Mayer Kenneth H, Crawford Phil, Dant Lydia, Gillespie Suzanne, Singal Robbie, Vandermeer Meredith, Muench John, Long Tim, Quach Thu, Chaudhry Amina, Crane Heidi M, Lembo Daniela, Mills Robert, McBurnie Mary Ann
1 Fenway Health, Harvard Medical School , Beth Israel Deaconess, Boston, Massachusetts.
2 Kaiser Permanente, Center for Health Research , Portland, Oregon.
AIDS Patient Care STDS. 2016 Jun;30(6):237-46. doi: 10.1089/apc.2015.0314.
Because of the advent of highly effective treatments, routine screening for HIV and hepatitis C virus (HCV) has been recommended for many Americans. This study explored the perceived barriers surrounding routine HIV and HCV screening in a diverse sample of community health centers (CHCs). The Community Health Applied Research Network (CHARN) is a collaboration of CHCs, with a shared clinical database. In July, 2013, 195 CHARN providers working in 12 CHCs completed a survey of their attitudes and beliefs about HIV and HCV testing. Summary statistics were generated to describe the prevalence of HIV and HCV and associated demographics by CHCs. HIV and HCV prevalence ranged from 0.1% to 5.7% for HIV and from 0.1% to 3.7% for HCV in the different CHCs. About 15% of the providers cared for at least 50 individuals with HIV and the same was true for HCV. Two-thirds saw less than 10 patients with HIV and less than half saw less than 10 patients with HCV. Less than two-thirds followed USPHS guidelines to screen all patients for HIV between the ages of 13 and 64, and only 44.4% followed the guidance to screen all baby boomers for HCV. Providers with less HIV experience tended to be more concerned about routine screening practices. More experienced providers were more likely to perceive lack of time being an impediment to routine screening. Many US CHC providers do not routinely screen their patients for HIV and HCV. Although additional education about the rationale for routine screening may be indicated, incentives to compensate providers for the additional time they anticipate spending in counseling may also facilitate increased screening rates.
由于高效治疗方法的出现，许多美国人被建议进行常规的艾滋病毒和丙型肝炎病毒（HCV）筛查。本研究探讨了社区卫生中心（CHC）多样化样本中围绕常规艾滋病毒和HCV筛查的感知障碍。社区卫生应用研究网络（CHARN）是一个由CHC组成的合作组织，拥有一个共享的临床数据库。2013年7月，在12个CHC工作的195名CHARN提供者完成了一项关于他们对艾滋病毒和HCV检测的态度和信念的调查。生成了汇总统计数据，以按CHC描述艾滋病毒和HCV的患病率及相关人口统计学特征。不同CHC中艾滋病毒的患病率在0.1%至5.7%之间，HCV的患病率在0.1%至3.7%之间。约15%的提供者至少照顾过50名艾滋病毒感染者，HCV感染者情况相同。三分之二的人看过不到10名艾滋病毒患者，不到一半的人看过不到10名HCV患者。不到三分之二的人遵循美国公共卫生署的指南对所有13至64岁的患者进行艾滋病毒筛查，只有44.4%的人遵循指南对所有婴儿潮一代进行HCV筛查。艾滋病毒经验较少的提供者往往更关注常规筛查做法。经验更丰富的提供者更有可能认为时间不足是常规筛查的障碍。许多美国CHC提供者没有对他们的患者进行常规的艾滋病毒和HCV筛查。虽然可能需要对常规筛查的基本原理进行更多教育，但对提供者因预计在咨询中花费的额外时间给予补偿的激励措施也可能有助于提高筛查率。
