Wasantioopapokakorn Montinee, Manopaiboon Chomnad, Phoorisri Thanongsri, Sukkul Akechittra, Lertpiriyasuwat Cheewanan, Ongwandee Sumet, Langkafah Farida, Kritsanavarin Usanee, Visavakum Prin, Jetsawang Bongkoch, Nookhai Somboon, Kitwattanachai Prapaporn, Weerawattanayotin Wanwimon, Losirikul Mana, Yenyarsun Naruemon, Jongchotchatchawal Nuchapong, Martin Michael
a Ministry of Public Health , Bureau of AIDS, TB and STIs , Nonthaburi , Thailand.
b Division of Global HIV & Tuberculosis (DGHT) , Thailand Ministry of Public Health-U.S. CDC Collaboration (TUC) , Nonthaburi , Thailand.
AIDS Care. 2018 Oct;30(10):1239-1245. doi: 10.1080/09540121.2018.1492697. Epub 2018 Jun 27.
HIV testing among men who have sex with men (MSM) and transgender (TG) women remains low in Thailand. The HIV prevention program (PREV) to increase HIV testing and link those who tested HIV-positive to care provided trainings to peer educators to conduct target mapping, identify high risk MSM and TG women through outreach education and offer them rapid HIV testing. Trained hospital staff provided HIV testing and counseling with same-day results at hospitals and mobile clinics and referred HIV-positive participants for care and treatment. We used a standardized HIV pre-test counseling form to collect participant characteristics and analyzed HIV test results using Poisson regression and Wilcoxon rank sum trend tests to determine trends over time. We calculated HIV incidence using data from participants who initially tested HIV-negative and tested at least one more time during the program. Confidence intervals for HIV incidence rates were calculated using the Exact Poisson method. From September 2011 through August 2016, 5,629 participants had an HIV test; their median age was 24 years, 1,923 (34%) tested at mobile clinics, 5,609 (99.6%) received their test result, and 1,193 (21%) tested HIV positive. The number of people testing increased from 458 in 2012 to 1,832 in 2016 (p < 0.001). Participants testing at mobile clinics were younger (p < 0.001) and more likely to be testing for the first time (p < 0.001) than those tested at hospitals. Of 1,193 HIV-positive participants, 756 (63%) had CD4 testing. Among 925 participants who returned for HIV testing, HIV incidence was 6.2 per 100 person-years. Incidence was highest among people 20-24 years old (10.9 per 100 person-years). HIV testing among MSM and TG women increased during the PREV program. HIV incidence remains alarmingly high especially among young participants. There is an urgent need to expand HIV prevention services to MSM and TG women in Thailand.
在泰国，男男性行为者（MSM）和变性女性（TG）中的艾滋病毒检测率仍然很低。旨在增加艾滋病毒检测并将艾滋病毒检测呈阳性者与护理服务联系起来的艾滋病毒预防项目（PREV），为同伴教育者提供培训，以进行目标人群定位，通过外展教育识别高危男男性行为者和变性女性，并为他们提供快速艾滋病毒检测。经过培训的医院工作人员在医院和流动诊所提供艾滋病毒检测和咨询服务，并在当天给出检测结果，同时将艾滋病毒检测呈阳性的参与者转介到护理和治疗机构。我们使用标准化的艾滋病毒检测前咨询表格收集参与者的特征，并使用泊松回归和威尔科克森秩和趋势检验分析艾滋病毒检测结果，以确定随时间的变化趋势。我们使用最初艾滋病毒检测呈阴性且在项目期间至少再检测一次的参与者的数据计算艾滋病毒发病率。艾滋病毒发病率的置信区间使用精确泊松方法计算。从2011年9月到2016年8月，5629名参与者进行了艾滋病毒检测；他们的年龄中位数为24岁，1923人（34%）在流动诊所进行检测，5609人（99.6%）收到了检测结果，1193人（21%）艾滋病毒检测呈阳性。检测人数从2012年的458人增加到2016年的1832人（p < 0.001）。在流动诊所检测的参与者比在医院检测的参与者更年轻（p < 0.001），且更有可能是首次检测（p < 0.001）。在1193名艾滋病毒检测呈阳性的参与者中，756人（63%）进行了CD4检测。在925名返回进行艾滋病毒检测的参与者中，艾滋病毒发病率为每100人年6.2例。发病率在20至24岁人群中最高（每100人年10.9例）。在艾滋病毒预防项目期间，男男性行为者和变性女性中的艾滋病毒检测有所增加。艾滋病毒发病率仍然高得惊人，尤其是在年轻参与者中。泰国迫切需要扩大针对男男性行为者和变性女性的艾滋病毒预防服务。
