与肯尼亚艾滋病毒成年人纳入差异化服务提供模式相关的因素
Marie-Claude C Lavoie1,2,3, Emily Koech4, Natalia Blanco2,3
1Division of Global Health Sciences, Department of Epidemiology and Public Health.
AIDS (London, England)
|September 14, 2023
概括
差异化服务交付 (DSD) 模式,如多个月分发 (MMD) 改善艾滋病毒护理. 年轻的年龄和切换ART疗法与较低的MMD吸收有关,而基于DTG的疗法增加了它.
科学领域:
- 公共卫生 公共卫生
- 艾滋病毒/艾滋病管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 差异化服务交付 (DSD) 模式,包括多个月分发 (MMD),旨在提供以客户为中心的艾滋病毒服务,并减少医疗机构的工作量.
- 评估影响MMD普及和保留的因素对于优化这些服务交付模式至关重要.
研究的目的:
- 评估与肯尼亚接受超过三种MMD (≥3MMD) 相关的个人和设施级因素.
- 确定与客户从≥3MMD转向不到三个MMD (<3MMD) 相关的因素.
主要方法:
- 进行了一项回顾性队列研究,涉及2017年7月至2019年12月期间有资格获得DSD的客户.
- 数据从奈洛比,基西和米戈里县的32个设施的随机客户样本中收集.
- 多级波桑回归模型被用来分析与≥3MMD吸收和切换相关的因素.
主要成果:
- 该研究包括3501名符合≥3MMD条件的客户,其中65%的客户在队列入门时被录取.
- 年龄较小的年龄组 (20-34岁) 和切换ART疗法与≥3MMD吸收的可能性较低有关.
- 与基于EFV的疗法相比,接受基于DTG的ART疗法与≥3MMD入学的可能性更高 (aRR: 1.10;95%CI: 1.05-1.15) 相关联.
结论:
- 客户级特征显著影响≥3MMD的入学率和回到3MMD的概率.
- 持续监测跨不同人群的DSD招生情况对于成功和持续实施这些HIV服务交付模式至关重要.
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