在科特迪瓦阿比让新诊断出的艾滋病毒感染成年人中,存在艾滋病毒检测机会错失的情况。
Missed opportunities for HIV testing among newly diagnosed HIV-infected adults in Abidjan, Côte d'Ivoire.
作者信息
Inghels Maxime, Niangoran Serge, Minga Albert, Yoboue Jean Michel, Dohoun Lambert, Yao Abo, Eholié Serge, Anglaret Xavier, Danel Christine
机构信息
Centre Population et Développement (CEPED), UMR 196 Paris Descartes-Institut de Recherche et Développement (IRD), France.
Programme PAC-CI/ANRS Research Site, CHU de Treichville, Abidjan, Côte d'Ivoire.
出版信息
PLoS One. 2017 Oct 4;12(10):e0185117. doi: 10.1371/journal.pone.0185117. eCollection 2017.
BACKGROUND
HIV testing is crucial for starting ART earlier in HIV-infected people. We describe Missed Opportunities (MO) for HIV testing among adults newly diagnosed with HIV in Abidjan, Côte d'Ivoire.
METHODS
Between april,2nd 2013 and april 1st 2014, a cross-sectional study was conducted among all adults newly diagnosed (< 1year) for HIV at the Blood Donors Medical Center of Abidjan with face to face questionnaire. An MO for HIV testing was defined as a medical consultation for a clinical indicator (e.g. symptoms, hospitalization, and pregnancy) or a non-clinical indicator (e.g. high-risk sexual behavior, HIV-infected partner) potentially related to an HIV infection but did not lead to HIV test proposal by a health care professional.
RESULTS
Of the 341 patients who attended the center suring this period, 273 (157 women and 116 men) were included in this analysis. 130 (47.6%) reported at least one medical consultation for an indicator relevant for a test proposal between 1 month and five years prior to their diagnosis. Among them, 92 (77.3%) experienced at least one MO for testing. The 273 included patients reported a total of 216 indicators; 146 (67.6%) were reported without test proposal and thus were MO. Hospitalization, extreme lose of weight, chronic or repeat fever and herpes zoster were the indicators with the largest number of MO. While 66 (24.2%) patients experienced non-clinical indicators relevant to risk of HIV infection, only 11 (4.0%) mentioned it to a health professional.
CONCLUSION
MO for HIV testing are frequent, even in situations for which testing is clearly recommended. Better train healthcare professionals and creating new opportunities of testing inside and, outside of medical settings are crucial to improve HIV control.
背景
艾滋病毒检测对于艾滋病毒感染者尽早开始抗逆转录病毒治疗至关重要。我们描述了在科特迪瓦阿比让新诊断出感染艾滋病毒的成年人中错过的艾滋病毒检测机会(MO)。
方法
2013年4月2日至2014年4月1日期间,在阿比让献血者医疗中心对所有新诊断(<1年)感染艾滋病毒的成年人进行了一项横断面研究,并进行了面对面问卷调查。艾滋病毒检测的错过机会被定义为因临床指标(如症状、住院和怀孕)或非临床指标(如高危性行为、艾滋病毒感染伴侣)进行的医疗咨询,这些指标可能与艾滋病毒感染有关,但医疗保健专业人员未提出艾滋病毒检测建议。
结果
在此期间到该中心就诊的341名患者中,273名(157名女性和116名男性)纳入本分析。130名(47.6%)报告在诊断前1个月至5年期间因与检测建议相关的指标至少进行了一次医疗咨询。其中,92名(77.3%)经历了至少一次检测错过机会。纳入研究的273名患者共报告了216项指标;146项(67.6%)报告后未提出检测建议,因此属于错过机会。住院、极度体重减轻、慢性或反复发热以及带状疱疹是错过机会最多的指标。虽然66名(24.2%)患者经历了与艾滋病毒感染风险相关的非临床指标,但只有11名(4.0%)向医疗专业人员提及。
结论
艾滋病毒检测的错过机会很常见,即使在明确建议进行检测的情况下也是如此。更好地培训医疗保健专业人员并在医疗机构内外创造新的检测机会对于改善艾滋病毒控制至关重要。