监狱中的艾滋病毒检测:比较最大限度地参与艾滋病毒治疗和预防的策略
Samantha R Levano1, Mallory E Epting1, Jacob A Pluznik1
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
PloS one
|June 23, 2023
概括
在监狱中进行常规的艾滋病毒检测至关重要. 快速治疗点 (rPOC) 测试为短期住院的艾滋病毒感染者 (PLWH) 提供了即时的结果,而基于实验室的测试增加了吸收,但延迟了结果.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 常规的艾滋病毒检测在美国监狱中不是标准的,尽管监禁人员中未被诊断的感染率很高.
- 在拘留设施中有效的艾滋病毒检测策略对于将艾滋病毒感染者 (PLWH) 与护理联系起来至关重要.
- 短暂停留的监狱环境需要快速的诊断方法,以最大限度地连接治疗.
研究的目的:
- 为了比较第三代快速治疗点 (rPOC) 艾滋病毒检测与第四代基于实验室的抗原/抗体 (LBAg/Ab) 检测对艾滋病毒护理级联的影响.
- 在一个大型城市监狱中,在rPOC和LBAg/Ab测试方法之间的过渡期间,评估艾滋病毒测试产量和与护理结果的联系.
- 评估不同艾滋病毒检测策略的有效性,以促进被监禁人口进入或重新进入艾滋病毒护理.
主要方法:
- 使用中断时间序列分析来比较两个不同的测试时期的总体历史数据.
- 数据包括每月进行的艾滋病毒检测率,收到的结果,抗逆转录病毒疗法 (ART) 启动和出院计划.
- 该研究在rPOC测试期间 (2019年1月至8月) 检查了14,237名入学者,并在LBAg/Ab测试期间 (2019年10月至2020年1月) 检查了7,569名入学者.
主要成果:
- 过渡到LBAg/Ab测试增加了38.5%的HIV测试吸收率,但在测试者中获得的测试结果率降低了13.1%.
- 在过渡到LBAg/Ab测试后,执行的HIV测试和获得的结果的综合率增加了20.4%.
- 虽然LBAg/Ab测试显示总体测试量较高,但rPOC测试为短期监狱人口提供了至关重要的即时结果.
结论:
- 基于实验室的抗原/抗体测试增加了监狱中的艾滋病毒测试采用率,但在短期逗留环境中,快速的护理点测试对于立即提供结果至关重要.
- 优化快速点诊艾滋病毒检测的普及,可以提高其在惩戒设施中的价值.
- 综合测试方法可能是最大限度地提高艾滋病毒检测并确保监狱人员迅速收到结果的最佳策略.
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