在一家大型儿科医院护理网络中，一组最近被诊断出 HIV 感染的青少年中，错过了 HIV 筛查的机会。
Missed Opportunities for HIV Screening Among a Cohort of Adolescents With Recently Diagnosed HIV Infection in a Large Pediatric Hospital Care Network.
机构信息
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
School of Medicine, New York University, New York City, New York.
出版信息
J Adolesc Health. 2018 Dec;63(6):799-802. doi: 10.1016/j.jadohealth.2018.07.010. Epub 2018 Oct 2.
PURPOSE
Routine human immunodeficiency virus (HIV) screening reduces HIV progression and transmission. Our aims were to determine prevalence and factors associated with prior HIV screening among a cohort of youth living with HIV.
METHODS
Retrospective chart review of youth living with HIV aged 14-26 at an HIV clinic comparing characteristics between those with and without HIV screening within the year prior to diagnosis RESULTS: Subjects (n = 301) were male (85%), African-American (87%), and men who have sex with men (84%). Subjects seen 1 year prior to diagnosis (n = 58) contributed 179 visits for missed opportunities with 59% having a documented sexual history in the electronic health record and 48% tested for HIV. Subjects with symptoms suggesting acute HIV infection (51%) were more likely to be tested (p = .04). In the adjusted model, documentation of sexual history and demographic factors was not associated with prior testing.
CONCLUSION
We identified high rates of missed opportunities for HIV testing and sexual history documentation in the year prior to diagnosis, underscoring the need for routine HIV screening in adolescents.
目的
常规人类免疫缺陷病毒（HIV）筛查可降低 HIV 的进展和传播。我们旨在确定感染 HIV 的青年队列中，既往 HIV 筛查的流行情况和相关因素。
方法
对在 HIV 诊所就诊的年龄在 14-26 岁的 HIV 感染者进行回顾性病历分析，比较诊断前 1 年内有和无 HIV 筛查者的特征。
结果
受试者（n=301）中 85%为男性，87%为非裔美国人，84%为男男性行为者。在诊断前 1 年就诊（n=58）的受试者贡献了 179 次就诊机会，其中 59%的患者电子健康记录中有记录的性病史，48%的患者接受了 HIV 检测。出现急性 HIV 感染症状的患者（51%）更有可能接受检测（p=0.04）。在调整后的模型中，性病史和人口统计学因素的记录与既往检测无关。
结论
我们发现，在诊断前 1 年中，HIV 检测和性病史记录的机会很高，这突显了青少年常规 HIV 筛查的必要性。
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