Translation and Evaluation Branch, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Analytic Consulting Services, Inc, Hillsborough, NC, USA.
Public Health Rep. 2023 Jul-Aug;138(4):625-632. doi: 10.1177/00333549221120239. Epub 2022 Aug 25.
Older adults represent nearly half of people living with HIV in the United States. The objective of this analysis was to describe HIV testing, demographic characteristics, and risks of adults aged ≥50 years (older adults) reached in 2019 by HIV testing programs funded by the Centers for Disease Control and Prevention (CDC).
We collected data from 101 CDC-funded community-based organizations and 61 health departments. All funding recipients submitted deidentified program service data for 2019 through a secure online CDC-supported system. We used multivariable robust Poisson regression to assess the association between demographic and risk characteristics and the proportion of tests that resulted in a new diagnosis. We also assessed the proportion of people who received a positive test result, were linked to HIV medical care, and were interviewed for partner services.
During 2019, among 2 452 507 CDC-funded HIV tests provided in the United States, 412 164 (16.8%) were provided to older adults. Among the 1059 (0.26% positivity) older adults with newly diagnosed HIV infection for whom we had data, 582 (68.4%) were linked to HIV medical care within 30 days of diagnosis and 494 (72.1%) were interviewed for partner services. Among the 2858 older adults with previously diagnosed HIV infection, 1321 (46.2%) reported not being in HIV medical care at the time of the test; of those with linkage data, 425 (49.9%) were linked to HIV medical care within 30 days of testing HIV positive.
More rapid disease progression and higher morbidity and mortality rates among older adults suggest that services are needed to ensure early diagnosis, rapid linkage, and interview for partner services.
在美国,近一半的艾滋病毒感染者是老年人。本分析的目的是描述 2019 年由疾病预防控制中心(CDC)资助的艾滋病毒检测项目所接触的年龄≥50 岁(老年人)的艾滋病毒检测、人口统计学特征和风险。
我们从 101 个 CDC 资助的社区组织和 61 个卫生部门收集数据。所有资助接受者通过一个安全的在线 CDC 支持系统提交 2019 年的匿名项目服务数据。我们使用多变量稳健泊松回归来评估人口统计学和风险特征与导致新诊断的检测比例之间的关联。我们还评估了接受阳性检测结果、与艾滋病毒医疗保健联系以及接受伙伴服务访谈的人数比例。
在 2019 年,在美国提供的 2452507 次 CDC 资助的艾滋病毒检测中,有 412164 次(16.8%)提供给了老年人。在我们有数据的 1059 名(0.26%阳性率)新诊断为艾滋病毒感染的老年人中,有 582 名(68.4%)在诊断后 30 天内与艾滋病毒医疗保健联系,有 494 名(72.1%)接受了伙伴服务访谈。在 2858 名以前诊断为艾滋病毒感染的老年人中,有 1321 名(46.2%)报告在检测时未接受艾滋病毒医疗保健;在有联系数据的人群中,有 425 名(49.9%)在艾滋病毒检测呈阳性后 30 天内与艾滋病毒医疗保健联系。
老年人的疾病进展更快、发病率和死亡率更高,这表明需要提供服务,以确保早期诊断、快速联系和接受伙伴服务的访谈。