Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON, M5T 3M7, Canada.
AIDS Behav. 2019 Apr;23(4):908-919. doi: 10.1007/s10461-018-2276-1.
Research suggests a burden of HIV among street-connected youth (SCY) in Kenya. We piloted the use of peer navigators (PNs), individuals of mixed HIV serostatus and with direct experience of being street-connected, to link SCY to HIV testing and care. From January 2015 to October 2017, PNs engaged 781 SCY (585 male, 196 female), median age 16 (IQR 13-20). At initial encounter, 52 (6.6%) were known HIV-positive and 647 (88.8%) agreed to HIV testing. Overall, 63/781 (8.1%) SCY engaged in this program were HIV-positive; 4.6% males and 18.4% females (p < 0.001). Of those HIV-positive, 48 (82.8%) initiated ART. As of October 2017, 35 (60.3%) of the HIV-positive SCY were alive and in care. The pilot suggests that PNs were successful in promoting HIV testing, linkage to care and ART initiation. More research is needed to evaluate how to improve ART adherence, viral suppression and retention in care in this population.
研究表明，肯尼亚街头流浪青年（SCY）中存在艾滋病毒负担。我们尝试使用同伴导航员（PN）来将 SCY 与艾滋病毒检测和护理联系起来，这些 PN 是混合艾滋病毒血清阳性且有直接街头流浪经验的个体。从 2015 年 1 月至 2017 年 10 月，PN 共接触了 781 名 SCY（585 名男性，196 名女性），中位年龄为 16 岁（IQR 13-20）。在初次接触时，有 52 名（6.6%）已知 HIV 阳性，647 名（88.8%）同意接受 HIV 检测。总体而言，参与该项目的 781 名 SCY 中有 63 名（8.1%）HIV 阳性；男性占 4.6%，女性占 18.4%（p<0.001）。在 HIV 阳性者中，有 48 人（82.8%）开始接受抗逆转录病毒治疗。截至 2017 年 10 月，35 名（60.3%）HIV 阳性 SCY 仍在世并接受治疗。该试点表明，PN 成功地促进了 HIV 检测、护理衔接和抗逆转录病毒治疗的启动。需要进一步研究如何提高该人群的抗逆转录病毒治疗依从性、病毒抑制率和护理保留率。
