美国高艾滋病毒发病率地区艾滋病毒辅助伴侣服务的组织、内容及病例发现效果

The Organization, Content, and Case-Finding Effectiveness of HIV Assisted Partner Services in High HIV Morbidity Areas of the United States.

作者信息

Golden Matthew R, AugsJoost Brett, Bender Melverta, Brady Kathleen A, Collins Lyell S, Dombrowski Julia D, Ealey Jamila, Garcia Christopher, George Dan, Gilliard Bernard, Harris Terrainia, Johnson Cynthia, Khosropour Christine M, Rumanes Sophia F, Surita Karen, Tabidze Irina, Udeagu Chi-Chi N, Walker-Baban Cherie, Cramer Natalie O

机构信息

Center for AIDS and STD.

Division of Allergy and Infectious Diseases.

出版信息

J Acquir Immune Defic Syndr. 2022 Apr 15;89(5):498-504. doi: 10.1097/QAI.0000000000002904.

DOI:10.1097/QAI.0000000000002904

PMID:34974472

Abstract

BACKGROUND

The contemporary effectiveness of assisted partner notification services (APS) in the United States is uncertain.

SETTING

State and local jurisdictions in the United States that reported ≥300 new HIV diagnoses in 2018 and were participating in the Ending the Epidemic Initiative.

METHODS

The study surveyed health departments to collect data on the content and organization of APS and aggregate data on APS outcomes for 2019. Analyses defined contact and case-finding indices (i.e., sex partners named and newly diagnosed per index case receiving APS) and estimated staff case-finding productivity.

RESULTS

Sixteen (84%) of 19 jurisdictions responded to the survey, providing APS outcome data for 14 areas (74%). Most health departments routinely integrated APS with linkage of cases and partners to HIV care (88%) and pre-exposure prophylaxis (88%). A total of 19,164 persons were newly diagnosed with HIV in the 14 areas. Staff initiated APS investigations on 14,203 cases (74%) and provided APS to 9937 cases (52%). Cases named 6799 partners (contact index = 0.68), of whom 1841 (27%) had previously diagnosed HIV, 2202 (32%) tested HIV negative, 541 (8% of named and 20% of tested partners) were newly diagnosed with HIV, and 2215 (33%) were not known to have tested. Across jurisdictions, the case-finding index was 0.054 (median = 0.05, range 0.015-0.12). Health departments employed 292 full-time equivalent staff to provide APS. These staff identified a median of 2.0 new HIV infections per staff per year. APS accounted for 2.8% of new diagnoses in 2019.

CONCLUSIONS

HIV case-finding resulting from APS in the United States is low.

摘要

背景

美国辅助性伴侣通知服务（APS）的当代有效性尚不确定。

地点

美国在2018年报告了≥300例新的艾滋病毒诊断病例且参与了“终结疫情倡议”的州和地方司法管辖区。

方法

该研究对卫生部门进行了调查，以收集有关APS的内容和组织的数据以及2019年APS结果的汇总数据。分析定义了接触和病例发现指数（即每名接受APS的索引病例所提及的性伴侣和新诊断出的病例），并估算了工作人员的病例发现生产力。

结果

19个司法管辖区中有16个（84%）回复了调查，提供了14个地区（74%）的APS结果数据。大多数卫生部门常规地将APS与病例及伴侣与艾滋病毒护理的联系（88%）和暴露前预防（88%）相结合。在这14个地区，共有19164人新诊断出感染艾滋病毒。工作人员对14203例病例（74%）启动了APS调查，并为9937例病例（52%）提供了APS。病例提及了6799名伴侣（接触指数=0.68），其中1841名（27%）先前已诊断出感染艾滋病毒，2202名（32%）艾滋病毒检测呈阴性，541名（占提及伴侣的8%，检测伴侣的20%）新诊断出感染艾滋病毒，2215名（33%）未知是否接受过检测。在各司法管辖区中，病例发现指数为0.054（中位数=0.05，范围0.015 - 0.12）。卫生部门雇用了292名全职等效工作人员来提供APS。这些工作人员平均每年每人识别出2.0例新的艾滋病毒感染病例。APS占2019年新诊断病例的2.8%。