监管场所中艾滋病检测政策的应用

在监狱及其他监管场所羁押的罪犯和违法犯罪人员是艾滋病的高危人群,对他们开展艾滋病病毒(HIV)抗体检测,对于及时发现和治疗HIV感染者和病人,预防进一步传播具有重要作用。但在开展强制检测、自愿咨询检测之间存在激烈的争论,世界卫生组织主张开展自愿咨询检测,但美国、南非、澳大利亚等国都曾经或正在实行强制检测。     

云南省艾滋病快速检测替代策略推广运用情况分析

目的 分析云南省艾滋病快速检测替代推广运用情况,为全省艾滋病实验室网络建设及艾滋病抗体补充试验检测策略选择提供经验和科学依据.方法 收集2018年全省艾滋病病毒(HIV)抗体筛查阳性样品补充试验检测策略选择情况及其检测结果,构建决策树模型,对传统确证检测(蛋白印迹试验,WB)和快速检测替代策略两种艾滋病抗体检测补充试验...     

艾滋病抗病毒治疗政策和策略分析与思考

目的把握艾滋病抗病毒治疗政策和策略现状,分析存在的问题,为调整完善艾滋病抗病毒治疗机制提供建议。方法采用文献回顾、数据资料收集和现场调查的方法。结果中国制定落实了艾滋病病人免费抗病毒治疗的政策和策略,建立了医疗机构和疾病预防控制机构服务相结合的治疗模式,探索建立了免费抗病毒治疗的药品供应、经费保障机制,将抗病毒治疗药品纳入城镇职工基本医疗保险支付范围,推动了抗病毒治疗工作的迅速开展,明显降低了病人的病死率。当前抗病毒治疗工作面临治疗服务规模和能力有限、治疗药品供应和管理机制不能适合治疗发展需要、治疗与现行基本医疗保障体系脱节、流动人口异地治疗办法尚不完善等问题。结论需要进一步健全以定点医疗机构为依托的抗病毒治疗服务体系,结合医改重建满足治疗需求的免费抗病毒治疗药品供应保障机制,将抗病毒治疗纳入现行的医疗保障范围,加快探索异地抗病毒治疗的办法     

宛城区艾滋病自愿咨询检测结果分析

艾滋病自愿咨询检测(VCT)不仅可以尽早发现、及时治疗和预防艾滋病病毒(HIV)感染,为受检者提供心理支持,而且还可以减少高危人群的高危性行为,预防HIV传播。南阳市宛城区艾滋病疫情主要是1995年前后经非法采供血传播引起,2004年8~9月份对全区既往有偿供血员进行普查登记及HIV检     

艾滋病临床检测中存在的问题和解决方法

实验室检测是艾滋病病毒(Humani mmunodeficiency virus,HIV)感染者/艾滋病(Acquiredi mmu-nodeficiency syndrome,AIDS)病人诊断的主要依据。各个时期均可通过血清HIV抗体的检测来进行诊断,但是在HIV抗体结果不确定或是HIV感染的"窗口期"时,要依靠核酸检测、抗原检测进行辅助诊断。另外,CD4+T细胞的检测和核酸检测在HIV感     

浙江省艾滋病自愿咨询检测求询者的动态变化分析

目的对比2008年和2009年浙江省艾滋病自愿咨询检测(VCT)数据,探索今后VCT工作的方向。方法通过下载艾滋病综合防治数据信息管理系统中,检测咨询信息管理定时统计的数据、2008年和2009年不同类型的求询者的数量和艾滋病病毒(HIV)阳性者的数量,利用卡方检验进行统计学分析。结果 2008年共完成咨询检测73 918人次,2009年共完成咨询检测81 386人次。求询者中有非婚异性性行为史者有上升趋势,2008年占46.98%(34 730/73 918),2009年占49.12%(39 977/81 386),两年对比差异有统计学意义(P<0.05)。2008年和2009年分别经VCT发现HIV感染者255人和331人,感染者中以男男性行为者、非婚异性性行为者、配偶/固定性伴HIV阳性者为主,注射吸毒史(P<0.05)、有非婚异性性行为史者(P<0.05)和有男男性行为史者对比,差异有统计学意义(P<0.05)。结论要对大众进行宣传艾滋病VCT服务,特别是针对具有男男性行为、非婚异性性行为、配偶/固定性伴HIV阳性的人群要加强宣传。     

北京市朝阳区艾滋病自愿咨询检测情况分析

目的调查北京市朝阳区艾滋病自愿咨询检测（VCT）人群的社会人口学特征和艾滋病病毒（HIV）感染状况,有针对性地制定朝阳区艾滋病健康教育和高危干预措施。方法对2007年6月-2008年9月,朝阳区疾病预防控制中心艾滋病VCT门诊求询者的调查结果进行分析。结果868名求询者接受咨询和血清HIV抗体检测,以20～40岁男性青壮年为主,占89.9%;男女比例7.19∶1;未婚占68.9%。求询原因以发生危险性行为为主,占86.3%。HIV抗体阳性41例,感染率为4.7%,以性途径感染为主（75.6%）,22人通过同性性行为感染。结论朝阳区艾滋病的传播以性途径为主,求询者以年轻、未婚和高学历男性为主,HIV感染在男男性行为人群（MSM）中检出率较高。因此,应对男性青壮年、MSM人群进行广泛的艾滋病健康教育,加强针对MSM人群的行为干预措施。     

江西省艾滋病自愿咨询检测现状分析

目的更好地做好江西省艾滋病防治工作。方法采用描述性方法分析江西省艾滋病自愿咨询检测(VCT)现状。结果从事艾滋病咨询工作的专职人员较少。接受检测后咨询及转介服务人数占检测前咨询人数的比例分别为5.22%、1.39%。接受检测的人以20~29岁人数最多,其次30~39岁。萍乡、南昌市检测初筛阳性构成比较高,分别为39.13%、26.09%。结论建立健全VCT服务网络,提高咨询服务质量。广泛开展对目标人群的VCT服务宣传和外展活动,有效开展VCT服务,遏制艾滋病的传播。     

HIV testing practices in Jamaica

OBJECTIVES: Prevention programmes often promote HIV testing as one possible strategy for combating the spread of the disease. The objectives of the present study were to examine levels of HIV testing practices in a large sample of Jamaicans and the relationships among HIV testing, sociodemographic variables and HIV-related behaviours. METHODS: A total of 1800 persons, aged 15-49 years, were surveyed between May and August 2004 using a household-level, interviewer-administered questionnaire. The questionnaire included HIV-related knowledge, attitudinal and behavioural items. For the present analyses, data from 1558 sexually experienced persons were examined. RESULTS: Approximately 38% of the sexually experienced sample reported a history of HIV testing. Hierarchical logistic regression analyses revealed that adults, females, persons with post-high school education and married persons were more likely to report previous HIV testing. Also, those who had attended an HIV/AIDS education workshop or discussion and those who reported knowing persons living with HIV/AIDS were more likely to report previous testing. However, HIV testing was not associated with condom use or with the number of sexual partners. CONCLUSIONS: The lack of significant findings establishing a relationship between testing and risky sexual behaviours should not negate the importance of HIV testing. Being informed regarding personal HIV serostatus is one of the first steps in self-protection. Effective messages and programmes promoting HIV testing need to be developed and implemented in Jamaica, in order to educate people about how to assess their level of risk with respect to contracting HIV infection.     

Routine, voluntary HIV testing in Durban, South Africa: correlates of HIV infection

Background

Routine HIV testing is increasingly recommended in resource‐limited settings. Our objective was to evaluate factors associated with a new diagnosis of HIV infection in a routine HIV testing programme in South Africa.

Methods

We established a routine HIV testing programme in an out‐patient department in Durban, South Africa. All registered adults were offered a rapid HIV test; we surveyed a sample of tested patients.

Results

During the 12‐week study, 1414 adults accepted HIV testing. Of those, 463 (32.7%) were HIV‐infected. Seven hundred and twenty (50.9%) were surveyed. Compared with married women, unmarried men were at the highest risk of HIV [odds ratio (OR) 6.84; 95% confidence interval (CI) 3.45–23.55], followed by unmarried women (OR 5.90; 95% CI 3.25–10.70) and married men (OR 4.00; 95% CI 2.04–7.83). Age 30–39 years (compared with ≥50 years; OR 5.10; 95% CI 2.86–9.09), no prior HIV test (OR 1.45; 95% CI 1.07–2.27) and an imperfect HIV knowledge score (OR 2.32; 95% CI 1.24–4.35) were also associated with HIV infection.

Conclusion

In a routine HIV testing programme in South Africa, rates of previously undiagnosed HIV were highest among men, young and unmarried patients, and those with poorer HIV knowledge. Better interventions are needed to improve HIV knowledge and decrease HIV risk behaviour.     

Risk factors associated with resistance to HIV testing among transwomen in Brazil

Transwomen are a high-risk population for HIV/AIDS worldwide. However, many transwomen do not test for HIV. This study aimed to identify factors associated with resistance to HIV testing among transwomen in Fortaleza/CE. A cross-sectional study was conducted between August and December 2008 with a sample of 304 transwomen recruited through respondent-driven sampling. Data analysis utilized Respondent-Driven Sampling Analysis Tool and SPSS 11.0. Univariate, bivariate, and multivariate analyses examined risk factors associated with resistance to HIV testing. Less than 18 years of age (OR?=?4.221; CI?=?2.419–7.364), sexual debut before 10 years of age (OR?=?6.760; CI?=?2.996–15.256), using illegal drugs during sex (OR?=?2.384; CI?=?1.310–4.339), experience of discrimination (OR?=?3.962; CI?=?1.540–10.195) and a belief that the test results were not confidential (OR?=?3.763; CI?=?2.118–6.688) are independently associated with resistance to testing. Intersectoral and targeted strategies aimed at encouraging the adoption of safer sexual behaviors and testing for HIV among transwomen are required.     

桂林市2008～2010年艾滋病自愿咨询及检测情况分析

目的了解艾滋病自愿咨询及检测人群的HIV感染分布情况,有针对性地开展艾滋病健康教育。方法由经过专业技术培训的医护人员对2008年1月至2010年12月在我院艾滋病咨询及免费检测门诊（VCT门诊）的1232例求询者进行HIV抗体（ELISA法）初筛检测,并对确诊试验阳性的患者情况进行分析。结果1232例求询者中75例HIV阳性（6．09％）。75例HIV阳性患者中男性49例,女性26例,其中外省流动人口3例。年龄3～78岁,其中21～40岁者39例（52．0％）。结论艾滋病的发病仍保持低流行状态,应加强对高危人群的检测及健康教育干预,更好的预防和控制艾滋病传播。     

Perceptions of door-to-door HIV counselling and testing in Botswana

Prevalence of HIV infection in Botswana is among the highest in the world, at 23.9% of 15 – 49-year-olds. Most HIV testing is conducted in voluntary counselling and testing centres or medical settings. Improved access to testing is urgently needed. This qualitative study assessed and documented community perceptions about the concept of door-to-door HIV counselling and rapid testing in two of the highest-prevalence districts of Botswana.

Community members associated many positive benefits with home-based, door-to-door HIV testing, including convenience, confidentiality, capacity to increase the number of people tested, and opportunities to increase knowledge of HIV transmission, prevention and care through provision of correct information to households. Community members also saw the intervention as increasing opportunities to engage and influence family members and to role model positive behaviours. Participants also perceived social risks and dangers associated with home-based testing including the potential for conflict, coercion, stigma, and psychological distress within households. Community members emphasised the need for individual and community preparation, including procedures to protect confidentiality, provisions for psychological and social support, and links to appropriate services for HIV-positive persons.     

The use of social marketing campaigns to increase HIV testing uptake: a systematic review

Social marketing campaigns have been increasingly used in HIV prevention efforts to address barriers to HIV testing. The purpose of this review is to evaluate the social marketing campaigns in the past ten years (2008–2017) that have targeted HIV testing or intent to test as an outcome, and synthesize the results to determine which campaigns work or do not work. The search was conducted using PubMed, Scopus, PsycINFO, EMBASE, and ABI/Inform. The quality assessment tool for quantitative studies developed by the Effective Public Health Practice Project was used to assess study quality. The search generated 373 articles, of which 13 articles met the inclusion criteria. These articles were from 13 distinct campaigns carried out in 9 countries, twelve of which were in high income countries. Sixty-nine percent (n?=?9) of the campaigns targeted MSM, gay men, or MSMW, 23% (n?=?3) targeted the general population, while 8% (n?=?1) focused on African-American women. The study designs for evaluating the campaigns were predominantly cross-sectional, with 4 of the articles combining two or three study designs to evaluate their campaign. Overall, 38% (n?=?5) of the campaigns had an increase in HIV testing outcomes, 23% (n?=?3) reported no change in HIV testing outcomes, and the remaining 38% (n?=?5) of the studies reported mixed outcomes. The results of the quality rating showed that 69% (n?=?9) of the papers had weak global ratings, while 31% (n?=?4) had moderate rating. None of the articles had a strong rating. This review displayed that social marketing campaigns intended to increase HIV testing uptake were effective in some context. Social marketing practitioners will need to come up with a standardized way of communicating the results of campaign exposure and impact so as to enhance comparison among the multitude of campaigns.     

凉山州2011年艾滋病病例CD4细胞检测情况分析

目的分析2011年凉山州艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病例）的CD4细胞检测情况,为提高工作质量及经费使用效益提供科学依据。方法在＂艾滋病综合防治数据信息管理系统＂中下载2011年凉山州的历史卡片,按照病例是否死亡及疾病状态分类,分析2011年随访病例的CD4检测情况。结果 2011年凉山州随访病例的CD4检测比例为55.9%,检测人次数比2010年增长56.5%。其中存活的HIV病例完成1次CD4检测的比例为49.2%,存活的AIDS病例完成2次CD4检测的比例为58.5%,未治疗的AIDS病例按照国家要求完成2次CD4检测的比例为31.6%,在治的AIDS病例按照国家要求完成2次CD4检测的比例为93.0%,死亡的HIV病例CD4检测的比例为8.1%,死亡的AIDS病例CD4检测的比例为44.0%。CD4重复检测的占全年检测总人次数的20.2%。CD4〈350/mm3 HIV/AIDS病例的抗病毒治疗覆盖率为64.9%。结论凉山州HIV/AIDS病例CD4检测工作取得显著成效,检测人次数增长迅速,在治的AIDS病例检测完成率超过国家考评标准23.0%。但仍存在检测比例较低、重复检测及治疗覆盖率较低等方面的问题。在今后的工作中,应避免重复检测,努力提高检测的比例及治疗覆盖率。     

Optimal HIV testing and earlier care: the way forward in Europe

The articles in this supplement were developed from a recent pan-European conference entitled 'HIV in Europe 2007: Working together for optimal testing and earlier care', which took place on 26–27 November in Brussels, Belgium. The conference, organized by a multidisciplinary group of experts representing advocacy, clinical and policy areas of the HIV field, was convened in an effort to gain a common understanding on the role of HIV testing and counselling in optimizing diagnosis and the need for earlier care. Key topics discussed at the conference and described in the following articles include: current barriers to HIV testing across Europe, trends in the epidemiology of HIV in the region, problems associated with undiagnosed infection and the psychosocial barriers impacting on testing. The supplement also provides a summary of the World Health Organization's recommendations for HIV testing in Europe and an outline of an indicator disease-guided approach to HIV testing proposed by a committee of experts from the European AIDS Clinical Society (EACS). We hope that consideration of the issues discussed in this supplement will help to shift the HIV field closer towards our ultimate goal: provision of optimal HIV testing and earlier care across the whole of the European region.     

云南省临沧市临翔区农村居民HIV检测服务利用和感染风险认知情况调查

目的了解云南临沧市临翔区农村居民对艾滋病病毒(HIV)检测的实际利用情况,以及对感染HIV风险的认知情况,为提高HIV检测服务利用提供基础信息。方法通过随机抽样方法,抽取大众人群进行面对面调查,对调查对象的一般人口统计学特征、HIV检测利用和自身感染风险等信息进行统计分析。结果 2007、2008、2009年,分别有1 153、909和899人参与。结果发现当地大众人群对HIV检测利用低于15%;超过60%的人愿意在医疗机构进行检测;超过50%的人没有意识到自身有感染HIV的风险,缺乏风险意识是影响他们不能主动进行检测的主要原因。结论当地农村居民对自身感染HIV的风险意识不足,影响了他们对HIV检测服务的利用,需对此制订干预措施来提高HIV检测率。