Kanara N, Cain K P, Chhum V, Eng B, Kim S, Keo S, Heller T A, Varma J K
United States Centers for Disease Control and Prevention Global AIDS Program-Cambodia, Phnom Penh, Cambodia.
Int J Tuberc Lung Dis. 2009 Feb;13(2):226-31.
Banteay Meanchey Province, Cambodia.
Cambodia has the highest incidence of tuberculosis (TB) in Asia. Not all TB patients are tested for human immunodeficiency virus (HIV). We assessed the association between distance to HIV testing facility and HIV testing rates.
We analyzed data on TB patients from 11 clinics to determine the proportion tested for HIV infection. We categorized each TB clinic as having a voluntary confidential counseling and testing (VCCT) center onsite, or being at <15 min, 15-30 min or >30 min driving distance to the nearest VCCT.
Of 1017 TB patients not previously tested for HIV, 708 (70%) were tested. Of 481 TB patients without onsite VCCT, 297 (62%) were tested, compared to 410 (77%) of 535 TB patients with onsite VCCT (RR 0.6, 95%CI 0.5-0.7). When the VCCT site was >15 min from the TB clinic, HIV testing occurred only half as frequently as when onsite VCCT was available.
TB patients treated at clinics without onsite or nearby HIV testing are less commonly tested for HIV infection. Making HIV testing available to TB patients without the necessity of traveling to a distant HIV testing site is likely to increase HIV testing rates.
柬埔寨班迭棉吉省。
柬埔寨是亚洲结核病发病率最高的国家。并非所有结核病患者都接受了人类免疫缺陷病毒（HIV）检测。我们评估了距离HIV检测机构的远近与HIV检测率之间的关联。
我们分析了来自11家诊所的结核病患者数据，以确定接受HIV感染检测的比例。我们将每家结核病诊所分类为现场设有自愿咨询检测（VCCT）中心，或距离最近的VCCT的驾车距离小于15分钟、15 - 30分钟或大于30分钟。
在1017名之前未接受过HIV检测的结核病患者中，708名（70%）接受了检测。在481名现场没有VCCT的结核病患者中，297名（62%）接受了检测，而在535名现场设有VCCT的结核病患者中，410名（77%）接受了检测（相对危险度0.6，95%可信区间0.5 - 0.7）。当VCCT地点距离结核病诊所超过15分钟车程时，HIV检测的频率仅为现场设有VCCT时的一半。
在没有现场或附近HIV检测机构的诊所接受治疗的结核病患者接受HIV感染检测的情况较少。让结核病患者无需前往遥远的HIV检测地点就能进行检测，可能会提高HIV检测率。
