在美国南部农村的艾滋病毒护理中的参与和保留,使用全付款人索赔数据库
Jun Tao1, Mofan Gu2, S Alexandra Marshall2
1Department of Medicine, Brown University, Providence, Rhode Island, United States of America.
PloS one
|December 30, 2025
概括
在阿肯色州农村地区,获得艾滋病毒护理仍然很困难. 这项研究发现艾滋病毒感染者的参与和留住人数存在重大差距,突出了差异和有针对性的干预措施的需要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 获得艾滋病毒治疗是农村地区的一个重大挑战.
- 阿肯色州的农村人口很高,但对艾滋病毒护理的参与和保留数据有限.
- 在艾滋病毒护理获取和结果方面的差异仍然存在,特别是在服务不足的地区.
研究的目的:
- 评估阿肯色州艾滋病毒感染者 (PLWH) 的艾滋病毒护理连续.
- 评估整个州艾滋病毒护理提供者的空间可访问性.
- 确定艾滋病毒护理参与和保留方面的差异,特别是农村和城市人口之间的差异.
主要方法:
- 从2013年至2017年使用了阿肯色州所有付款人索赔数据库 (APCD).
- 使用诊断声明和抗逆转录病毒疗法 (ART) 处方识别的PLWH.
- 使用CD4/病毒负载 (VL) 测试频率定义参与和保留;使用ArcGIS评估地理空间访问.
主要成果:
- 在阿肯色州确定了5033个PLWH.
- 观察到低年CD4 (18-21%) 和VL (47-51%) 的测试率.
- ART处方填充量各不相同 (61-88%);艾滋病毒检测率较低,特别是在农村县.
- 在农村地区,提供者访问有限 (每50个PLWH中1个) 和护理参与率较低.
- 在护理参与和保留方面发现了显著的性别和农村/城市差异.
结论:
- 在阿肯色州,艾滋病毒护理参与和保留方面存在重大差距.
- 农村人口在获得和维持艾滋病毒治疗方面面临更大的挑战.
- 有针对性的干预措施对于解决差距和打击阿肯色州艾滋病毒流行病至关重要.
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