Hong Nguyen Thi Thu, Wolfe Mitchell I, Dat Tran Tien, McFarland Deborah A, Kamb Mary L, Thang Nguyen Trong, Thai Hoang Nam, Del Rio Carlos
U.S. Centers for Disease Control and Prevention (CDC), Global AIDS Program, 7 Lang Ha St., Dong Da, Hanoi, Vietnam.
AIDS Educ Prev. 2011 Jun;23(3 Suppl):30-48. doi: 10.1521/aeap.2011.23.3_supp.30.
This study evaluated the utilization of HIV voluntary counseling-and-testing (VCT) services targeting high-risk populations in Vietnam in order to inform decisions on program improvement and expansion. A total of 158,888 records collected from 55 VCT sites supported by the U.S. Centers for Disease Control and Prevention's Global AIDS Program in the period of 2002 to 2007 were used to analyze sociodemographic characteristics, risk exposures, seropositivity, test refusal, and failure to return for test results among VCT clients. High-risk exposures, such as injection drug use, commercial sex work, homosexual contacts or heterosexual contacts with high-risk sex partners, were reported in 126,815 (81%) records. Among high-risk clients, any condom use in the past month ranged from 34% to 71%. During the study period, 19% of the VCT encounters resulted in a positive HIV test; of those persons tested, 23% of men and 13% of women were HIV-positive. High HIV positivity rates were associated with injection drug use, being ill/recommended by health care provider, and having an HIV-infected sex partner. Of all records, 6.1% documented refusal of HIV testing. Failure to return for results was reported in 3.5% of records for clients who were tested. Previously testing positive was the strongest predictor of test refusal, and being referred by peer educators was associated with failure to return for results. The VCT program in Vietnam successfully targeted high-risk populations, and clients had high return rates using a standard testing strategy. Interventions to increase consistent condom use and promote access to prevention services among sex partners of high-risk individuals should be implemented and evaluated.
本研究评估了越南针对高危人群的艾滋病毒自愿咨询检测（VCT）服务的利用情况，以便为项目改进和扩展决策提供依据。2002年至2007年期间，从美国疾病控制与预防中心全球艾滋病项目支持的55个VCT站点收集了共计158,888份记录，用于分析VCT服务对象的社会人口学特征、风险暴露情况、血清阳性率、检测拒绝情况以及未返回获取检测结果的情况。在126,815（81%）份记录中报告了高危暴露情况，如注射吸毒、商业性工作、同性恋接触或与高危性伴的异性恋接触。在高危服务对象中，过去一个月内任何时候使用避孕套的比例在34%至71%之间。在研究期间，19%的VCT咨询检测结果为艾滋病毒阳性；在接受检测的人群中，23%的男性和13%的女性艾滋病毒呈阳性。高艾滋病毒阳性率与注射吸毒、患病/经医疗服务提供者建议以及有艾滋病毒感染的性伴有关。在所有记录中，6.1%记录了拒绝艾滋病毒检测的情况。在接受检测的服务对象中，3.5%的记录报告未返回获取结果。之前检测呈阳性是检测拒绝的最强预测因素，由同伴教育者转介与未返回获取结果有关。越南的VCT项目成功地针对了高危人群，并且服务对象使用标准检测策略的回访率很高。应实施并评估旨在增加持续使用避孕套以及促进高危个体性伴获得预防服务的干预措施。
