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HIV 母婴垂直传播感染儿童告知状况的初步研究:美国南部一家儿科 HIV 门诊的行政记录回顾性分析。

Preliminary study on HIV status disclosure to perinatal infected children: retrospective analysis of administrative records from a pediatric HIV clinic in the southern United States.

机构信息

Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.

Department of Pediatrics, School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.

出版信息

BMC Res Notes. 2020 May 24;13(1):253. doi: 10.1186/s13104-020-05097-z.

Abstract

OBJECTIVE

The World Health Organization recommends disclosing HIV-status between 6 and 12 years; American Academy of Pediatrics recommends that children are informed at "school age." Neither suggests an optimal age when children should learn of their status to improve viral load suppression. Considering that virally suppressed people do not transmit HIV and that interrupting the transmission cycle is critical to ending the HIV epidemic, our objective is to examine the relationship between age of disclosure and viral load suppression by evaluating data from a pediatric HIV clinic in the southern United States. Records from perinatal infected patients seen between 2008 and 2018 were analyzed (N = 61).

RESULTS

Longitudinal suppression was low across all groups when benchmarked against the UNAIDS 90% global target; black patients were less likely to achieve suppression compared to white patients (41% vs. 75%, p = 0.04). Adopted children were more likely to achieve suppression than children living with biological family (71% vs. 44%, p < 0.05). Children who learned of their status between 10 and 12 had the highest rate of suppression (65%) compared to peers who learned of their status younger (56%) or older (38%). Our preliminary study is designed to spark research on refining the current recommendations on HIV-status disclosure to perinatal infected children.

摘要

目的

世界卫生组织建议在 6 至 12 岁之间告知艾滋病病毒感染者的身份;美国儿科学会建议儿童在“学龄”时被告知。两者都没有提出一个最佳的年龄,让儿童了解自己的状况以提高病毒载量抑制率。鉴于病毒抑制者不会传播艾滋病毒,而且中断传播周期对结束艾滋病流行至关重要,因此我们的目的是通过评估美国南部一家儿科艾滋病诊所的数据,研究告知感染艾滋病病毒的儿童其身份的年龄与病毒载量抑制之间的关系。分析了 2008 年至 2018 年间接受治疗的围产期感染患者的记录(N=61)。

结果

与艾滋病规划署 90%的全球目标相比,所有组别的纵向抑制率都很低;与白人患者相比,黑人患者更不可能实现抑制(41%对 75%,p=0.04)。被收养的儿童比与亲生家庭一起生活的儿童更有可能实现抑制(71%对 44%,p<0.05)。与更早(56%)或更晚(38%)得知自己感染状况的同龄人相比,在 10 至 12 岁之间得知自己感染状况的儿童的抑制率最高(65%)。我们的初步研究旨在引发关于完善当前针对围产期感染儿童的艾滋病病毒感染者身份告知建议的研究。

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