Doctors with Africa CUAMM, Shinyanga, Tanzania.
Independent statistician, Solagna, Italy.
PLoS One. 2022 Apr 12;17(4):e0266870. doi: 10.1371/journal.pone.0266870. eCollection 2022.
Test & Treat Project offers universal HIV testing and access to antiretroviral treatment in Northern Tanzania. The current cross-sectional study provides midterm results on HIV testing and counseling activities through community outreaches and facility-based services. A total 255,329 HIV tests were performed: 198,451 (77.7%) during testing campaigns in the villages, 12,592 (4.9%) during special events outreach and 44,286 (17.4%) in the health facilities. Females represented 53.8% (23,809) among those tested in the health facilities, while males were the majority in the community (54.4%, 114,835). Over one third of tests (n = 104,605, 41%) were performed among first-time testers. The overall HIV positivity rate was 1.2%, ranging from 0.7% in the community to 3.8% in the health facilities and decreased over time. Using a multivariable analysis, a positive test result was associated with age ≥ 50 years (PR 1.22, 95% CI 1.11 to 1.34), with female gender (PR 1.61, 95% CI 1.50 to 1.73), being tested in health facilities (PR 5.00, 95% CI 4.65 to 5.36) and for the first time (PR 1.86, 95% CI 1.73 to 2.00). The estimated proportion of PLHIV who knew their status of the project area increased by 28.6% (from 35.7% to 64.3%) and 11.1% (from 57.7% to 68.8%) in the project areas of Shinyanga and Simiyu regions respectively. Reaching the first UNAIDS 90 target by the end of this project seems possible. Future strategies should focus on improving PITC coverage, implementing more targeted testing modalities, together with current universal community-based approach.
Test & Treat 项目在坦桑尼亚北部提供普遍的艾滋病毒检测和抗逆转录病毒治疗。本项中期研究提供了通过社区外展和医疗机构服务进行艾滋病毒检测和咨询活动的结果。共进行了 255329 次艾滋病毒检测：198451 次（77.7%）是在村庄的检测活动中进行的，12592 次（4.9%）是在特别活动外展中进行的，44286 次（17.4%）是在医疗机构中进行的。在医疗机构接受检测的人群中，女性占 53.8%（23809 人），而男性在社区中占多数（54.4%，114835 人）。超过三分之一的检测（n=104605，41%）是在首次检测者中进行的。总体艾滋病毒阳性率为 1.2%，范围从社区的 0.7%到医疗机构的 3.8%，并随时间推移而下降。使用多变量分析，阳性检测结果与年龄≥50 岁（PR1.22，95%CI1.11-1.34）、女性（PR1.61，95%CI1.50-1.73）、在医疗机构接受检测（PR5.00，95%CI4.65-5.36）和首次检测（PR1.86，95%CI1.73-2.00）有关。项目地区艾滋病毒感染者知晓自身状况的比例估计增加了 28.6%（从 35.7%增至 64.3%）和 11.1%（从 57.7%增至 68.8%），分别在欣延加和西米尤地区。到本项目结束时实现联合国艾滋病规划署 90 目标似乎是可能的。未来的策略应侧重于提高接触点检测覆盖率，实施更有针对性的检测模式，同时保持当前普遍的基于社区的方法。
