Integrated Community Based Initiatives, Kabwohe, Uganda.
AIDS Patient Care STDS. 2010 Nov;24(11):735-41. doi: 10.1089/apc.2010.0096.
More than 80% of the people infected with HIV in low-income countries of sub-Saharan Africa do not know their HIV serostatus. Innovative measures of increasing access to HIV counseling and testing (HCT) are urgently needed so as to improve care and prevention. We implemented a home-based HCT program in Bushenyi District from September 2004 to March 2007, in Uganda where approximately 90% of people aged older than 14 years had never tested for HIV to gauge whether it was acceptable and increased uptake of HCT. Twenty-nine teams comprising a counselor and a laboratory assistant systematically visited homes offering HCT for all people older than 14 years of age and at-risk children (mother deceased or HIV infected) using a rapid HIV testing three-test algorithm. HIV-infected people received cotrimoxazole prophylaxis, were supplied with long-lasting insecticide-treated bed nets and equipment for treatment of drinking water at home, and were referred for assessment for antiretroviral therapy. The program reached 92,984 (63%) of all the homes in the district. Of these, 32,3621 people were eligible for HCT, and 28,2857 (87%) were present at home and were offered pretest counseling. A total of 264,966 (94%) accepted testing and received their results, of whom 11,359 (4.3%) were HIV-infected. Ninety percent of those testing had never tested before. The cost of testing was $7.83 per previously untested client. Ninety-seven percent of HIV-infected people initiated cotrimoxazole prophylaxis, 74% received bed nets, 70% received water treatment equipment, and 11% began antiretroviral therapy. Forty-four percent of people who were in an HIV-discordant relationship were infected. These results demonstrate that home-based HCT was well-accepted, feasible, and effective in identifying HIV-infected individuals who did not know their HIV status in rural Uganda.
撒哈拉以南非洲低收入国家超过 80%的艾滋病毒感染者不知道自己的艾滋病毒血清状况。迫切需要采取创新措施，增加艾滋病毒咨询和检测（HCT）的机会，以改善护理和预防工作。我们于 2004 年 9 月至 2007 年 3 月在乌干达布森约地区实施了一项基于家庭的 HCT 方案，在那里，大约 90%的 14 岁以上的人从未接受过艾滋病毒检测，以评估其是否可以接受并增加 HCT 的采用率。29 个小组由一名顾问和一名实验室助理组成，他们系统地访问家庭，为所有 14 岁以上的人和高危儿童（母亲去世或感染艾滋病毒的儿童）提供 HCT，使用快速艾滋病毒检测三测试算法。感染艾滋病毒的人接受复方新诺明预防，提供长效驱虫蚊帐和家用饮用水处理设备，并转介评估是否接受抗逆转录病毒治疗。该方案覆盖了该地区 92,984 户家庭（63%）。其中，32,3621 人有资格接受 HCT，28,2857 人（87%）在家中，并接受了检测前咨询。共有 264,966 人（94%）接受了检测并收到了检测结果，其中 11,359 人（4.3%）感染了艾滋病毒。90%的接受检测者以前从未接受过检测。每个新接受检测者的检测费用为 7.83 美元。97%的感染艾滋病毒的人开始接受复方新诺明预防，74%的人获得了蚊帐，70%的人获得了水处理设备，11%的人开始接受抗逆转录病毒治疗。44%的艾滋病毒不一致关系者受到感染。这些结果表明，基于家庭的 HCT 在乌干达农村地区是可行的，能够有效识别那些不知道自己艾滋病毒状况的艾滋病毒感染者。
