Patrick Rudy, Greenberg Alan, Magnus Manya, Opoku Jenevieve, Kharfen Michael, Kuo Irene
*Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC; and †District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration, Washington, DC.
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3(Suppl 3):S397-S407. doi: 10.1097/QAI.0000000000001417.
We developed an HIV testing dashboard to complement the HIV care continuum in selected high-risk populations. Using National HIV Behavioral Surveillance (NHBS) data, we examined trends in HIV testing and care for men who have sex with men (MSM), persons who inject drugs (PWID), and heterosexuals at elevated risk (HET).
Between 2007 and 2015, 4792 participants ≥18 years old completed a behavioral survey and were offered HIV testing. For the testing dashboard, proportions ever tested, tested in the past year, testing HIV-positive, and newly testing positive were calculated. An abbreviated care continuum for self-reported positive (SRP) persons included ever engagement in care, past year care, and current antiretroviral (ARV) use. The testing dashboard and care continuum were calculated separately for each population. Chi-square test for trend was used to assess significant trends over time.
Among MSM, lifetime HIV testing and prevalence significantly increased from 96% to 98% (P = 0.01) and 14%-20% (P = 0.02) over time; prevalence was highest among black MSM at all time points. HIV prevalence among female persons who inject drugs was significantly higher in 2015 vs. 2009 (27% and 13%; P < 0.01). Among heterosexuals at elevated risk from 2010 to 2013, annual testing increased significantly (45%-73%; P < 0.001) and the proportion newly diagnosed decreased significantly (P < 0.01). Self-reported positive MSM had high levels of care engagement and antiretroviral use; among self-reported positive persons who inject drugs and heterosexuals at elevated risk, past year care engagement and antiretroviral use increased over time.
The HIV testing dashboard can be used to complement the HIV care continuum to display improvements and disparities in HIV testing and care over time.
我们开发了一个艾滋病病毒检测信息平台，以补充特定高危人群中的艾滋病病毒治疗连续服务。利用全国艾滋病病毒行为监测（NHBS）数据，我们研究了男男性行为者（MSM）、注射毒品者（PWID）和高危异性恋者（HET）的艾滋病病毒检测及治疗趋势。
2007年至2015年期间，4792名年龄≥18岁的参与者完成了一项行为调查，并接受了艾滋病病毒检测。对于检测信息平台，计算了曾接受检测、过去一年接受检测、检测呈艾滋病病毒阳性以及新检测呈阳性的比例。自我报告呈阳性（SRP）者的简化治疗连续服务包括曾接受治疗、过去一年接受治疗以及目前使用抗逆转录病毒（ARV）药物。针对每个人群分别计算检测信息平台和治疗连续服务情况。采用趋势卡方检验评估随时间的显著趋势。
在男男性行为者中，终身艾滋病病毒检测率和患病率随时间显著上升，分别从96%升至98%（P = 0.01）和从14%升至20%（P = 0.02）；在所有时间点，黑人男男性行为者的患病率最高。2015年注射毒品女性的艾滋病病毒患病率显著高于2009年（分别为27%和13%；P < 0.01）。在2010年至2013年的高危异性恋者中，年度检测显著增加（从45%增至73%；P < 0.001），新诊断比例显著下降（P < 0.01）。自我报告呈阳性的男男性行为者有较高的治疗参与度和抗逆转录病毒药物使用率；在自我报告呈阳性的注射毒品者和高危异性恋者中，过去一年的治疗参与度和抗逆转录病毒药物使用率随时间增加。
艾滋病病毒检测信息平台可用于补充艾滋病病毒治疗连续服务，以展示艾滋病病毒检测及治疗随时间的改善情况和差异。
