在肯尼亚西部一个大型家庭 HIV 检测计划中,青少年和成年人的 HIV 检测率和流行率。
HIV testing uptake and prevalence among adolescents and adults in a large home-based HIV testing program in Western Kenya.
机构信息
*USAID-Academic Model Providing Access to Healthcare (AMPATHPlus) Partnership, Eldoret, Kenya; †Department of Epidemiology, School of Public Health, College of Health Sciences, Moi University, Eldoret, Kenya; ‡Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN; §Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya; ‖Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN; ¶Regenstrief Institute, Inc, Indianapolis, IN; and #Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
出版信息
J Acquir Immune Defic Syndr. 2014 Feb 1;65(2):e58-66. doi: 10.1097/QAI.0b013e3182a14f9e.
OBJECTIVE
To describe HIV testing uptake and prevalence among adolescents and adults in a home-based HIV counseling and testing program in western Kenya.
METHODS
Since 2007, the Academic Model Providing Access to Healthcare program has implemented home-based HIV counseling and testing on a large scale. All individuals aged ≥13 years were eligible for testing. Data from 5 of 8 catchments were included in this analysis. We used descriptive statistics and multivariate logistic regression to examine testing uptake and HIV prevalence among adolescents (13-18 years), younger adults (19-24 years), and older adults (≥25 years).
RESULTS
There were 154,463 individuals eligible for analyses as follows: 22% adolescents, 19% younger adults, and 59% older adults. Overall mean age was 32.8 years and 56% were female. HIV testing was high (96%) across the following 3 groups: 99% in adolescents, 98% in younger adults, and 94% in older adults (P < 0.001). HIV prevalence was higher (11.0%) among older adults compared with younger adults (4.8%) and adolescents (0.8%) (P < 0.001). Those who had ever previously tested for HIV were less likely to accept HIV testing (adjusted odds ratio: 0.06, 95% confidence interval: 0.05 to 0.07) but more likely to newly test HIV positive (adjusted odds ratio: 1.30, 95% confidence interval: 1.21 to 1.40). Age group differences were evident in the sociodemographic and socioeconomic factors associated with testing uptake and HIV prevalence, particularly, gender, relationship status, and HIV testing history.
CONCLUSIONS
Sociodemographic and socioeconomic factors were independently associated with HIV testing and prevalence among the age groups. Community-based treatment and prevention strategies will need to consider these factors.
目的
描述肯尼亚西部一个家庭为基础的艾滋病毒咨询和检测方案中青少年和成年人的艾滋病毒检测率和流行率。
方法
自 2007 年以来,学术模式提供医疗保健方案已经大规模地实施了家庭为基础的艾滋病毒咨询和检测。所有年龄在≥13 岁的人均有资格接受检测。本分析包括了 8 个抽样区中的 5 个区的数据。我们使用描述性统计和多变量逻辑回归来检查青少年(13-18 岁)、年轻成年人(19-24 岁)和老年人(≥25 岁)中的检测率和艾滋病毒流行率。
结果
有 154463 人符合分析条件,如下:22%为青少年,19%为年轻成年人,59%为老年人。总体平均年龄为 32.8 岁,56%为女性。以下 3 组的艾滋病毒检测率均很高(96%):青少年为 99%,年轻成年人为 98%,老年成年人为 94%(P<0.001)。与年轻成年人(4.8%)和青少年(0.8%)相比,老年成年人的艾滋病毒流行率更高(11.0%)(P<0.001)。曾经接受过艾滋病毒检测的人不太可能接受艾滋病毒检测(调整后的优势比:0.06,95%置信区间:0.05 至 0.07),但更有可能新检测出艾滋病毒阳性(调整后的优势比:1.30,95%置信区间:1.21 至 1.40)。在与检测率和艾滋病毒流行率相关的社会人口统计学和社会经济因素方面,年龄组之间存在差异,特别是性别、关系状况和艾滋病毒检测史。
结论
社会人口统计学和社会经济因素与年龄组中的艾滋病毒检测和流行率独立相关。基于社区的治疗和预防策略将需要考虑这些因素。