门诊全部抽血患者艾滋病检测策略可行性及效果研究

Study on the Feasibility and Effectiveness of Strategy to Provide HIV Test for all Outpatients with Blood Withdrawn for Other Tests in Healthcare Settings

目的探索对由于其他临床目的抽血化验的门诊患者进行HIV筛查策略的可行性,并评价该策略的实施效果,为进一步扩大HIV检测提供新的思路。方法采用自身前后对照的类实验设计,选择某县人民医院门诊部前瞻性实施该策略4个月,同时选择实施前相同长度的时间段作为对照,收集策略实施前后的HIV检测数和新检出HIV阳性数,比较实施前后的效果。结果实施该策略后门诊患者HIV检测量增加22.3倍,新检出HIV阳性人数从5人增加到19人(P=0.002),早期检出HIV阳性人数从1人增加到7人(P=0.025)。结论医疗机构门诊全部抽血患者实施艾滋病筛查策略可行性较好,能够显著增加门诊患者检测率,有力促进了HIV感染者的多发现和早发现。

Objective To study the feasibility and effectiveness of a new provider-initiated HIV testing and counselling（PITC） strategy,in which all patients in an outpatient department with blood withdrawn for any clinical reason were tested for HIV.Methods Quasi experiment design with pre-and post-comparison was applied.The outpatient department of a county hospital was selected to conduct the new PITC strategy in a period of 4 months,and the same time span before PITC strategy was set as control period.Main outcome measure was number of patients with newly identified HIV infection.Results HIV testing volume increased 22.3 folds after the implementation of the new PITC strategy.Newly identified HIV cases increased from 5 to 19（P=0.002） and those with early diagnosis increased from 1 to 7（P=0.025）.Conclusions The new PITC strategy works fairly well in clinical settings and it can dramatically increase the testing rate among patients in the outpatient department,which subsequently contributes to more and earlier identification of latent HIV cases.