Weiser John, Tie Yunfeng, Lu Jen-Feng, Colasanti Jonathan A, Fanfair Robyn Neblett, Beer Linda
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
DLH Corporation, Atlanta, Georgia, USA.
Open Forum Infect Dis. 2022 Jun 10;9(7):ofac280. doi: 10.1093/ofid/ofac280. eCollection 2022 Jul.
The HIV Medicine Association of the Infectious Disease Society of America publishes Primary Care Guidance for Persons with Human Immunodeficiency Virus. We assessed receipt of recommended baseline tests among newly diagnosed patients initiating HIV care.
The Medical Monitoring Project is a Centers for Disease Control and Prevention survey designed to produce nationally representative estimates of behavioral and clinical characteristics of adults with diagnosed HIV in the United States. We analyzed data for 725 participants in the 2015-2019 data collection cycles who received an HIV diagnosis within the past 2 years and had ≥1 HIV provider visit. We estimated the prevalence of having recommended tests after the first HIV provider visit and between 3 months before and 3/6 months after the first HIV provider visit and estimated prevalence differences of having 4 combinations of tests by sociodemographic and clinical characteristics.
Within 6 months of care initiation, HIV monitoring tests were performed for 91.3% (95% CI, 88.7%-93.8%) of patients; coinfection blood tests, 27.5% (95% CI, 22.5%-32.4%); site-based STI tests, 59.7% (95% CI, 55.4%-63.9%); and blood chemistry and hematology tests, 50.8% (95% CI, 45.8%-55.8%). Patients who were younger, gay, or bisexual were more likely to receive site-based STI tests, and patients receiving care at Ryan White HIV/AIDS Program (RWHAP)-funded facilities were more likely than patients at non-RWHAP-funded facilities to receive all test combinations.
Receipt of recommended baseline tests among patients initiating HIV care was suboptimal but was more likely among patients at RWHAP-funded facilities. Embedding clinical decision support in HIV provider workflow could increase recommended baseline testing.
美国传染病学会的艾滋病医学协会发布了《人类免疫缺陷病毒感染者初级保健指南》。我们评估了新诊断开始接受艾滋病护理的患者中接受推荐的基线检查的情况。
医疗监测项目是美国疾病控制与预防中心开展的一项调查，旨在对美国已诊断感染艾滋病的成年人的行为和临床特征做出具有全国代表性的估计。我们分析了2015 - 2019年数据收集周期中725名参与者的数据，这些参与者在过去2年内被诊断出感染艾滋病且至少有1次艾滋病医疗服务提供者就诊经历。我们估计了首次就诊后以及首次就诊前3个月至就诊后3/6个月内接受推荐检查的患病率，并按社会人口统计学和临床特征估计了接受4种检查组合的患病率差异。
在开始护理的6个月内，91.3%（95%置信区间，88.7% - 93.8%）的患者进行了艾滋病监测检查；合并感染血液检查为27.5%（95%置信区间，22.5% - 32.4%）；基于场所的性传播感染检查为59.7%（95%置信区间，55.4% - 63.9%）；血液化学和血液学检查为50.8%（95%置信区间，45.8% - 55.8%）。年龄较小、男同性恋或双性恋患者更有可能接受基于场所的性传播感染检查，在瑞安·怀特艾滋病项目（RWHAP）资助机构接受护理的患者比在非RWHAP资助机构的患者更有可能接受所有检查组合。
开始接受艾滋病护理的患者中，接受推荐的基线检查的情况并不理想，但在RWHAP资助机构的患者中更有可能接受检查。将临床决策支持融入艾滋病医疗服务提供者的工作流程中可以增加推荐的基线检查。
