Ford Chandra L, Lee Sung-Jae, Wallace Steven P, Nakazono Terry, Newman Peter A, Cunningham William E
a Department of Community Health Sciences, Los Angeles (UCLA) Fielding School of Public Health , University of California , Los Angeles , CA , USA.
AIDS Care. 2015;27(2):189-97. doi: 10.1080/09540121.2014.963008. Epub 2014 Oct 10.
The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus (HIV) testing of every client presenting for services in venues where HIV prevalence is high. Because older adults (aged ≥50 years) have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent (past 12 months) and ever HIV testing in a probability sample of at-risk adults (N = 1238) seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category (<50 years vs. ≥50 years) and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months (odds ratio [OR] = 0.6; 95% confidence interval [CI] = 0.40-0.90) or ever (OR = 0.6; 95% CI = 0.40-0.90). Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis.
美国疾病控制与预防中心建议，在艾滋病毒感染率较高的场所，对每一位前来接受服务的客户进行常规的人类免疫缺陷病毒（HIV）检测。由于老年人（年龄≥50岁）如果在艾滋病毒疾病病程后期才得到诊断，其预后特别差，因此在这些场所为年轻人提供的任何筛查也应提供给老年人。我们在一个有风险的成年人概率样本（N = 1238）中，研究了近期（过去12个月）和曾经进行HIV检测方面与年龄相关的差异，这些成年人在提供HIV检测的针头交换点、性传播疾病诊所和拉丁裔社区诊所寻求服务。使用带有广义估计方程的多元逻辑回归，我们估计了年龄类别（<50岁与≥50岁）与每种HIV检测结果之间的关联。即使在控制了诸如近期注射吸毒等协变量之后，老年人在过去12个月内进行检测（优势比[OR] = 0.6；95%置信区间[CI] = 0.40 - 0.90）或曾经进行检测（OR = 0.6；95% CI = 0.40 - 0.90）的几率也比年轻人低40%。在这些艾滋病毒感染率较高的场所的客户中，存在与年龄相关的HIV检测差异，这可能导致已知的与年龄相关的艾滋病毒感染诊断延迟和长期预后不良的差异。
