Department of Pediatrics, Johns Hopkins School of Medicine, 200 N. Wolfe St Room 3147, Baltimore, MD, 21287, USA.
Faculty of Mathematics and Physics, Department of Probability and Statistics, Charles University, Prague, Czech Republic.
AIDS Behav. 2018 Feb;22(2):569-579. doi: 10.1007/s10461-017-1807-5.
Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18-24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61-0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05-1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85-2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08-1.36), and marriage (aOR 1.55; 95% CI 1.37-1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18-24 vs. 25-32 years).
全球新感染艾滋病毒的人群中,年轻人占很大比例,但他们利用艾滋病毒检测和咨询(HTC)的比例仍然很低。作为南非(索韦托和夸祖鲁-纳塔尔)、津巴布韦、坦桑尼亚和泰国的社区动员和移动 HTC 试点的 HPTN 043/NIMH 项目接受的一部分,我们利用 2011 年进行的基于人群的横断面家庭调查的干预后数据,评估了研究参与者中社会人口统计学和行为决定因素与 HTC 的相关性,研究参与者按照研究臂、地点和性别进行分组。使用最近(过去 12 个月内)进行 HIV 检测的 13755 名参与者的完整个人数据,采用多变量逻辑回归模型,以最近进行 HTC 作为结局。青年(18-24 岁)并不能预测最近进行 HTC,除非高危青年有多个同时存在的性伴侣,否则他们最近进行检测的可能性较小(调整后的比值比[aOR] 0.75;95%置信区间[CI] 0.61-0.92),而报告单一性伴侣的青年则更有可能进行最近的检测。重要的是,干预措施在各个不同的环境中都取得了成功,南非的成功率为特定地点的 aOR 1.27(95%CI 1.05-1.53),泰国的成功率为 aOR 2.30(95%CI 1.85-2.84)。最后,在各种不同的环境中,较高的教育程度(aOR 1.67;95%CI 1.42,1.96)、较高的社会经济地位(aOR 1.21;95%CI 1.08-1.36)和婚姻状况(aOR 1.55;95%CI 1.37-1.75)都与最近进行 HTC 呈正相关,而这些因素在研究臂、地点、性别或年龄组(18-24 岁与 25-32 岁)之间没有显著差异。
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