1 HIV/STD/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA.
2 Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Public Health Rep. 2018 Nov/Dec;133(2_suppl):43S-51S. doi: 10.1177/0033354918801893.
Tennessee was 1 of 8 states that received funding from the Care and Prevention in the United States Demonstration Project, which aimed to reduce HIV-related morbidity and mortality among racial/ethnic and sexual minority populations. The objective of this study was to describe implementation of a social network strategy (SNS) program, which leverages personal connections in social networks, to reach people with undiagnosed HIV infection for HIV testing. We targeted young black men who have sex with men (MSM) at 3 agencies in Memphis and Nashville, Tennessee, during 2013-2016.
Specialists at the 3 agencies identified MSM with and without diagnosed HIV infection (ie, recruiters) who could recruit members from their social networks for HIV testing (ie, network associates). Both recruiters and network associates received OraQuick rapid and confirmatory HIV tests. We used χ and Fisher exact tests to assess differences in demographic characteristics, HIV testing, and care engagement status by agency.
Of 1752 people who were tested for HIV in the SNS program, 158 (9.0%) tested positive; of these, 80 (50.6%) were newly diagnosed with HIV. Forty-seven of the 78 (60.3%) people who were previously diagnosed with HIV were not in care in the previous 12 months; of these, 27 (57.4%) were reengaged in medical care. Of 80 people newly diagnosed with HIV, 44 (55.0%) were linked to care.
The SNS program ascertained HIV status among a high-risk population in a heavily burdened region. Further program evaluation is needed to understand how to improve linkage to care among people with newly diagnosed HIV.
田纳西州是获得“美国关怀与预防示范项目”资金的 8 个州之一,该项目旨在降低种族/族裔和性少数群体与艾滋病毒相关的发病率和死亡率。本研究的目的是描述一种社会网络策略(SNS)计划的实施情况,该计划利用社交网络中的个人关系,让未被诊断出感染艾滋病毒的人接受艾滋病毒检测。我们在 2013 年至 2016 年期间针对田纳西州孟菲斯和纳什维尔的 3 家机构中的年轻男男性行为者(MSM)开展了这项工作。
3 家机构的专家确定了有和没有诊断出 HIV 感染的 MSM(即招聘人员),他们可以从自己的社交网络中招募成员进行 HIV 检测(即网络伙伴)。招聘人员和网络伙伴都接受了 OraQuick 快速和确证 HIV 检测。我们使用 χ 和 Fisher 精确检验来评估机构间在人口统计学特征、HIV 检测和护理参与状况方面的差异。
在 SNS 计划中接受 HIV 检测的 1752 人中,有 158 人(9.0%)检测呈阳性;其中 80 人(50.6%)新诊断出 HIV 感染。在之前 12 个月内,78 名之前被诊断出 HIV 感染的人中,有 47 人(60.3%)未接受护理;其中 27 人(57.4%)重新接受了医疗护理。在新诊断出 HIV 感染的 80 人中,有 44 人(55.0%)被联系到护理服务。
SNS 计划在重灾区确定了高危人群的 HIV 状况。需要进一步的项目评估,以了解如何提高新诊断出 HIV 感染人群的护理衔接率。