Objective We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis, and baseline CD4^＋ T cell count among individuals attending HIV voluntary counseling and testing （VCT） clinics in Wuxi, Ch...Objective We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis, and baseline CD4^＋ T cell count among individuals attending HIV voluntary counseling and testing （VCT） clinics in Wuxi, China. Methods A repeat HIV testing within 12 months was recorded if individuals had their first test with negative results, during 2013-2014 and retested within 12 months. An incident HIV diagnosis was recorded if individuals had their first test with negative results, during 2013-2015 and had a subsequent positive result at any point by the end of 2015. Data on HIV testing and diagnosis among individuals attending 32 VCT clinics from 2013 to 2015 and HIV diagnosis from other clinical services in Wuxi, China, were retrieved. A multivariate logistic regression model was used to analyze factors associated with repeat HIV testing. Cox regression was used to evaluate factors associated with incident HIV diagnosis. Results From 2013 to 2014, 11,504 individuals tested HIV negative at their first recorded test, with 655 （5.7%） retesting within 12 months. Higher repeat HIV testing within 12 months was associated with male gender [adjusted odds ratio （a OR） = 1.7, 95% confidence interval （CI）： 1.4-2.2], risk behaviors [commercial heterosexual behaviors （a OR = 1.4, CI： 1.1-1.6）, male-male sexual behaviors （a OR = 3.7, CI： 2.7-4.9）], injection drug use （a OR = 9.9, CI： 6.5-15.1）, and having taken HIV tests previously （a OR = 2.0, CI： 1.6-2.4）. From 2013 to 2015, 1,088 individuals tested negative on HIV test at their visit and at ≥ 2 subsequent tests; of them 30 had incident HIV diagnosis. The overall rate of incident HIV diagnosis among all VCT individuals was 1.6 （95% CI： 1.1-2.1） per 100 person-years. Incident HIV diagnosis was associated with male gender [adjusted hazard ratio （a HR） = 8.5, 95% CI： 1.9-38.1], attending hospital-based VCT clinics （a HR = 7.8, 95% CI： 1.1-58.3）, and male-male sexual behavior （a HR = 8.4, 95% CI： 1.5-46.7）. Individuals diagnosed at VCT clinics had higher CD4＋ T cell count compared with those diagnosed at other clinical services （median 407 vs. 326 copies/mm3, P = 0.003）. Conclusion VCT individuals in Wuxi, China, had a low repeat HIV testing rate and high HIV incidence. VCT-clinic-based interventions aimed at increasing repeat HIV testing are needed to detect more cases at an earlier stage, especially among individuals at high risk for HIV infection such as men who have sex with men.展开更多
Background: HIV testing and counseling (HTC) plays a central role in specific prevention of mother-to-child transmission (PMTCT) interventions, as these interventions depend on the woman knowing her HIV status. Over n...Background: HIV testing and counseling (HTC) plays a central role in specific prevention of mother-to-child transmission (PMTCT) interventions, as these interventions depend on the woman knowing her HIV status. Over ninety percent of HIV infection in children is acquired through mother-to-child transmission. Objectives: This study assessed pregnant women’s knowledge of HIV/AIDS, their awareness of HIV testing and counseling, and compared the uptake of HTC to the previously practiced voluntary counseling and testing (VCT) in a teaching hospital in northern Nigeria. Materials and Methods: A pre-tested, structured interview questionnaire was administered on a cross-section survey of 270 antenatal clients in Ahmadu Bello University Teaching Hospital (ABUTH), Nigeria. Information about knowledge of HIV/AIDS and attitude towards HTC was elicited among respondents. Results: Eighty-nine percent of respondents were aware of HIV/AIDS.?The knowledge of route of disease transmission was high, with 87.4% and 81.1% of studyparticipants mentioning sexual activity and mother-to-child transmission, respectively. Majority of respondents (98.9%) were aware of HTC and approved of it (91.1%) while 7.8% declined and the remaining 1.1% were undecided. Fourteen percent of respondents didn’t approve of retesting in labour. Sixty-eight percent of respondents were aware of interventions to prevent mother-to-child transmission of HIV. Switching from VCT to HTC has dramatically improved the uptake of testing from 78.9% in 2006 to 91.1% in 2012. Conclusion: Routine HIV testing and counseling is more acceptable than voluntary counseling and testing among antenatal clients. Although the awareness and uptake of HTC were quite high among the antenatal clients, there is still a need to intensify health education and incorporate husbands into the counseling session when necessary to convince the remaining minority who are still ignorant of the benefits of HTC.展开更多
基金supported by the Wuxi Municipal Health and Family Planning Commission[MS201613,QNRC033,ZDXK009]Wuxi Municipal Bureau on Science and Technology[CSZ0N1512]Early Career Fellowship from Australian National Health and Medical Research Commission[APP1092621]
文摘Objective We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis, and baseline CD4^＋ T cell count among individuals attending HIV voluntary counseling and testing （VCT） clinics in Wuxi, China. Methods A repeat HIV testing within 12 months was recorded if individuals had their first test with negative results, during 2013-2014 and retested within 12 months. An incident HIV diagnosis was recorded if individuals had their first test with negative results, during 2013-2015 and had a subsequent positive result at any point by the end of 2015. Data on HIV testing and diagnosis among individuals attending 32 VCT clinics from 2013 to 2015 and HIV diagnosis from other clinical services in Wuxi, China, were retrieved. A multivariate logistic regression model was used to analyze factors associated with repeat HIV testing. Cox regression was used to evaluate factors associated with incident HIV diagnosis. Results From 2013 to 2014, 11,504 individuals tested HIV negative at their first recorded test, with 655 （5.7%） retesting within 12 months. Higher repeat HIV testing within 12 months was associated with male gender [adjusted odds ratio （a OR） = 1.7, 95% confidence interval （CI）： 1.4-2.2], risk behaviors [commercial heterosexual behaviors （a OR = 1.4, CI： 1.1-1.6）, male-male sexual behaviors （a OR = 3.7, CI： 2.7-4.9）], injection drug use （a OR = 9.9, CI： 6.5-15.1）, and having taken HIV tests previously （a OR = 2.0, CI： 1.6-2.4）. From 2013 to 2015, 1,088 individuals tested negative on HIV test at their visit and at ≥ 2 subsequent tests; of them 30 had incident HIV diagnosis. The overall rate of incident HIV diagnosis among all VCT individuals was 1.6 （95% CI： 1.1-2.1） per 100 person-years. Incident HIV diagnosis was associated with male gender [adjusted hazard ratio （a HR） = 8.5, 95% CI： 1.9-38.1], attending hospital-based VCT clinics （a HR = 7.8, 95% CI： 1.1-58.3）, and male-male sexual behavior （a HR = 8.4, 95% CI： 1.5-46.7）. Individuals diagnosed at VCT clinics had higher CD4＋ T cell count compared with those diagnosed at other clinical services （median 407 vs. 326 copies/mm3, P = 0.003）. Conclusion VCT individuals in Wuxi, China, had a low repeat HIV testing rate and high HIV incidence. VCT-clinic-based interventions aimed at increasing repeat HIV testing are needed to detect more cases at an earlier stage, especially among individuals at high risk for HIV infection such as men who have sex with men.
文摘Background: HIV testing and counseling (HTC) plays a central role in specific prevention of mother-to-child transmission (PMTCT) interventions, as these interventions depend on the woman knowing her HIV status. Over ninety percent of HIV infection in children is acquired through mother-to-child transmission. Objectives: This study assessed pregnant women’s knowledge of HIV/AIDS, their awareness of HIV testing and counseling, and compared the uptake of HTC to the previously practiced voluntary counseling and testing (VCT) in a teaching hospital in northern Nigeria. Materials and Methods: A pre-tested, structured interview questionnaire was administered on a cross-section survey of 270 antenatal clients in Ahmadu Bello University Teaching Hospital (ABUTH), Nigeria. Information about knowledge of HIV/AIDS and attitude towards HTC was elicited among respondents. Results: Eighty-nine percent of respondents were aware of HIV/AIDS.?The knowledge of route of disease transmission was high, with 87.4% and 81.1% of studyparticipants mentioning sexual activity and mother-to-child transmission, respectively. Majority of respondents (98.9%) were aware of HTC and approved of it (91.1%) while 7.8% declined and the remaining 1.1% were undecided. Fourteen percent of respondents didn’t approve of retesting in labour. Sixty-eight percent of respondents were aware of interventions to prevent mother-to-child transmission of HIV. Switching from VCT to HTC has dramatically improved the uptake of testing from 78.9% in 2006 to 91.1% in 2012. Conclusion: Routine HIV testing and counseling is more acceptable than voluntary counseling and testing among antenatal clients. Although the awareness and uptake of HTC were quite high among the antenatal clients, there is still a need to intensify health education and incorporate husbands into the counseling session when necessary to convince the remaining minority who are still ignorant of the benefits of HTC.
