Mwangi Mary, Kellogg Timothy A, Dadabhai Sufia S, Bunnell Rebecca, Baltazar Godfrey, Ngare Carol, K'opiyo George, Mburu Margaret, Kim Andrea A
U.S. Centers for Disease Control and Prevention, Nairobi, Kenya.
San Francisco Department of Public Health, California, USA.
Open AIDS J. 2014 Mar 7;8:7-16. doi: 10.2174/1874613601408010007. eCollection 2014.
Population-based surveys with HIV testing in settings with low testing coverage provide opportunities for participants to learn their HIV status. Survey participants (15-64 years) in a 2007 nationally representative population-based HIV serologic survey in Kenya received a voucher to collect HIV test results at health facilities 6 weeks after blood draw. Logistic regression models were fitted to identify predictors of individual and couple collection of results. Of 15,853 adults consenting to blood draw, 7,222 (46.7%) collected HIV test results (46.5% men, 46.8% women). A third (39.5%) of HIV-infected adults who were unaware of their infection and 48.2% of those who had never been tested learned their HIV status during KAIS. Individual collection of HIV results was associated with older age, with the highest odds among adults aged 60-64 years (adjusted odds ratio [AOR], 1.6, 95% confidence interval [CI] 1.2-2.1); rural residence (AOR 1.8, 95%CI 1.2-2.6); and residence outside Nairobi, with the highest odds in the sparsely populated North Eastern province (AOR 8.0, 95%CI 2.9-21.8). Of 2,685 married/cohabiting couples, 18.5% collected results as a couple. Couples in Eastern province and in the second and middle wealth quintiles were more likely to collect results than those in Nairobi (AOR 3.2, 95%CI 1.1-9.4) and the lowest wealth quintile (second AOR 1.5, 95%CI 1.1-2.3; middle AOR 1.6, 95% CI 1.2-2.3, respectively. Many participants including those living with HIV learned their HIV status in KAIS. Future surveys need to address low uptake of results among youth, urban residents, couples and those with undiagnosed HIV infection.
在检测覆盖率较低的地区开展的基于人群的艾滋病病毒检测调查,为参与者提供了了解自身艾滋病病毒感染状况的机会。在2007年肯尼亚一项具有全国代表性的基于人群的艾滋病病毒血清学调查中,参与调查的对象为15至64岁人群,他们在抽血6周后可凭代金券到医疗机构领取艾滋病病毒检测结果。采用逻辑回归模型来确定个人及夫妻领取检测结果的预测因素。在15853名同意抽血的成年人中,7222人(46.7%)领取了艾滋病病毒检测结果(男性为46.5%,女性为46.8%)。在肯尼亚艾滋病病毒感染状况调查(KAIS)期间,三分之一(39.5%)此前未意识到自己感染艾滋病病毒的成年人以及48.2%从未接受过检测的人了解到了自己的艾滋病病毒感染状况。个人领取艾滋病病毒检测结果与年龄较大有关,在60至64岁的成年人中领取检测结果的几率最高(调整后的优势比[AOR]为1.6,95%置信区间[CI]为1.2至2.1);农村居住地区(AOR为1.8,95%CI为1.2至2.6);以及内罗毕以外的地区,在人口稀少的东北省领取检测结果的几率最高(AOR为8.0,95%CI为2.9至21.8)。在2685对已婚/同居伴侣中,18.5%的伴侣共同领取了检测结果。与内罗毕(AOR为3.2,95%CI为1.1至9.4)以及最贫困五分之一人群(第二个AOR为1.5,95%CI为1.1至2.3;中等收入五分之一人群AOR为1.6,95%CI为1.2至2.3)相比,东部省份以及第二和中等收入五分之一人群中的伴侣更有可能共同领取检测结果。包括艾滋病病毒感染者在内的许多参与者在肯尼亚艾滋病病毒感染状况调查中了解到了自己的艾滋病病毒感染状况。未来的调查需要解决年轻人、城市居民、伴侣以及未被诊断出感染艾滋病病毒者中检测结果领取率较低的问题。