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印度尼西亚凯迪里市实现联合国艾滋病规划署90-90-90目标的现状及与HIV病毒载量抑制相关的因素

Current Status Towards 90-90-90 UNAIDS Target and Factors Associated with HIV Viral Load Suppression in Kediri City, Indonesia.

作者信息

Ssekalembe Geofrey, Isfandiari Muhammad Atoillah, Suprianto Hendick

机构信息

Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

Dinas Kesehatan Kota Kediri, Kediri, Indonesia.

出版信息

HIV AIDS (Auckl). 2020 Jan 16;12:47-57. doi: 10.2147/HIV.S231173. eCollection 2020.

Abstract

INTRODUCTION

In 2016, UN Member States committed to reduce new HIV infections to fewer than 500,000 annually by 2020, a 75% reduction compared with 2010, reduce AIDS-related deaths to fewer than 500,000 globally as a means of ending AIDS by 2030. The UNAIDS 2020 target is to have 90% of the people living with HIV know their status, 90% of the people living with HIV (who know their HIV status as positive) are already on ART treatment, 90% of people on treatment are virally suppressed. The objective of this study is to determine the current status towards the 2020 90-9-90 UNAIDS target and the factors associated with HIV viral load suppression in Kediri city.

METHODS

The study was a cross-sectional study in Kediri city. The researcher collected secondary data, carried in-depth interviews, then determined the percentage of HIV-positive patients that did a HIV test and received their results as Positive, the percentage of HIV-positive patients that started ART treatment, the percentage of HIV-positive patients that have viral load suppression from the viral load tests done. A simple bivariate logistic and multivariate logistic regression was used to determine the significant factors that determine viral suppression.

RESULTS

The progress towards the 90-90-90 UNAIDS target was at 6.4%, 74.9%, 9.9%. The time taken by the HIV-positive patient to start ART treatment from the time of confirmation of HIV positive (AOR= 83.191, CI: 1.617-4280.115) and decrease in body weight of the patient (AOR=29.636, CI: 1.193-736.167) were found to significantly influence viral load suppression.

CONCLUSION

There is a need to scale up HIV case-detection capacity through creating awareness about HIV, HIV testing and counselling and expand the ART services so as to achieve the 90-0-90 UNAIDS target. Early initiation to ART treatment (Test and Treat) and encouraging body gaining behaviors are needed to achieve viral load suppression.

摘要

引言

2016年,联合国会员国承诺到2020年将新的艾滋病毒感染人数减少到每年50万以下,与2010年相比减少75%,在全球范围内将与艾滋病相关的死亡人数减少到50万以下,以此作为到2030年终结艾滋病的一种手段。联合国艾滋病规划署2020年的目标是使90%的艾滋病毒感染者知晓自己的感染状况,90%的艾滋病毒感染者(知晓自己感染状况呈阳性)已经接受抗逆转录病毒治疗(ART),90%接受治疗的人病毒得到抑制。本研究的目的是确定在凯迪里市实现2020年联合国艾滋病规划署90-90-90目标的当前状况以及与艾滋病毒病毒载量抑制相关的因素。

方法

该研究是在凯迪里市进行的一项横断面研究。研究人员收集二手数据,进行深入访谈,然后确定进行艾滋病毒检测并得到阳性结果的艾滋病毒阳性患者的百分比、开始接受抗逆转录病毒治疗的艾滋病毒阳性患者的百分比、通过病毒载量检测病毒得到抑制的艾滋病毒阳性患者的百分比。采用简单的双变量逻辑回归和多变量逻辑回归来确定决定病毒抑制的显著因素。

结果

在实现联合国艾滋病规划署90-90-90目标方面的进展分别为6.4%、74.9%、9.9%。发现艾滋病毒阳性患者从确认艾滋病毒阳性时起开始接受抗逆转录病毒治疗所花费的时间(比值比=83.191,置信区间:1.617-4280.115)以及患者体重下降(比值比=29.636,置信区间:1.193-736.167)对病毒载量抑制有显著影响。

结论

需要通过提高对艾滋病毒的认识、艾滋病毒检测和咨询来扩大艾滋病毒病例检测能力,并扩大抗逆转录病毒治疗服务,以实现联合国艾滋病规划署90-90-90目标。需要尽早开始抗逆转录病毒治疗(检测并治疗)并鼓励增加体重的行为来实现病毒载量抑制。

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