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美国确诊 HIV 感染者中按出生地划分的抗逆转录病毒处方、护理保留率和病毒抑制情况-2015-2017 年,医疗监测项目。

Antiretroviral prescription, retention in care and viral suppression by place of birth among adults with diagnosed HIV in the United States-2015-2017, medical monitoring project.

机构信息

Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.

ICF, Atlanta, GA, USA.

出版信息

AIDS Care. 2021 Jan;33(1):86-91. doi: 10.1080/09540121.2020.1738007. Epub 2020 Mar 10.

Abstract

HIV clinical outcomes have not been fully assessed by place of birth at the national level. We analyzed the Medical Monitoring Project data, an annual cross-sectional survey designed to produce nationally representative estimates on adults with diagnosed HIV in the United States, collected during 2015-2017 ( = 7617). We compared sociodemographic, behavioral, and clinical outcomes by place of birth using Rao-Scott chi-square tests (< .05). Overall, 13.6% of adults with diagnosed HIV were non-US-born. During the past 12 months, a higher percentage of non-US-born than US-born adults, respectively, were prescribed ART (89.4% vs. 84.1%), retained in care (87.1% vs. 80.0%), virally suppressed at the last test (77.2% vs. 70.9%), and had sustained viral suppression (70.9% vs. 63.3%). A lower percentage of non-US-born adults reported binge drinking (13.0% vs. 16.1%), using non-injection drugs (15.3% vs. 31.7%), and suffering from depression (15.9% vs. 23.3%) or anxiety (10.0% vs. 20.2%). A significantly higher percentage of non-US-born adults had Ryan White HIV/AIDS Program (RWHAP) coverage (54.4% vs. 43.1%) and attended a RWHAP-funded health care facility (73.9% vs. 66.6%). Factors contributing to better HIV clinical outcomes among non-US-born persons may include access to RWHAP coverage, lower levels of substance use, and better mental health.

摘要

在国家层面上,HIV 的临床结局尚未充分按出生地进行评估。我们分析了医疗监测项目的数据,该项目是一项年度横断面调查,旨在对美国已确诊 HIV 的成年人产生全国代表性估计,收集于 2015-2017 年(=7617)。我们使用 Rao-Scott 卡方检验比较了不同出生地的社会人口统计学、行为和临床结局(<0.05)。总体而言,13.6%的确诊 HIV 成年人不是美国出生的。在过去的 12 个月中,与美国出生的成年人相比,非美国出生的成年人分别有更高的比例接受了抗逆转录病毒治疗(89.4%对 84.1%)、保持在护理中(87.1%对 80.0%)、最后一次检测时病毒得到抑制(77.2%对 70.9%)和持续病毒抑制(70.9%对 63.3%)。较低比例的非美国出生的成年人报告狂饮(13.0%对 16.1%)、使用非注射毒品(15.3%对 31.7%)以及患有抑郁症(15.9%对 23.3%)或焦虑症(10.0%对 20.2%)。非美国出生的成年人中,有更高比例的人享有 Ryan White HIV/AIDS 计划(RWHAP)覆盖(54.4%对 43.1%),并在 RWHAP 资助的医疗保健机构就诊(73.9%对 66.6%)。非美国出生者 HIV 临床结局较好的原因可能包括获得 RWHAP 覆盖、较低的物质使用水平和较好的心理健康。

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