Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA.
Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia.
AIDS Behav. 2023 Nov;27(11):3571-3583. doi: 10.1007/s10461-023-04071-7. Epub 2023 May 18.
Novel community-based approaches are needed to achieve and sustain HIV epidemic control in Zambia. Under the Stop Mother and Child HIV Transmission (SMACHT) project, the Community HIV Epidemic Control (CHEC) differentiated service delivery model used community health workers to support HIV testing, ART linkage, viral suppression, and prevention of mother-to-child transmission (MTCT). A multi-methods assessment included programmatic data analysis from April 2015 to September 2020, and qualitative interviews from February to March 2020. CHEC provided HIV testing services to 1,379,387 clients; 46,138 were newly identified as HIV-positive (3.3% yield), with 41,366 (90%) linked to ART. By 2020, 91% (60,694/66,841) of clients on ART were virally suppressed. Qualitatively, healthcare workers and clients benefitted from CHEC, with provision of confidential services, health facility decongestion, and increased HIV care uptake and retention. Community-based models can increase uptake of HIV testing and linkage to care, and help achieve epidemic control and elimination of MTCT.
在赞比亚，需要创新的社区方法来实现并维持艾滋病毒疫情的控制。在停止母婴艾滋病毒传播（SMACHT）项目下，社区艾滋病毒流行控制（CHEC）差异化服务提供模式利用社区卫生工作者来支持艾滋病毒检测、抗逆转录病毒治疗（ART）衔接、病毒抑制和预防母婴传播（PMTCT）。一个多方法评估包括 2015 年 4 月至 2020 年 9 月的方案数据分析，以及 2020 年 2 月至 3 月的定性访谈。CHEC 为 1379387 名客户提供了艾滋病毒检测服务；新发现 46138 人艾滋病毒阳性（3.3%的检出率），其中 41366 人（90%）与抗逆转录病毒治疗（ART）衔接。到 2020 年，66841 名接受抗逆转录病毒治疗的患者中有 91%（60694/66841）病毒得到抑制。从定性角度来看，医疗保健工作者和客户受益于 CHEC，提供保密服务、医疗机构去拥堵化以及增加艾滋病毒护理的参与和保留。基于社区的模式可以提高艾滋病毒检测和衔接护理的参与率，并有助于实现疫情控制和消除母婴传播。
