Peterman T A, Todd K A, Mupanduki I
Division of STD/HIV Prevention, National Center for Prevention Services, Centers for Disease Control and Prevention, Atlanta, Georgia, 30333, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 May 1;12(1):69-74. doi: 10.1097/00042560-199605010-00010.
We wished to identify opportunities for improving the yield of positive HIV test results from federally funded HIV counseling and testing programs. We reviewed client records from 1992 and 1993 for targeting opportunities at the site level based on site type (i.e., family planning clinic) and the seropositivity in the past and at the client level based on the client's history of a past negative test, demographics, and risk history. We studied 1,281,606 records from 1992. The number of tests and opportunities for site-level targeting varied by project area. Seropositivity varied by site type, but the best predictor of seropositivity was seropositivity at that site in the past. Of 1,102 sites with <1% of tests positive in 1992, only five had >3% positive in 1993. Sites with no positive tests in 1992 performed 99,468 tests in 1993, and only 292 (0.3%) were positive. Clients with a past negative test had a slightly lower seropositivity (1.5%) than clients with no previous test (2.0%). In sites with a low (0.1-2.0%) seropositivity, clients with no transmission risk by history were unlikely to be infected (0.8% for black men). However, in sites with high (> or =5%) seropositivity, clients without risk were often infected (5.7% for black men). Opportunities for targeting were identified. They vary considerably by project area and testing site. These opportunities for targeting should be considered by sites as AIDS prevention strategies evolve.
我们希望找到机会，以提高联邦资助的艾滋病咨询与检测项目中HIV检测阳性结果的产出率。我们查阅了1992年和1993年的客户记录，以便根据场所类型（如计划生育诊所）在场所层面以及根据客户过去检测结果为阴性的病史、人口统计学特征和风险史在客户层面确定目标机会。我们研究了1992年的1,281,606条记录。检测数量和场所层面的目标机会因项目领域而异。血清阳性率因场所类型而异，但血清阳性率的最佳预测指标是该场所过去的血清阳性率。在1992年检测阳性率低于1%的1,102个场所中，只有5个场所在1993年的阳性率超过3%。1992年无阳性检测结果的场所在1993年进行了99,468次检测，其中只有292次（0.3%）为阳性。过去检测结果为阴性的客户的血清阳性率（1.5%）略低于之前未检测过的客户（2.0%）。在血清阳性率较低（0.1 - 2.0%）的场所，根据病史无传播风险的客户感染的可能性不大（黑人男性为0.8%）。然而，在血清阳性率较高（≥5%）的场所，无风险的客户经常被感染（黑人男性为5.7%）。确定了目标机会。它们因项目领域和检测场所的不同而有很大差异。随着艾滋病预防策略的演变，各场所应考虑这些目标机会。
