"他们从十步后退开始":一项混合方法研究,比较了海地艾滋病毒感染者青少年和年轻人的社区和临床艾滋病毒检测
Vanessa Rouzier1,2, Rose-Cardelle Riche2, Bianca Louis2
1Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
AIDS care
|December 18, 2025
概括
基于社区的艾滋病毒检测可以识别艾滋病毒感染的青少年和年轻人 (AYALH). 然而,通过社区测试确定的患者在抗逆转录病毒疗法 (ART) 护理中的12个月保留时间较低,而不是临床呈现的AYALH.
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
- 青少年健康 青少年健康
背景情况:
- 基于社区的艾滋病毒检测对于识别高风险青少年和艾滋病毒感染的年轻人至关重要 (AYALH).
- 关于通过基于社区的测试策略确定AYALH的长期结果的数据有限.
- 了解护理途径和保养对于改善 AYALH 的健康结果至关重要.
研究的目的:
- 为了比较通过社区艾滋病毒检测识别的AYALH与那些在海地艾滋病毒诊所自我介绍的人之间的抗逆转录病毒治疗 (ART) 护理的12个月保留时间.
- 确定与ART保留相关的因素,包括ART启动的时间 (即时与延迟).
- 探索提供者对AYALH护理经验的观点,并收集改善结果的建议.
主要方法:
- 一项涉及606名艾哈迈德 (15-24岁) 艾滋病病毒阳性测试的比较研究.
- 测量结果包括ART启动后的12个月保留时间和ART启动的时间 (≤7天vs>7天).
- 纳入了与医疗保健提供者聚焦小组讨论的定性数据.
主要成果:
- 在社区测试者中,12个月的保留时间比临床测试者 (68%) 低 (57%).
- 立即启动ART (≤7天) 与更高的非保留率 (aOR=1.62) 相关.
- 社区测试人员往往缺乏对艾滋病毒诊断的社会支持和情感准备.
结论:
- 通过社区测试发现的AYALH需要加强心理社会和临床支持,以改善ART保留.
- 立即启动ART,虽然看似有益,但与该队列中更高的非保留率有关,这表明需要量身定制的支持.
- 通过社区艾滋病毒检测确定AYALH的优化护理途径对于长期健康结果至关重要.
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