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在男男性行为者中,哪些因素与医疗服务提供者建议进行HIV检测有关?

What Factors Are Associated With Receiving a Recommendation to Get Tested for HIV by Health Care Providers Among Men Who Have Sex With Men?

作者信息

Vincent Wilson, McFarland Willi, Raymond H Fisher

机构信息

*HIV Seroepidemiology Unit, Department of Medicine, University of California, San Francisco; and †San Francisco Department of Public Health, Center for Public Health Research, San Francisco, CA.

出版信息

J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3(Suppl 3):S357-S362. doi: 10.1097/QAI.0000000000001411.

Abstract

BACKGROUND

The approach of treatment as prevention for reducing HIV incidence and prevalence hinges on early detection of HIV infection and treatment to achieve viral suppression and, thus, to reduce HIV transmissibility. However, men who have sex with men (MSM), who are at greater risk of HIV infection than the average adult in the United States, are often not tested because many providers do not provide routine opt-out testing or even recommend HIV testing.

METHODS

In a sample of 244 MSM in San Francisco, CA, this study examined whether (1) sociodemographic characteristics (ie, youth, education, employment status, being African American, being Latino), (2) health care access and utilization, and (3) participants disclosing their sexual orientation to their health care providers were associated with their odds of having received a recommendation from a health care provider for HIV testing.

RESULTS

Results showed that none of the sociodemographic or health care-related factors were associated with whether a health care provider recommended HIV testing, but MSM disclosing their sexual orientation to their health care providers was associated with an over 8 times greater odds of MSM receiving a recommendation for HIV testing.

CONCLUSION

The study findings underscore the need for routine opt-out HIV testing to screen members of high-risk populations who may not enter the HIV continuum of care and for health care providers to be able to ask patients about HIV risk behavior and sexual orientation and behavior.

摘要

背景

将治疗作为预防手段以降低艾滋病毒发病率和流行率的方法,取决于对艾滋病毒感染的早期检测以及通过治疗实现病毒抑制,从而降低艾滋病毒的传播性。然而,男男性行为者(MSM)感染艾滋病毒的风险高于美国普通成年人,他们往往不接受检测,因为许多医疗服务提供者不提供常规的主动退出式检测,甚至不建议进行艾滋病毒检测。

方法

在加利福尼亚州旧金山的244名男男性行为者样本中,本研究调查了(1)社会人口学特征(即青年、教育程度、就业状况、非裔美国人、拉丁裔)、(2)医疗保健的可及性和利用率,以及(3)参与者向其医疗服务提供者披露其性取向是否与他们从医疗服务提供者那里获得艾滋病毒检测建议的几率相关。

结果

结果显示,社会人口学或与医疗保健相关的因素均与医疗服务提供者是否建议进行艾滋病毒检测无关,但向医疗服务提供者披露其性取向的男男性行为者获得艾滋病毒检测建议的几率高出8倍多。

结论

研究结果强调了对可能未进入艾滋病毒连续护理体系的高危人群成员进行常规主动退出式艾滋病毒检测的必要性,以及医疗服务提供者有能力询问患者有关艾滋病毒风险行为以及性取向和性行为的情况。

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