Fiorillo Suzanne P, Landman Keren Z, Tribble Alison C, Mtalo Antipas, Itemba Dafrosa K, Ostermann Jan, Thielman Nathan M, Crump John A
Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC, United States.
AIDS Care. 2012;24(10):1264-71. doi: 10.1080/09540121.2012.658751. Epub 2012 Mar 1.
While HIV counseling and testing (HCT) has been considered an HIV preventive measure in Africa, data are limited describing behavior changes following HCT. This study evaluated behavior changes and estimated HIV seroincidence rate among returning HCT clients. Repeat and one-time testing clients receiving HCT services in Moshi, Tanzania were identified. Information about sociodemographic characteristics, HIV-related behaviors and testing reasons were collected, along with HIV serostatus. Six thousand seven hundred and twenty-seven clients presented at least once for HCT; 1235 (18.4%) were HIV seropositive, median age was 29.7 years and 3712 (55.3%) were women. 1382 repeat and 4272 one-time testers were identified. Repeat testers were more likely to be male, older, married, or widowed, and testing because of unfaithful partner or new sexual partner. One-time testers were more likely to be students and testing due to illness. At second test, repeat testers were more likely to report that partners had received HIV testing, not have concurrent partners, not suspect partners have HIV, and have partners who did not have other partners. Clients who intended to change behaviors after the first test were more likely to report having changed behaviors by remaining abstinent (OR 2.58; p<0.0001) or using condoms (OR 2.00; p=0.006) at the second test. HIV seroincidence rate was 1.49 cases/100 person-years (PY). Clients presenting for repeat HCT reported some reduction of risky behavior and improved knowledge of sexual practices and HIV serostatus of their partners. Promoting behavior change through HCT should continue to be a focus of HIV prevention efforts in sub-Saharan Africa.
虽然在非洲，艾滋病毒咨询与检测（HCT）一直被视为一种艾滋病毒预防措施，但描述HCT后行为变化的数据有限。本研究评估了接受HCT的回访客户的行为变化，并估计了艾滋病毒血清感染率。在坦桑尼亚莫希，确定了接受HCT服务的重复检测者和一次性检测者。收集了有关社会人口学特征、与艾滋病毒相关的行为及检测原因的信息，以及艾滋病毒血清学状态。6727名客户至少前来接受过一次HCT；1235人（18.4%）艾滋病毒血清呈阳性，中位年龄为29.7岁，3712人（55.3%）为女性。确定了1382名重复检测者和4272名一次性检测者。重复检测者更有可能为男性、年龄较大、已婚或丧偶，检测原因是伴侣不忠或有新的性伴侣。一次性检测者更有可能是学生，检测原因是患病。在第二次检测时，重复检测者更有可能报告其伴侣接受过艾滋病毒检测、没有同时交往的伴侣、不怀疑伴侣感染艾滋病毒，且伴侣没有其他性伴侣。打算在第一次检测后改变行为的客户，在第二次检测时更有可能报告已通过保持禁欲（比值比2.58；p<0.0001）或使用避孕套（比值比2.00；p=0.006）来改变行为。艾滋病毒血清感染率为1.49例/100人年（PY）。前来接受重复HCT的客户报告称，一些危险行为有所减少，对性行为及伴侣的艾滋病毒血清学状态的了解有所改善。通过HCT促进行为改变应继续作为撒哈拉以南非洲艾滋病毒预防工作的重点。
