Tan Cheryl, Van Handel Michelle, Johnson Christopher, Dietz Patricia
Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Program Evaluation Branch, Atlanta, GA.
Public Health Rep. 2016 Jan-Feb;131(1):137-44. doi: 10.1177/003335491613100120.
We determined whether or not HIV testing in publicly funded settings in the United States increased after 2006, when CDC recommended expanded HIV screening in health-care settings for all people aged 13-64 years.
We analyzed 2003-2010 National Health Interview Survey data to estimate annual national percentages of people aged 18-64 years who were tested for HIV in the previous 12 months. Estimates were calculated by setting (publicly funded, yes/other) and stratified by sex. Test settings were categorized as publicly funded based on the contribution of public funds for HIV testing. We used logistic regression modeling to assess statistical significance in linear trends for 2003-2006 and 2006-2010, adjusting for age, race/ethnicity, and health insurance coverage. Using model parameters for survey year, we calculated the estimated annual percentage change (EAPC) in HIV testing as the difference in the model-predicted testing prevalence between baseline and first post-baseline years, divided by baseline prevalence.
During 2006-2010, the percentage of women tested for HIV in publicly funded settings increased significantly from 1.9% in 2006 to 2.4% in 2010 (EAPC=6.9%, p=0.008) and the percentage tested in other settings remained fairly stable, from 9.7% in 2006 to 9.6% in 2010 (EAPC=-0.5%, p=0.708). During the same period, the percentage of men tested for HIV in publicly funded settings increased, but not significantly, from 1.5% in 2006 to 1.9% in 2010 (EAPC=5.3%, p=0.110) and the percentage tested in other settings decreased significantly from 7.5% in 2006 to 6.2% in 2010 (EAPC=-4.4%, p=0.001).
Although HIV testing in publicly funded settings increased among women during 2006-2010, testing rates remained low, and no similar increase occurred among men. As such, all test settings should increase HIV screening, particularly for men.
我们确定了在美国,自2006年疾病控制与预防中心(CDC)建议在医疗机构中对所有13至64岁人群扩大HIV筛查后,公共资助机构中的HIV检测是否有所增加。
我们分析了2003 - 2010年国家健康访谈调查数据,以估算过去12个月中接受HIV检测的18至64岁人群的年度全国百分比。估算值按检测机构(公共资助机构,是/其他)进行计算,并按性别分层。根据公共资金对HIV检测的贡献,检测机构被归类为公共资助机构。我们使用逻辑回归模型评估2003 - 2006年和2006 - 2010年线性趋势的统计学显著性,并对年龄、种族/族裔和医疗保险覆盖情况进行了调整。利用调查年份的模型参数,我们计算了HIV检测的估计年度百分比变化(EAPC),即基线年份和基线后第一年模型预测的检测患病率之差除以基线患病率。
在2006 - 2010年期间,公共资助机构中接受HIV检测的女性百分比从2006年的1.9%显著增加到2010年的2.4%(EAPC = 6.9%,p = 0.008),而在其他机构接受检测的百分比保持相当稳定,从2006年的9.7%降至2010年的9.6%(EAPC = -0.5%,p = 0.708)。在同一时期,公共资助机构中接受HIV检测的男性百分比有所增加,但不显著,从2006年的1.5%增至2010年的1.9%(EAPC = 5.3%,p = 0.110),而在其他机构接受检测的百分比从2006年的7.5%显著降至2010年的6.2%(EAPC = -4.4%,p = 0.001)。
尽管在2006 - 2010年期间公共资助机构中的HIV检测在女性中有所增加,但检测率仍然较低,且男性中未出现类似增加。因此,所有检测机构都应增加HIV筛查,尤其是针对男性。