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首页> 外文期刊>BMC Health Services Research >A comparison of linkage to HIV care after provider-initiated HIV testing and counselling (PITC) versus voluntary HIV counselling and testing (VCT) for patients with sexually transmitted infections in Cape Town, South Africa
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A comparison of linkage to HIV care after provider-initiated HIV testing and counselling (PITC) versus voluntary HIV counselling and testing (VCT) for patients with sexually transmitted infections in Cape Town, South Africa

机译：南非开普敦针对性传播感染的患者，由提供者启动的艾滋病毒检测和咨询（PITC）与自愿性艾滋病毒检测和咨询（VCT）后的艾滋病毒护理联系的比较

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Background We examined linkage to care for patients with sexually transmitted infection who were diagnosed HIV-positive via the provider-initiated HIV testing and counselling (PITC) approach, as compared to the voluntary counselling and testing (VCT) approach, as little is known about the impact of expanded testing strategies on linkage to care. Methods In a controlled trial on PITC (Cape Town, 2007), we compared HIV follow-up care for a nested cohort of 930 HIV-positive patients. We cross-referenced HIV testing and laboratory records to determine access to CD4 and viral load testing as primary outcomes. Secondary outcomes were HIV immune status and time taken to be linked to HIV care. Logistic regression was performed to analyse the difference between arms. Results There was no difference in the main outcomes of patients with a record of CD4 testing (69.9% in the intervention, 65.2% in control sites, OR 0.82 (CI: 0.44-1.51; p?=?0.526) and viral load testing (14.9% intervention versus 10.9% control arm; OR 0.69 (CI: 0.42-1.12; p?=?0.131). In the intervention arm, ART-eligible patients (based on low CD4 test result), accessed viral load testing approximately 2.5?months sooner than those in the control arm (214?days vs. 288?days, HR: 0.417, 95% CI: 0.221-0.784; p?=?0.007). Conclusion The PITC intervention did not improve linkage to CD4 testing, but shortened the time to viral load testing for ART-eligible patients. Major gaps found in follow-up care across both arms, indicate the need for more effective linkage-to-HIV care strategies. Trial registration Current Controlled Trials ISRCTN93692532
机译：背景与自愿咨询和检测（VCT）方法相比，我们研究了通过提供者发起的HIV检测和咨询（PITC）方法被诊断为HIV阳性的性传播感染患者的护理联系。扩展的测试策略对护理联系的影响。方法在PITC的一项对照试验（开普敦，2007年）中，我们比较了930名HIV阳性患者的嵌套队列的HIV随访护理。我们交叉引用了HIV检测和实验室记录，以确定获得CD4和病毒载量检测的主要结果。次要结果是HIV免疫状态和与HIV护理相关的时间。进行逻辑回归分析各臂之间的差异。结果记录有CD4测试的患者的主要结局无差异（干预组为69.9％，对照组为65.2％，OR为0.82（CI：0.44-1.51; p？=？0.526））（干预组为14.9％，对照组为10.9％;或0.69（CI：0.42-1.12; p？=？0.131）。在干预组中，符合ART要求的患者（基于低CD4检测结果）接受了约2.5？的病毒载量检测。比对照组早了几个月（214天vs 288天，HR：0.417，95％CI：0.221-0.784; p？=？0.007）结论PITC干预并未改善与CD4检测的联系，但缩短了接受抗逆转录病毒疗法的患者的病毒载量检测时间，双方后续治疗之间存在重大差距，表明需要更有效的与HIV的治疗策略联动审判注册当前对照试验ISRCTN93692532

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