STD Control Department, Guangdong Provincial Center for Skin Diseases and STD Control, Guangzhou, China.
J Acquir Immune Defic Syndr. 2011 Aug 15;57(5):e106-11. doi: 10.1097/QAI.0b013e31821d3694.
HIV testing is still stigmatized among many high-risk groups in China, whereas routine syphilis testing has been widely accepted at sexually transmitted infection (STI) clinics. This project used the platform of a rapid syphilis screening test to expand HIV test uptake. The objective of this study was to use multilevel modeling to analyze determinants of syphilis and HIV-testing uptake at STI clinics in China.
2061 STI patients at 6 clinics in Guangdong Province were offered free rapid syphilis and free rapid HIV testing. Test uptake was defined by patient receipt of results and a multilevel model was used to analyze predictors of uptake.
This was the first syphilis or HIV test for the large majority (1388, 77.7%) of participants. Syphilis test uptake and HIV test uptake were high (1681, 81.6%, syphilis test uptake; 1673, 81.2% HIV test uptake). HIV test uptake was significantly concordant with syphilis test uptake (τb = 0.89, P < 0.001). The most parsimonious model of refusing HIV test uptake included the following variables: being married, having a previous HIV test, being unaccompanied, and participating in the last 2 months of the study.
STI clinic-based screening for syphilis and HIV represents an excellent opportunity for scaling up integrated services, especially in South China where syphilis and sexually transmitted HIV cases are both rapidly increasing. Effective integration of HIV testing into routine clinical practice requires an understanding not only of individual test uptake but also of the broader social context of HIV testing.
在中国，许多高危人群仍然对艾滋病检测存在污名化，而常规梅毒检测已在性传播感染（STI）诊所得到广泛接受。本项目利用快速梅毒筛查试验的平台，扩大了艾滋病检测的覆盖面。本研究的目的是利用多水平模型分析中国 STI 诊所中梅毒和艾滋病检测的决定因素。
广东省 6 家诊所的 2061 名 STI 患者接受了免费的快速梅毒和快速 HIV 检测。检测结果的接收情况定义了检测的采用情况，多水平模型用于分析采用的预测因素。
对于绝大多数参与者（1388 人，77.7%）来说，这是他们第一次进行梅毒或艾滋病检测。梅毒检测和 HIV 检测的采用率都很高（1681 人，81.6%，梅毒检测采用率；1673 人，81.2%，HIV 检测采用率）。HIV 检测采用率与梅毒检测采用率显著相关（τb=0.89，P<0.001）。拒绝 HIV 检测采用的最简化模型包括以下变量：已婚、有过 HIV 检测史、无人陪伴、参与研究的最后 2 个月。
基于 STI 诊所的梅毒和 HIV 筛查代表了扩大综合服务的绝佳机会，特别是在中国南方，梅毒和性传播 HIV 病例都在迅速增加。将 HIV 检测有效纳入常规临床实践不仅需要了解个体检测采用情况，还需要了解 HIV 检测的更广泛社会背景。
