月至2006年2月期间，对伦敦15家艾滋病毒治疗中心新诊断出艾滋病毒呈阳性的非洲人进行了一项调查。该调查包括一份保密的自我填写问卷，并与临床医生填写的临床记录相关联。
共完成了263份问卷，占所接触患者的79.5%，49.8%（131/263）的参与者被诊断为晚期艾滋病毒疾病（诊断时CD4细胞计数<200个/微升）。在艾滋病毒诊断前一年，76.4%（181/237）的人看过全科医生，38.3%（98/256）的人去过门诊服务，15.2%（39/257）的人去过住院服务，这代表着错过更早艾滋病毒诊断的机会。在看过全科医生的人中，17.6%（31/176）的人提到了艾滋病毒和/或艾滋病毒检测问题，37.1%（78/210）的人之前艾滋病毒检测呈阴性，其中32.5%是在英国进行的检测。寻求医疗关注的原因多种多样，通常与潜在的艾滋病毒状况没有明显关联。尽管该人群主要来自艾滋病毒高流行国家，但个人对风险的认知相对较低，且缺乏对检测益处的了解。
非洲人正在利用医疗服务，但临床医生未能有效利用这些机会进行艾滋病毒感染的预防和诊断。该社区对个人风险的认知相对较低，且未察觉到健康问题，这意味着临床医生需要在应对艾滋病毒方面更加积极主动。
