Wools-Kaloustian Kara, Kimaiyo Silvester, Musick Beverly, Sidle John, Siika Abraham, Nyandiko Winstone, Einterz Robert, Tierney William M, Yiannoutsos Constantin T
Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202-5124, USA.
AIDS. 2009 Jan 14;23(2):195-201. doi: 10.1097/QAD.0b013e32831cc0e6.
The President's Emergency Plan for AIDS Relief committed $15 billion to addressing HIV in resource-poor settings.
To assess the impact of The President's Emergency Plan for AIDS Relief on the treatment services of an HIV care program.
DESIGN, SETTING, AND PATIENTS: Cohort study utilizing computerized medical records of nonpregnant adults enrolled into the Academic Model for the Prevention and Treatment of HIV/AIDS system, in western Kenya between 27 November 2001 and 24 July 2006.
Number of clinics and patients enrolled in Academic Model for the Prevention and Treatment of HIV/AIDS, as well as patient demographics, immunologic, and clinical characteristics during three periods defined by the availability of combination antiretroviral therapy (cART).
Enrollment as of May 2006 was 23,539. Mean monthly enrollment increased from 64 to 815 between periods 1 and 3. The median CD4 cell count at enrollment during period 3 (172 cells/microl) was significantly higher than for period 2 (119 cells/microl; P < 0.001). World Health Organization stage at enrollment differed significantly between periods with 6.7% having stage 4 disease in period 3 compared with 13.8% during period 1 (P < 0.001). Significantly more patients had complete documentation of cART eligibility, during period 3 as compared with the previous periods. Time from enrollment to cART initiation decreased from a median of 64 weeks in period 1 to 12 weeks during period 3 (P < 0.001).
The President's Emergency Plan for AIDS Relief funding has allowed Academic Model for the Prevention and Treatment of HIV/AIDS to significantly increase the number of individuals receiving HIV care and provided the ability to expand services allowing for identification of patients earlier in their disease process.
总统防治艾滋病紧急救援计划投入150亿美元用于在资源匮乏地区应对艾滋病病毒。
评估总统防治艾滋病紧急救援计划对一个艾滋病护理项目治疗服务的影响。
设计、地点和患者：队列研究，利用2001年11月27日至2006年7月24日期间肯尼亚西部纳入艾滋病病毒预防和治疗学术模式系统的非孕成年人的计算机化医疗记录。
纳入艾滋病病毒预防和治疗学术模式的诊所和患者数量，以及在由联合抗逆转录病毒疗法（cART）可用性定义的三个时期内患者的人口统计学、免疫学和临床特征。
截至2006年5月，登记人数为23,539人。第1阶段和第3阶段之间，月平均登记人数从64人增加到815人。第3阶段登记时的CD4细胞计数中位数（172个/微升）显著高于第2阶段（119个/微升；P<0.001）。登记时的世界卫生组织疾病分期在各时期之间有显著差异，第3阶段有6.7%的患者处于4期疾病，而第1阶段为13.8%（P<0.001）。与前几个时期相比，第3阶段有更多患者有cART资格的完整记录。从登记到开始cART的时间从中位数第1阶段的64周减少到第3阶段的12周（P<0.001）。
总统防治艾滋病紧急救援计划的资金使艾滋病病毒预防和治疗学术模式能够显著增加接受艾滋病护理的人数，并提供了扩大服务的能力，从而能够在疾病进程的早期识别患者。
