莫桑比克辅助性人类免疫缺陷病毒伴侣服务的可接受性和有效性：一项城市公共诊所试点项目的结果
Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic.
作者信息
Myers R Serene, Feldacker Caryl, Cesár Freide, Paredes Zulmira, Augusto Gerito, Muluana Chadreque, Citao Sinesia, Mboa-Ferrao Catarina, Karajeanes Esmeralda, Golden Matthew R
机构信息
From the *International Training and Education Center for Health (I-TECH), †Department of Global Health, University of Washington, Seattle, WA; ‡Maputo Provincial Health Department; §Ariel Glaser Pediatric AIDS Foundation, Maputo, Mozambique; and ¶Division of Infectious Diseases and the Center for AIDS and STD, University of Washington, Seattle, WA.
出版信息
Sex Transm Dis. 2016 Nov;43(11):690-695. doi: 10.1097/OLQ.0000000000000529.
BACKGROUND
Assisted partner services (APS) involves offering persons with human immunodeficiency virus (HIV) assistance notifying and testing their sex partners. Assisted partner services is rarely available in sub-Saharan Africa. We instituted a pilot APS program in Maputo, Mozambique.
METHODS
Between June and September 2014, community health workers (CHWs) offered APS to persons with newly diagnosed HIV (index patients [IPs]). Community health workers interviewed IPs at baseline, 4 and 8 weeks. At baseline, CHWs counseled IPs to notify partners and encourage their HIV testing, but did not notify partners directly. At 4 weeks, CHWs notified partners directly. We compared 4- and 8-week outcomes to estimate the impact of APS on partner notification, HIV testing and HIV case finding.
RESULTS
Community health workers offered 223 IPs APS, of whom 220 (99%) accepted; CHWs collected complete follow-up data on 206 persons; 79% were women, 74% were married, and 50% named >1 sex partner. Index patients named 262 HIV-negative partners at baseline. At 4 weeks, before APS, IPs had notified 193 partners (74%), but only 82 (31%) had HIV tested; 43 (13%) tested HIV positive. Assisted partner services resulted in the notification of 22 additional partners, testing of 83 partners and 43 new HIV diagnoses. In relative terms, APS increased partner notification, testing, and HIV case finding by 13%, 101%, and 125%. Seventy-two (35%) of 206 IPs were in ongoing HIV serodiscordant partnerships. Only 2.5 IPs needed to receive APS to identify a previously undiagnosed HIV-infected partner or an ongoing HIV serodiscordant partnership. Two (1%) IPs reported APS-related adverse events.
CONCLUSIONS
Assisted partner services is acceptable to Mozambicans newly diagnosed with HIV, identifies large numbers of serodiscordant partnerships and persons with undiagnosed HIV, and poses a low risk of adverse events.
背景
性伴侣协助服务（APS）是指为感染人类免疫缺陷病毒（HIV）的人提供协助，以便通知其性伴侣并让其接受检测。在撒哈拉以南非洲地区，性伴侣协助服务很少见。我们在莫桑比克马普托开展了一项性伴侣协助服务试点项目。
方法
2014年6月至9月期间，社区卫生工作者（CHWs）为新诊断出感染HIV的人（索引患者[IPs]）提供性伴侣协助服务。社区卫生工作者在基线、4周和8周时对索引患者进行访谈。在基线时，社区卫生工作者为索引患者提供咨询，建议他们通知伴侣并鼓励其接受HIV检测，但不直接通知伴侣。在4周时，社区卫生工作者直接通知伴侣。我们比较了4周和8周时的结果，以评估性伴侣协助服务对伴侣通知、HIV检测和HIV病例发现的影响。
结果
社区卫生工作者为223名索引患者提供了性伴侣协助服务，其中220名（99%）接受了服务；社区卫生工作者收集了206人的完整随访数据；79%为女性，74%已婚，50%列出了超过1名性伴侣。索引患者在基线时列出了262名HIV阴性伴侣。在4周时，在提供性伴侣协助服务之前，索引患者已通知了193名伴侣（74%），但只有82名（31%）接受了HIV检测；43名（13%）检测结果为HIV阳性。性伴侣协助服务导致另外22名伴侣得到通知，83名伴侣接受检测，43名新的HIV诊断病例。相对而言，性伴侣协助服务使伴侣通知、检测和HIV病例发现分别增加了13%、101%和125%。206名索引患者中有72名（35%）处于持续的HIV血清学不一致关系中。仅需2.5名索引患者接受性伴侣协助服务，就能识别出一名此前未被诊断出感染HIV的伴侣或一种持续的HIV血清学不一致关系。两名（1%）索引患者报告了与性伴侣协助服务相关的不良事件。
结论
新诊断出感染HIV的莫桑比克人可以接受性伴侣协助服务，该服务能识别出大量血清学不一致关系和未被诊断出感染HIV的人，且不良事件风险较低。
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