National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai road, Changing district, Beijing, 102206, China.
Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
BMC Public Health. 2018 Nov 6;18(1):1235. doi: 10.1186/s12889-018-6147-5.
In China, antiretroviral therapy (ART) clinics focus on treating people living with HIV and are not required to undertake testing of high-risk populations. To improve partner testing among MSM, we implemented a health communication pilot intervention integrating partner testing with ART services. We aimed to assess the feasibility of the partner referral service and identify the predictors of both successful partner referral for HIV testing and HIV-positive test results among referred partners.
This program ran from April 2014 through December 2015 at designated ART clinics in six cities. The index participants, men living with HIV enrolled at an ART clinic, were assigned a case manager who assumed responsibility for routine ART-related counseling and mobilization of HIV-positive index participants for partner referral testing. Case managers were either nurses or contract staff. The successful referral rate was the proportion of index participants who referred a sexual partner for HIV testing. The HIV-positive partner rate was the proportion of the newly referred contacts who tested HIV-positive. Factors associated with the successful referral rate and the HIV-positive partner rate were assessed.
Two thousand three hundred eighty-two index participants were enrolled. The median age was 30 years (IQR 26-37). 829index participants (34.80%) successfully referred at least one sexual partner for screening, and 92 (11.10%) referred partners were HIV-positive. Having a hospital nurse as case manager was associated with both successful partner referral (AHR = 1.56, 95% CI = 1.36-1.80) and having a HIV-positive partner (AHR = 2.35, 95% CI = 1.45-3.92). Index participants who were married (AHR = 1.44, 95% CI = 1.20-1.73) or employed (AHR = 1.29, 95% CI = 1.11-1.49) were more likely to successfully refer a partner for testing. Stable male partner relations were more likely to result in a referred partner testing HIV-positive (AHR = 5.50, 95% CI = 1.85-16.39).
Our findings indicated that integration of MSM partner testing with ART services via health communication was feasible. Nurses as case managers effectively encouraged index participants to refer their sexual partners for HIV testing.
在中国，抗逆转录病毒治疗 (ART) 诊所专注于治疗艾滋病毒感染者，无需对高危人群进行检测。为了提高男男性行为者 (MSM) 的伴侣检测率，我们实施了一项健康传播试点干预措施，将伴侣检测与 ART 服务相结合。我们旨在评估伴侣转介服务的可行性，并确定成功转介 HIV 检测的预测因素以及转介伴侣的 HIV 阳性检测结果。
该项目于 2014 年 4 月至 2015 年 12 月在六个城市的指定 ART 诊所进行。指数参与者为在 ART 诊所登记的 HIV 感染者男性，为每位参与者分配一名个案经理，负责常规的 ART 相关咨询以及动员 HIV 阳性指数参与者进行伴侣转介检测。个案经理为护士或合同工。成功转介率为指数参与者转介性伴侣进行 HIV 检测的比例。新转介接触者的 HIV 阳性率为新转介接触者中 HIV 阳性检测结果的比例。评估了与成功转介率和 HIV 阳性伴侣率相关的因素。
共纳入 2382 名指数参与者。中位年龄为 30 岁（IQR 26-37）。829 名指数参与者（34.80%）成功转介至少一名性伴侣进行筛查，92 名（11.10%）转介伴侣 HIV 阳性。有医院护士作为个案经理与成功转介伴侣（AHR=1.56，95%CI=1.36-1.80）和 HIV 阳性伴侣（AHR=2.35，95%CI=1.45-3.92）相关。已婚（AHR=1.44，95%CI=1.20-1.73）或有工作（AHR=1.29，95%CI=1.11-1.49）的指数参与者更有可能成功转介伴侣进行检测。稳定的男性伴侣关系更有可能导致转介伴侣 HIV 检测阳性（AHR=5.50，95%CI=1.85-16.39）。
我们的研究结果表明，通过健康传播将 MSM 伴侣检测与 ART 服务相结合是可行的。护士作为个案经理有效地鼓励指数参与者转介其性伴侣进行 HIV 检测。
