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首页> 外文期刊>JMIR public health and surveillance. >Peer Recruitment Strategies for Female Sex Workers Not Engaged in HIV Prevention and Treatment Services in C?te d’Ivoire: Program Data Analysis
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Peer Recruitment Strategies for Female Sex Workers Not Engaged in HIV Prevention and Treatment Services in C?te d’Ivoire: Program Data Analysis

机译：女性性工作者的同行招聘策略未参与C？TE D'Ivoire的艾滋病毒预防和治疗服务：计划数据分析

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Background: In the context of the mostly generalized HIV epidemic in C?te d’Ivoire, key populations bear a higher burden of HIV than that borne by the general reproductive-aged population. Mathematical models have demonstrated the significant potential impact and cost-effectiveness of improving the coverage of HIV prevention and treatment services for key populations in C?te d’Ivoire. However, in 2019, coverage of these services remained limited by multiple intersecting stigmas affecting key populations, necessitating the study of innovative implementation strategies to better meet the needs of those most marginalized. Here, we leverage programmatic data to compare the effectiveness of the enhanced and traditional peer outreach approaches in reaching and providing community HIV testing to female sex workers not readily engaged in HIV prevention and treatment services in C?te d’Ivoire. Objective: The aim of this study was to describe the characteristics of female sex workers reached by the LINKAGES project in C?te d’Ivoire with enhanced peer outreach and traditional peer outreach and to compare HIV-related outcomes between the women reached by both strategies. Methods: Deidentified routine programmatic data collected as part of LINKAGES C?te d’Ivoire between October 2017 and April 2018 were used in these analyses. Demographic characteristics and HIV indicators including HIV testing history, HIV case-finding, linkage to HIV treatment, and treatment initiation were assessed using descriptive statistics. Differences in these indicators were compared by outreach strategy using Pearson chi-square tests. Results: There were 9761 women reached with enhanced peer outreach and routine peer outreach included in these analyses. The overall case-finding rate in the sample was 7.8% (698/8851). Compared with women reached by routine outreach, those reached by enhanced peer outreach were more likely to have previously been tested for HIV (enhanced: 1695/2509, 67.6%; routine: 4302/7252, 60.0%; χ 2 1 =43.8; P =.001). The enhanced peer outreach approach was associated with a higher HIV case-finding rate (enhanced: 269/2507 10.7%; routine: 429/6344, 6.8%; χ 2 1 =32.3; P =.001), higher proportion of linkage to treatment (enhanced: 258/269, 95.9%; routine: 306/429, 71.3%; χ 2 1 =64.4; P =.001), and higher proportion of treatment initiation (enhanced: 212/269, 78.8%; routine: 315/429, 73.3%; χ 2 1 =2.6; P =.11). Women reached by both approaches were categorized as high risk for HIV-related behaviors such as condomless sex and number of sex acts in the previous week. Conclusions: These analyses suggest that the novel peer-referral strategy, the enhanced peer outreach approach, was effective in reaching female sex workeres in C?te d’Ivoire with demonstrated acquisition risks for HIV and who had not been effectively engaged by routine outreach approaches. Scaling up novel strategies such as enhanced peer outreach in the context of differentiated service models may be needed to optimize HIV prevention and treatment outcomes for key populations in C?te d’Ivoire.
机译：背景：在C？TE D'Ivoire的主要推广艾滋病毒疫情的背景下，主要种群对艾滋病毒的负担高于一般生殖年龄的人口。数学模型表明了改善C-TE D'IVoire的关键群体覆盖艾滋病预防和治疗服务的覆盖率的显着潜在影响和成本效益。但是，2019年，这些服务的覆盖率仍然受到影响关键人群的多个交叉柱头的限制，需要研究创新实施策略，以更好地满足最边缘化的需求。在这里，我们利用程序化数据来比较增强和传统的同行外联方法的有效性，以便在C-TE D'Ivoire中易于从事艾滋病毒预防和治疗服务的女性性工作者提供社区艾滋病毒检测。目的：本研究的目的是描述C-TE D'IVOIRE中达到的女性性工作者的特征，以加强同行外联和传统的同行外联，并在两种策略之间比较妇女与妇女达到的艾滋病毒相关结果。方法：作为连锁人C的一部分收集的实证常规编程数据在这些分析中使用了2017年10月至2018年4月之间的C？TE D'Ivoire。使用描述性统计评估与HIV检测历史，HIV病史，HIV治疗联系的人口特征和艾滋病毒指标，并使用描述性统计来评估和治疗开始。通过使用Pearson Chi-Square测试，通过外联战略进行了这些指标的差异。结果：在这些分析中有9761名妇女达到了增强的同伴外展和常规同行外展。样品中的总体案例调查率为7.8％（698/8851）。与常规外展达成的妇女相比，通过增强的同伴外展达成的人更有可能对艾滋病毒进行测试（提高：1695 / 2509,67.6％;常规：4302/7252,60.0％;χ21 = 43.8; p = .001）。增强的同行外联方法与较高的HIV案例调查率有关（增强：269/2507 10.7％;常规：429/6344,6.8％;χ21 = 32.3; p = .001），连锁比例较高治疗（增强：258 / 269,95.9％;常规：306/429,71.3％;χ21= 64.4; p = .001），治疗开始比例更高（增强：212/269,78.8％;常规： 315 / 429,73.3％;χ21 = 2.6; p = .11）。两种方法达到的妇女被分类为高艾滋病毒相关行为的高风险，如前一周内的心公司和性别行为。结论：这些分析表明，新的同行推荐战略，增强的同行外联校长，有效地在C？TE D'IVOIRE中达到了女性性工作者，并表现出艾滋病毒的收购风险，并没有通过常规外展方法有效地参与。 。可能需要在鉴别的服务模型的背景下进行扩展新的策略，例如增强的同伴外展，以优化C？TE D'Ivoire中的关键群体的艾滋病毒预防和治疗结果。

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