埃塞俄比亚西部内克梅特专科医院接受终身治疗的艾滋病毒感染者当日启动抗逆转录病毒治疗及相关因素
Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia.
作者信息
Bayisa Lami, Bayisa Diriba, Turi Ebisa, Mulisa Diriba, Tolossa Tadesse, Akuma Adugna Olani, Bokora Merga Chala, Rundasa Dawit Tesfaye
机构信息
Department of Nursing, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia.
Department of Midwifery, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia.
出版信息
HIV AIDS (Auckl). 2023 Jan 24;15:11-22. doi: 10.2147/HIV.S395238. eCollection 2023.
BACKGROUND
The test-and-treat approach recommends early ART initiation (same day). Early ART start has double the benefits as treatment and as prevention. However, there is limited information regarding same-day ART initiation in Ethiopia. Hence, this study aimed to assess the magnitude and factors of same-day ART initiation among people living with HIV (PLHIV) on ART at Nekemte specialized hospital, in Western Ethiopia.
METHODS
A cross-sectional study was conducted among 483 PLHIV from January 10 to February 15, 2021. Data were collected using an investigator-administered questionnaire. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Variables with P-value <0.25 from bivariable analysis were included in the multivariable analysis. AOR with 95% CI and P-value <0.05 were used to declare statistical significance.
RESULTS
A total of 483 study subjects participated and gave a 100% response rate. Two thirds (65%) of them started ART on the same day with a 95% CI [60.2-68.8]. Urban dwellers (AOR = 3.93 (95% 1.96-7.87)), with no OIs (AOR = 4.02 (95% CI: 1.54-10.47)), not screened for TB (AOR = 6.02 (95% CI: 1.71-21.15)), tested via VCT (AOR = 2.32 (95% CI: 1.37-3.26)), who have not used CPT (AOR = 1.88 (95% CI: 1.10-3.23)), who have not used IPT (AOR = 2.36 (95% CI: 1.0-5.57)), who were tested in 2019/20 (AOR = 2.37 (95% CI: 1.08-5.518)), and with BMI ≥25 kg/m (AOR = 2.18 (95% CI: 1.05-4.52)) were significantly associated with same-day ART initiation.
CONCLUSION
Two thirds of study subjects initiated ART on the same day as HIV diagnosis. Voluntary testing and immediate referral to HIV care, advocating test-and-treat, and intensive counseling should be strengthened and reinforced for newly diagnosed HIV-positive people. Given that, high attention should be paid to individuals from urban residence, not screened for TB, who have not used CPT and IPT prophylaxis.
背景
检测即治疗方法建议尽早开始抗逆转录病毒治疗（当日开始）。尽早开始抗逆转录病毒治疗在治疗和预防方面都有双倍益处。然而，关于埃塞俄比亚当日开始抗逆转录病毒治疗的信息有限。因此，本研究旨在评估埃塞俄比亚西部内克梅特专科医院接受抗逆转录病毒治疗的艾滋病毒感染者（PLHIV）中当日开始抗逆转录病毒治疗的比例及相关因素。
方法
于2021年1月10日至2月15日对483名艾滋病毒感染者进行了一项横断面研究。使用调查员管理的问卷收集数据。分别使用Epi Data 3.1和STATA 14.0进行数据录入和分析。双变量分析中P值<0.25的变量纳入多变量分析。使用95%置信区间的调整后比值比（AOR）和P值<0.05来判定统计学显著性。
结果
共有483名研究对象参与，应答率为100%。其中三分之二（65%）的人在当日开始抗逆转录病毒治疗，95%置信区间为[60.2 - 68.8]。城市居民（AOR = 3.93（95% 1.96 - 7.87））、无机会性感染（AOR = 4.02（95% CI：1.54 - 10.47））、未进行结核病筛查（AOR = 6.02（95% CI：1.71 - 21.15））、通过自愿咨询检测（VCT）进行检测（AOR = 2.32（95% CI：1.37 - 3.26））、未使用复方新诺明预防治疗（CPT）（AOR = 1.88（95% CI：1.10 - 3.23））、未使用异烟肼预防治疗（IPT）（AOR = 2.36（95% CI：1.0 - 5.57））、在2019/20年度接受检测（AOR = 2.37（95% CI：1.08 - 5.518））以及体重指数（BMI）≥25 kg/m²（AOR = 2.18（95% CI：1.05 - 4.52））与当日开始抗逆转录病毒治疗显著相关。
结论
三分之二的研究对象在艾滋病毒诊断当日开始抗逆转录病毒治疗。对于新诊断的艾滋病毒阳性者，应加强自愿检测并立即转介至艾滋病毒治疗、倡导检测即治疗以及强化咨询。鉴于此，应高度关注城市居民、未进行结核病筛查、未使用CPT和IPT预防治疗的个体。
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