美国临床和社区检测在发现未诊断的 HIV 感染者方面的潜在贡献。
Potential Contributions of Clinical and Community Testing in Identifying Persons with Undiagnosed HIV Infection in the United States.
机构信息
Philip R. Lee Institute for Health Policy Studies, 8785University of California San Francisco (UCSF) and Consortium to Assess Prevention Economics (CAPE), Berkeley, CA, USA.
Division of General Medical Disciplines, 1242Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA.
出版信息
J Int Assoc Provid AIDS Care. 2020 Jan-Dec;19:2325958220950902. doi: 10.1177/2325958220950902.
BACKGROUND
An estimated 166,155 individuals in the United States have undiagnosed HIV infection. We modeled the numbers of HIV-infected individuals who could be diagnosed in clinical and community settings by broadly implementing HIV screening guidelines.
SETTING
United States.
METHODS
We modeled testing for general population (once lifetime) and high-risk populations (annual): men who have sex with men, people who inject drugs, and high-risk heterosexuals. We used published data on HIV infections, HIV testing, engagement in clinical care, and risk status disclosure.
RESULTS
In clinical settings, about 76 million never-tested low-risk and 2.6 million high-risk individuals would be tested, yielding 36,000 and 55,000 HIV diagnoses, respectively. In community settings, 30 million low-risk and 4.4 million high-risk individuals would be tested, yielding 75,000 HIV diagnoses.
CONCLUSION
HIV testing in clinical and community settings diagnoses similar numbers of individuals. Lifetime and risk-based testing are both needed to substantially reduce undiagnosed HIV.
背景
据估计，美国有 166155 名未确诊的 HIV 感染者。我们通过广泛实施 HIV 筛查指南，对可在临床和社区环境中诊断出的 HIV 感染者数量进行了建模。
地点
美国。
方法
我们对一般人群（一生中一次）和高危人群（每年）进行了检测建模：男男性行为者、注射毒品者和高危异性恋者。我们使用了 HIV 感染、HIV 检测、参与临床护理和风险状况披露的已发表数据。
结果
在临床环境中，约 7600 万从未接受过检测的低危人群和 260 万高危人群将接受检测，分别产生 36000 和 55000 例 HIV 诊断。在社区环境中，3000 万低危人群和 440 万高危人群将接受检测，产生 75000 例 HIV 诊断。
结论
临床和社区环境中的 HIV 检测诊断出了数量相似的人群。需要终生和基于风险的检测，才能大幅减少未确诊的 HIV。
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