2014年美国61个卫生部门辖区内疾病控制与预防中心资助的针对新诊断女性的人类免疫缺陷病毒检测、阳性率及服务提供情况

Centers for Disease Control and Prevention-Funded Human Immunodeficiency Virus Testing, Positivity, and Service Delivery among Newly Diagnosed Women in 61 Health Department Jurisdictions, United States, 2014.

作者信息

Seth Puja, Figueroa Argelia, Wang Guoshen

机构信息

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Womens Health Issues. 2016 Sep-Oct;26(5):496-503. doi: 10.1016/j.whi.2016.05.011. Epub 2016 Jul 12.

Abstract

BACKGROUND

More than 1.2 million persons are living with human immunodeficiency virus (HIV) in the United States; at the end of 2011, 23% of them were women. Minority women are disproportionately affected by HIV, and new infections are higher among older women. HIV testing and service delivery among women funded by the U.S. Centers for Disease Control and Prevention (CDC) is examined.

METHODS

Data were submitted by 61 health department jurisdictions. HIV testing, HIV-positive tests, new HIV diagnoses among women, and linkage and referral services among newly diagnosed women are described. Differences across demographic characteristics for HIV diagnoses, linkage, and referral services were assessed. Diagnoses were identified as new when women who tested HIV positive were not found to be reported previously in the jurisdiction's HIV surveillance system; when jurisdictions could not verify prior test results in their surveillance systems, new diagnoses were identified by self-report.

RESULTS

Of CDC-funded testing events in 2014, 1,484,902 (48.7%) were among women, and they accounted for 19.5% of all HIV-positive testing events. Among women tested, 0.4% were HIV positive, and 0.1% had new HIV diagnoses. Women aged 40 and older and Black women were more likely to test HIV positive (0.7% and 0.5%, respectively). Among newly diagnosed women, 62.8% were linked within any timeframe, 57.1% were linked within 90 days, 74.1% were referred to partner services, 57.5% were interviewed for partner services, and 55.5% were referred to HIV risk reduction services.

CONCLUSIONS

Among all women receiving CDC-funded HIV testing, Black women and older women were more likely to have HIV-positive tests and new diagnoses. Although women overall may not be at the highest risk for HIV, Black women in this sample are disproportionately affected. Additionally, linkage, referral, and interview services for women need improvement. Targeted testing approaches may ensure effective test-and-treat strategies for women.

摘要

背景

美国有超过120万人感染了人类免疫缺陷病毒(HIV);截至2011年底,其中23%为女性。少数族裔女性受HIV影响的比例过高,老年女性中的新感染病例更多。本文对美国疾病控制与预防中心(CDC)资助的针对女性的HIV检测及服务提供情况进行了研究。

方法

61个卫生部门辖区提交了数据。描述了HIV检测、HIV阳性检测结果、女性中新发HIV诊断病例以及新诊断女性的关联和转诊服务情况。评估了HIV诊断、关联和转诊服务在人口统计学特征方面的差异。当在辖区的HIV监测系统中未发现此前报告过HIV检测呈阳性的女性时,诊断被确定为新发;当辖区无法在其监测系统中核实先前的检测结果时,新发诊断通过自我报告来确定。

结果

在2014年由CDC资助的检测活动中,1,484,902例(48.7%)是针对女性的,这些检测占所有HIV阳性检测活动的19.5%。在接受检测的女性中,0.4%的人HIV检测呈阳性,0.1%的人有新发HIV诊断。40岁及以上的女性和黑人女性HIV检测呈阳性的可能性更高(分别为0.7%和0.5%)。在新诊断的女性中,62.8%在任何时间段内都建立了关联,57.1%在90天内建立了关联,74.1%被转介到性伴服务机构,57.5%接受了性伴服务访谈,55.5%被转介到HIV风险降低服务机构。

结论

在所有接受CDC资助的HIV检测的女性中,黑人女性和老年女性HIV检测呈阳性及新发诊断的可能性更高。尽管总体而言女性感染HIV的风险可能不是最高的,但该样本中的黑人女性受到的影响不成比例。此外,针对女性的关联、转诊和访谈服务需要改进。有针对性的检测方法可能确保针对女性的有效检测和治疗策略。

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