基于场所的HIV测试在性工作热点地区以覆盖与HIV感染的青少年女性和年轻女性:肯尼亚蒙巴萨的一项横断面研究

摘要:通过在性工作热点地区开展基于场所的艾滋病病毒(HIV)检测,我们估计了年轻女性和少女(AGYW)中新发HIV感染的潜在人数。我们利用了2015年在肯尼亚蒙巴萨的热点地区进行的AGYW过渡研究的热点点位统计和横断面生物行为调查数据。我们比较了卖淫的AGYW(YSW,N=408)和不卖淫的AGYW(NSW,N=891)之间的HIV传播。同时,我们通过HIV快速检测在蒙巴萨的热点地区估计了AGYW的潜在和可行的新诊断人数(假设100%接受检测并准确率为100%的情况下进行估计)。我们采用多变量逻辑回归分析,确定了最近接受HIV检测(在过去一年内)的AGYW的特点。YSW和NSW中,10.1%(N=37/365)和3.6%(N=30/828)的人感染了HIV,其中已知感染者分别占27.0%(N=10/37)和30.0%(N=9/30)(p=0.79)。快速测试的接受率为89.3%,敏感性为80.4%。热点点位统计估计了蒙巴萨热点地区的AGYW人数为15,635人(范围:12,172-19,097)。潜在和可行的新诊断人数分别为627人(范围:310-1,081)和450人(范围:223-776)。因此,基于热点地区的检测可以将未被诊断的比例从71.6%降低到20.2%。YSW和NSW最近接受HIV检测的特征类似。在调整其他因素后,YSW进行最近HIV检测的概率是NSW的2倍(OR:2.1,95% CI:1.6-3.1)。通过基于热点地区的HIV检测能够填补传统的以诊所为基础的HIV预防和检测服务的不足。

作者:Huiting Ma (1), Linwei Wang (1), Peter Gichangi (2,3), Vernon Mochache (4), Griffins Manguro (3), Helgar K Musyoki (5), Parinita Bhattacharjee (6,7), Franc{c}ois Cholette (8,9), Paul Sandstrom (8,9), Marissa L Becker (7), Sharmistha Mishra (1,10,11,12) (on behalf of the Transitions Study Team, (1) Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada, (2) University of Nairobi, Nairobi, Kenya, (3) International Centre for Reproductive Health-Kenya, Mombasa, Kenya, (4) University of Maryland, Centre for International Health, Education and Biosecurity, College Park, United States, (5) National AIDS & STI Control Programme, Nairobi, Kenya, (6) Key Populations Technical Support Unit, Partners for Health and Development in Africa, Nairobi, Kenya, (7) Centre for Global Public Health, University of Manitoba, Winnipeg, Canada, (8) National HIV and Retrovirology Laboratory, JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada, (9) Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada, (10) Department of Medicine, University of Toronto, Toronto, Canada, (11) Institute of Medical Science, University of Toronto, Toronto, Canada, (12) Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada)

论文ID:1912.04949

分类:Other Quantitative Biology

分类简称:q-bio.OT

提交时间:2019-12-12

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