MMWR Morb Mortal Wkly Rep. 2018 Jun 29;67(25):714-717. doi: 10.15585/mmwr.mm6725a3.
Since 2006, CDC has recommended routine, provider-initiated human immunodeficiency virus (HIV) screening (i.e., HIV screening at least once in lifetime) for all patients aged 13-64 years in all health care settings (1). Whereas evidence related to the frequency of HIV testing is available, less is known about the prevalence and predictors of providers' HIV test offers to patients (2). National HIV Behavioral Surveillance (NHBS) data from Virginia were used to examine the prevalence and predictors of provider-initiated HIV test offers to heterosexual adults aged 18-60 years at increased risk for HIV acquisition. In a sample of 333 persons who visited a health care provider in the 12 months before their NHBS interview, 194 (58%) reported not receiving an HIV test offer during that time, approximately one third of whom (71, 37%) also reported never having had an HIV test in their lifetime. In multivariable analysis, the prevalence of HIV test offers was significantly lower among men than among women (adjusted prevalence ratio [aPR] = 0.72; 95% confidence interval [CI] = 0.53-0.97). Provider-initiated HIV test offers are an important strategy for increasing HIV testing among heterosexual populations; there is a need for increased provider-initiated HIV screening among heterosexual adults who are at risk for acquiring HIV, especially men, who were less likely than women to be offered HIV screening in this study.
自 2006 年以来,疾控中心建议在所有医疗保健环境中对所有 13-64 岁的患者进行常规、由提供者发起的人类免疫缺陷病毒(HIV)筛查(即一生中至少进行一次 HIV 筛查)(1)。尽管已经有了与 HIV 检测频率相关的证据,但对于提供者向患者提供 HIV 检测的频率和预测因素知之甚少(2)。弗吉尼亚州的全国 HIV 行为监测(NHBS)数据被用于研究在感染 HIV 风险增加的 18-60 岁异性恋成年人中,由提供者发起的 HIV 检测提议的流行率和预测因素。在一个在 NHBS 访谈前的 12 个月内曾就诊于医疗保健提供者的 333 人中,有 194 人(58%)报告在此期间未收到 HIV 检测提议,其中约三分之一(71 人,37%)也报告他们一生中从未接受过 HIV 检测。在多变量分析中,男性提供 HIV 检测提议的比例明显低于女性(调整后的流行率比 [aPR] = 0.72;95%置信区间 [CI] = 0.53-0.97)。由提供者发起的 HIV 检测提议是增加异性恋人群 HIV 检测的重要策略;需要增加对感染 HIV 风险较高的异性恋成年人的由提供者发起的 HIV 筛查,特别是在这项研究中,男性比女性更不可能被提供 HIV 筛查。