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首页> 外文期刊>BMC Health Services Research >Association between patient-reported HIV status and provider recommendation for screening in an opportunistic cervical Cancer screening setting in Jos, Nigeria
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Association between patient-reported HIV status and provider recommendation for screening in an opportunistic cervical Cancer screening setting in Jos, Nigeria

机译：患者报告的艾滋病毒培养和提供者建议在JOS，尼日利亚的机会主义宫颈癌筛查环境中进行筛选

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Cervical cancer screening (CCS) is an important health service intervention for prevention of morbidity and mortality from invasive cervical cancer. The role of provider recommendation and referral is critical in utilization of this services particularly in settings where screening is largely opportunistic. We sought to understand how patient-reported human immunodeficiency virus (HIV) infection status is associated with provider referral in an opportunistic screening setting. We performed a cross-sectional analysis of data on a sample of women who had received a CCS at the "Operation Stop" cervical cancer (OSCC) screening service in Jos, Nigeria over a 10-year time period (2006-2016). We used the de-identified records of women who had their first CCS to analyze the association between patient-reported HIV and likelihood of provider-referral at first CCS. We performed descriptive statistics with relevant test of association using Student t-test (t-test) for continuous variables and Pearson chi square or Fisher exact test where applicable for categorical variables. We also used a bivariable and multivariable logistic regression models to estimate the independent association of patient-reported HIV on provider referral. All statistical tests were performed using STATA version 14.1, College Station, Texas, USA. Level of statistical significance was set at 0.05. During the 10-year period, 14,088 women had their first CCS. The reported HIV prevalence in the population was 5.0%; 95% CI: 4.6, 5.4 (703/14,088). The median age of women who were screened was 37?years (IQR; 30-45). Women who were HIV infected received more referrals from providers compared to women who were HIV uninfected (68.7% versus 49.2%), p-value ?0.001. Similarly, we found an independent effect of patient-reported HIV infection on the likelihood for provider-referral in the screened sample (aOR?=?2.35; 95% CI: 1.95, 2.82). Our analysis supports the design of health systems that facilitates providers' engagement and provision of necessary counseling for CCS in the course of routine clinical care. The practice of offering recommendation and referrals for CCS to women at high risk of cervical cancer, such as HIV infected women should be supported.
机译：宫颈癌筛查（CCS）是预防侵袭性宫颈癌的发病率和死亡率的重要保健干预。提供商推荐和转诊的作用对于在筛选主要机会主义的环境中使用此服务的利用至关重要。我们试图了解患者报告的人类免疫缺陷病毒（HIV）感染状态如何与机会主义的筛查环境相关联的提供者推荐。我们对在尼日利亚的JOS的“操作停止”宫颈癌（OSCC）筛选服务中收到了CCS的妇女样本的数据进行了横截面分析，在10年期间（2006-2016）。我们利用第一个CCS分析患者报告的艾滋病病毒关系和第一个CCS推荐的患者之间的关联的妇女的De-Idented记录。我们使用学生T-Test（T-Test）对关联的相关测试进行了描述性统计数据，用于连续变量和Pearson Chi Square或Fisher精确测试，适用于分类变量。我们还使用了一款可自行式和多变量的逻辑回归模型来估计患者报告的艾滋病毒对提供商推荐的独立协会。所有统计测试都是使用Stata版本14.1，大学站，美国德克萨斯州的所有统计测试。统计显着性水平设定为0.05。在10年期间，14,088名妇女的第一届CCS。报告的艾滋病毒患病率为5.0％; 95％CI：4.6,5.4（703/14,088）。被筛选的妇女的中位年龄为37？年（IQR; 30-45）。与艾滋病毒联合疫情的女性相比，被艾滋病毒感染的妇女接受了来自提供者的更多推荐（68.7％，与49.2％），p值<0.001。同样，我们发现患者报告的艾滋病毒感染对筛选样品中提供者转诊的可能性的独立效果（AOR？= 2.35; 95％CI：1.95,2.82）。我们的分析支持卫生系统的设计，促进提供商在常规临床护理过程中为CCS进行参与和提供必要的咨询。应支持向宫颈癌的高危患者提供CCS的建议和转介的做法，例如艾滋病毒感染妇女。

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