Department of Emergency Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Department of Global Health, University of Washington, Seattle, WA, USA.
Glob Public Health. 2021 Dec;16(12):1848-1855. doi: 10.1080/17441692.2020.1847310. Epub 2020 Nov 21.
Communication interventions to enhance linkage to HIV care have been successful in sub-Saharan Africa but have not been assessed among refugees. Refugees and Ugandan nationals participating in HIV testing in Nakivale Refugee Settlement were offered weekly phone call and short message service (SMS) reminders. We assessed linkage to care and predictors of linkage within 90 days of testing, comparing Intervention participants to those unwilling or ineligible to participate (Non-Intervention). Of 208 individuals diagnosed with HIV, 101 (49%) participated in the intervention. No difference existed between Intervention and Non-intervention groups in linkage to care (73 [72%] vs. 76 [71%], = 0.88). Excluding those who linked prior to receipt of intervention, the intervention improved linkage (69 [68%] vs. 50 [47%], = 0.002). Participants were more likely to link if they were older (aOR 2.39 [1.31, 4.37], = 0.005) or Ugandan nationals (aOR 3.76 [1.12, 12.66], = 0.033). Although the communication intervention did not significantly improve linkage to HIV care, the linkage was improved when excluding those with same-day linkage. Excluding participants without a phone was a significant limitation; these data are meant to inform more rigorous designs moving forward. Innovative methods to improve linkage to HIV care for this vulnerable population are urgently needed.
在撒哈拉以南非洲，沟通干预措施已被证明可以成功促进艾滋病毒感染者接受治疗，但尚未在难民中进行评估。在纳基瓦莱难民营参与艾滋病毒检测的难民和乌干达国民会收到每周一次的电话和短信提醒。我们评估了在检测后 90 天内的治疗关联情况和关联的预测因素，将干预组与不愿意或无资格参与的组（非干预组）进行了比较。在 208 名被诊断患有 HIV 的人中，有 101 人（49%）参与了干预。在接受治疗关联方面，干预组与非干预组之间没有差异（73[72%]比 76[71%]， = 0.88）。排除在接受干预之前就已联系的人后，干预措施提高了联系率（69[68%]比 50[47%]， = 0.002）。如果参与者年龄较大（OR 2.39[1.31, 4.37]， = 0.005）或为乌干达国民（OR 3.76[1.12, 12.66]， = 0.033），则更有可能联系。尽管沟通干预措施并未显著改善与艾滋病毒护理的联系，但排除那些在同一天联系的人后，联系得到了改善。排除没有手机的参与者是一个重大限制；这些数据旨在为未来更严格的设计提供信息。迫切需要为这一弱势群体找到改善与艾滋病毒护理联系的创新方法。
