Departments of Medicine and Community Health, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
AIDS Patient Care STDS. 2010 Feb;24(2):117-26. doi: 10.1089/apc.2009.0269.
Provider-initiated routine HIV testing is being scaled up throughout the world, however, little is known about the outcomes of routine HIV testing on subsequent behavior. This study examined the initial outcomes of provider-initiated routine HIV testing at a rural Ugandan hospital regarding partner HIV testing, sexual risk behavior, disclosure, and HIV care seeking. In a prospective cohort study, 245 outpatients receiving routine HIV testing completed baseline and 3-month follow-up interviews. After receiving routine HIV testing the percentage of participants engaging in risky sex decreased from 70.1% to 50.3% among HIV-negative and from 75.0% to 53.5% among HIV-positive participants, the percentage knowing their partner(s)' HIV status increased from 18.7% to 34.3% of HIV-negative and from 14.3% to 35.7% of HIV-positive participants. Among those reporting risky sex at baseline, HIV-positive participants were more likely to eliminate risky sex in general and specifically to become abstinent at follow-up than were HIV-negative participants. Similarly, unmarried participants who were risky at baseline were more likely to become safe in general, become abstinent, and start 100% condom use than were married/cohabitating participants. Rates of disclosure were high. Over 85% of those who tested HIV positive enrolled in care. Routine HIV testing in this setting may promote earlier HIV diagnosis and access to care but leads to only modest reductions in risky sexual behavior. To fully realize the potential HIV prevention benefits of routine HIV testing an emphasis on tailored risk-reduction counseling may be necessary.
医疗机构主动提供的常规 HIV 检测在全球范围内得到了推广，然而，对于常规 HIV 检测对后续行为的影响，我们知之甚少。本研究考察了乌干达农村地区一家医院实施医疗机构主动提供的常规 HIV 检测后的初步结果，包括性伴侣 HIV 检测、性行为风险、披露和 HIV 护理寻求。在一项前瞻性队列研究中，245 名接受常规 HIV 检测的门诊患者完成了基线和 3 个月随访访谈。接受常规 HIV 检测后，HIV 阴性参与者发生危险性行为的比例从 70.1%降至 50.3%，HIV 阳性参与者从 75.0%降至 53.5%；HIV 阴性参与者中知晓性伴侣 HIV 状况的比例从 18.7%上升至 34.3%，HIV 阳性参与者从 14.3%上升至 35.7%。在基线时报告有危险性行为的参与者中，HIV 阳性参与者更有可能总体上消除危险性行为，特别是在随访时保持禁欲，而非 HIV 阴性参与者。同样，在基线时存在危险行为的未婚参与者更有可能总体上变得安全，保持禁欲并开始 100%使用安全套，而非已婚/同居参与者。披露率很高。超过 85%的 HIV 检测阳性者都参加了护理。在这种情况下，常规 HIV 检测可能会促进更早的 HIV 诊断和获得护理，但只会导致性行为风险适度降低。为了充分实现常规 HIV 检测在预防 HIV 方面的潜在益处，可能需要强调有针对性的降低风险咨询。
