评价澳大利亚墨尔本一家性健康中心实施的新的由护士主导的快速“检测即走”艾滋病毒/性传播感染检测服务在男男性行为人群中的实施情况。

Evaluation of the Implementation of a New Nurse-Led Express "Test-And-Go" Human Immunodeficiency Virus/Sexually Transmitted Infection Testing Service for Men Who Have Sex With Men at a Sexual Health Center in Melbourne, Australia.

出版信息

Sex Transm Dis. 2018 Jun;45(6):429-434. doi: 10.1097/OLQ.0000000000000777.

Abstract

BACKGROUND

In August 2015, a nurse-led express human immunodeficiency virus (HIV)/sexually transmitted infection (STI) testing service "Test-And-Go" (TAG) for asymptomatic men who have sex with men (MSM) was implemented in a large public sexual health center in Melbourne, Australia. We aimed to compare the clients' characteristics between the TAG and routine walk-in service among asymptomatic MSM.

METHODS

This study was conducted at the Melbourne Sexual Health Centre, Australia, between August 5, 2015, and June 1, 2016. General estimating equation logistic regression models were constructed to examine the association between the use of TAG service and clients' demographic characteristics, sexual behaviors, and HIV/STI positivity. Clients' consultation and waiting times for both services were calculated.

RESULTS

Of the 3520 consultations, 784 (22.3%) were TAG services and 2736 (77.7%) were routine walk-in services for asymptomatic MSM. Asymptomatic MSM were more likely to use the TAG service if they were born in Australia (adjusted odds ratio, 1.29; 95% confidence interval, 1.07-1.56), and had more than 6 male partners in the last 12 months (adjusted odds ratio, 1.13; 95% confidence interval, 1.08-1.58). Age, HIV status, condomless anal sex and HIV/STI positivity did not differ between the two services. The TAG service had a shorter median waiting time (8.4 minutes vs 52.9 minutes; p < 0.001) and consultation time (8.9 minutes vs 17.6 minutes; p < 0.001) than the routine walk-in service.

CONCLUSIONS

Although country of birth and sexual behaviors differed between clients attending the 2 services, there were no differences in HIV and STI positivity. Importantly, the TAG service required less waiting and consultation time and hence created additional clinic capacity at the general clinic to see clients who are at higher risk.

摘要

背景

2015 年 8 月，澳大利亚墨尔本的一家大型公共性健康中心实施了一项由护士主导的快速艾滋病毒（HIV）/性传播感染（STI）检测服务“Test-And-Go”（TAG），旨在为无症状男男性行为者（MSM）提供服务。本研究旨在比较 TAG 服务和无症状 MSM 常规门诊服务的客户特征。

方法

本研究于 2015 年 8 月 5 日至 2016 年 6 月 1 日在澳大利亚墨尔本性健康中心进行。采用广义估计方程逻辑回归模型，分析了使用 TAG 服务与客户人口统计学特征、性行为和 HIV/STI 阳性之间的关系。计算了两种服务的客户咨询和等待时间。

结果

在 3520 次就诊中，784 次（22.3%）为 TAG 服务，2736 次（77.7%）为无症状 MSM 的常规门诊服务。如果 MSM 出生在澳大利亚（调整后的优势比，1.29；95%置信区间，1.07-1.56），并且在过去 12 个月中有超过 6 个性伴侣（调整后的优势比，1.13；95%置信区间，1.08-1.58），他们更有可能使用 TAG 服务。年龄、HIV 状态、无保护肛交和 HIV/STI 阳性在两种服务之间没有差异。TAG 服务的中位数等待时间（8.4 分钟比 52.9 分钟；p<0.001）和咨询时间（8.9 分钟比 17.6 分钟；p<0.001）均短于常规门诊服务。