Love Yourself, Inc., Mandaluyong, Metro Manila, Philippines.
Kirby Institute, 2786University of New South Wales, Sydney, Australia.
Int J STD AIDS. 2021 Jul;32(8):718-728. doi: 10.1177/0956462420987435. Epub 2021 Feb 3.
The HIV epidemic in the Philippines is the fastest growing globally, and disproportionately affects cisgender men who have sex with men (cis-MSM) demanding effective strategies for this key population (KP) group. KP-specific and community-based (CB) interventions have improved the HIV response elsewhere, but these have yet to be evaluated locally. We analyzed the HIV care cascade outcomes in a KP-led, CB HIV test-and-treat center and determined factors that affect these by performing a retrospective study of medical records of 3137 patients diagnosed from January 2016 to March 2019 in LoveYourself in Manila, Philippines. Multivariate logistic regression was performed to determine predictors affecting the likelihood of antiretroviral therapy (ART) initiation and viral load (VL) suppression. As to UNAIDS 90-90-90 targets, LoveYourself had higher rates than national outcomes with 78% initiated ART and 84% achieved VL suppression. Such satisfactory performance is consistent with other studies exploring CB, KP-led approaches among cis-MSM. Patients who presented with WHO Stages 2-4 and those with sexually transmitted infections were less likely to initiate ART. Patients who presented with WHO Stages 2-4 and those whose ART was started late were less likely to be virally suppressed. These findings suggest the need to develop responsive interventions to reach the UNAIDS targets.
菲律宾的艾滋病毒疫情是全球增长最快的，不成比例地影响着与顺性别男性发生性关系的男性（顺性别男性），这就需要为这一关键人群（KP）群体制定有效的策略。针对 KP 的具体措施和社区为基础的（CB）干预措施在其他地方改善了艾滋病毒应对措施，但这些措施尚未在当地进行评估。我们分析了由 KP 领导的、以社区为基础的 HIV 检测和治疗中心的 HIV 护理级联结果，并通过对 2016 年 1 月至 2019 年 3 月在菲律宾马尼拉的 LoveYourself 确诊的 3137 名患者的病历进行回顾性研究，确定了影响这些结果的因素。我们采用多变量逻辑回归分析来确定影响抗逆转录病毒治疗（ART）启动和病毒载量（VL）抑制的因素。在实现 UNAIDS 90-90-90 目标方面，LoveYourself 的表现优于国家结果，有 78%的患者开始接受 ART，84%的患者达到了 VL 抑制。这种令人满意的表现与其他探索 CB、KP 领导的顺性别男性中的方法的研究一致。出现世界卫生组织（WHO）第 2-4 期的患者以及患有性传播感染的患者ART 启动的可能性较低。出现世界卫生组织（WHO）第 2-4 期和 ART 启动较晚的患者VL 抑制的可能性较低。这些发现表明，需要制定有针对性的干预措施来实现 UNAIDS 的目标。
