Social and Behavioral Interventions Program, Department of International Health, Room E5033, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
AIDS Behav. 2013 Jun;17(5):1571-90. doi: 10.1007/s10461-012-0241-y.
Provider-initiated HIV testing and counseling (PITC) has expanded since 2007 WHO guidelines were established. We conducted a systematic review of PITC in low- and middle-income countries. Peer-reviewed studies were included if they measured pre-post or multi-arm outcomes. Two coders abstracted data using standardized forms. Nineteen studies were included, all from sub-Saharan Africa (N = 15) or Asia (N = 4). Studies were conducted in clinics for antenatal/family planning/child health (N = 12), tuberculosis (N = 4), outpatient (N = 1), sexually transmitted diseases (N = 1), and methadone maintenance (N = 1). HIV testing uptake increased after PITC. Condom use also increased following PITC in most studies; nevirapine uptake and other outcomes were mixed. Few negative outcomes were identified. Findings support PITC as an important intervention to increase HIV testing. PITC's impact on other outcomes is mixed, but does not appear to be worse than voluntary counseling and testing. PITC should continue to be expanded and rigorously evaluated across settings and outcomes.
自 2007 年世界卫生组织指南出台以来，提供者启动的 HIV 检测和咨询（PITC）已经得到了扩展。我们对中低收入国家的 PITC 进行了系统评价。如果研究测量了前后或多臂结果，则纳入同行评议的研究。两位编码员使用标准化表格提取数据。纳入了 19 项研究，均来自撒哈拉以南非洲（N=15）或亚洲（N=4）。研究在产前/计划生育/儿童保健诊所（N=12）、结核病（N=4）、门诊（N=1）、性传播疾病（N=1）和美沙酮维持治疗（N=1）中进行。在 PITC 之后，HIV 检测的采用率增加了。在大多数研究中，PITC 后避孕套的使用也增加了；奈韦拉平的使用和其他结果则好坏参半。只发现了少数负面结果。研究结果支持 PITC 作为增加 HIV 检测的重要干预措施。PITC 对其他结果的影响好坏参半，但似乎并不比自愿咨询和检测更差。应继续在不同环境和结果中扩大和严格评估 PITC。
