Lubogo David, Ddamulira John Bosco, Tweheyo Raymond, Wamani Henry
Department of Community Health and Behavioural Sciences, Makerere University, College of Health Sciences, School of Public Health, P.O.Box 7072, Kampala, Uganda.
Department of Disease Control and Environmental Health, Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda.
BMC Fam Pract. 2015 Nov 3;16:162. doi: 10.1186/s12875-015-0379-6.
The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4-1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000-81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda.
In a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis.
The majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25-34 years (AOR = 5.1, 95 % CI: 1.5-17.1), male sex (AOR = 2.3, 95 % CI: 1.2-4.4), urban residence (AOR = 2.5, CI: 1.1-5.9) and lack of family support (AOR = 0.5, CI: 0.2-0.9).
There was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.
艾滋病毒/艾滋病这一健康挑战继续肆虐世界上许多资源匮乏的国家。2012年，全球与艾滋病毒/艾滋病相关的死亡总数达160万（140万 - 190万），其中约75%发生在撒哈拉以南非洲，乌干达有6.3万（5.2万 - 8.1万）人死于该病。如果艾滋病毒/艾滋病感染者能够更容易获得艾滋病毒护理和治疗，那么与艾滋病毒/艾滋病相关的大部分发病和死亡情况是可以避免的。因此，本研究的目的是探讨乌干达东部库米区一个居家艾滋病毒咨询和检测项目所确定的艾滋病毒血清阳性患者中，与获得艾滋病毒护理服务相关的因素。
在2009年2月进行的一项横断面研究中，我们探究了预测变量：与获得艾滋病毒护理和治疗相关的社会人口统计学、卫生设施及社区因素。主要结局指标是报告接受复方新诺明预防治疗的情况。
大多数[81.1%（284/350）]受访者接受了复方新诺明预防治疗（表明获得了艾滋病毒护理）。与获得艾滋病毒护理相关的主要因素包括：年龄25 - 34岁（调整后比值比[AOR] = 5.1，95%置信区间[CI]：1.5 - 17.1）、男性（AOR = 2.3，95% CI：1.2 - 4.4）、城市居住（AOR = 2.5，CI：1.1 - 5.9）以及缺乏家庭支持（AOR = 0.5，CI：0.2 - 0.9）。
从库米居家艾滋病毒咨询和检测项目转诊而来的艾滋病毒阳性患者在卫生设施中获得艾滋病毒护理和治疗服务的比例相对较高。与获得艾滋病毒护理服务相关的因素包括：年龄组、性别、居住情况以及是否有支持性家庭。因此，在类似环境中参与提供艾滋病毒护理和治疗服务的利益相关者在制定改善艾滋病毒护理服务可及性的干预措施时，应考虑这些社会人口统计学变量。
