Mitsch Andrew, Surendera Babu Aruna, Seneca Dean, Whiteside Y Omar, Warne Donald
1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
2 ICF Macro International, Inc., Corporate Square, Atlanta, GA, USA.
Int J STD AIDS. 2017 Sep;28(10):953-961. doi: 10.1177/0956462416681183. Epub 2016 Nov 21.
The objective of this study was to measure linkage to care, retention in care, and suppressed viral load (VL) among American Indians/Alaska Natives (AIs/ANs) aged ≥13 years with diagnosed HIV infection. We used national HIV case surveillance data to measure linkage to care, defined as ≥1 CD4 or VL test ≤1 month after HIV diagnosis during 2013; retention in care, defined as ≥2 CD4 or VL tests ≥3 months apart during 2012; and suppressed VL, defined as <200 copies/mL at the most recent VL test during 2012. In 2013, 74.1% of AIs/ANs were linked to care. At year-end 2012, 46.9% of AIs/ANs were retained in care and 45.1% were virally suppressed. A lower percentage of females (41.3%), compared with males (46.5), were virally suppressed. By age group, the lowest percentage of virally suppressed AIs/ANs (37.5%) were aged 13-34 years. To improve individual health and to prevent HIV among AIs/ANs, outcomes must improve - particularly for female AIs/ANs and for AIs/ANs aged 13-34 years. Screening for HIV infection in accordance with Centers for Disease Control and Prevention's testing recommendations can lead to improvements along the continuum of HIV care.
本研究的目的是衡量年龄≥13岁的已确诊感染艾滋病毒的美国印第安人/阿拉斯加原住民(AI/AN)获得治疗的比例、治疗留存率以及病毒载量(VL)抑制情况。我们使用全国艾滋病毒病例监测数据来衡量获得治疗的情况,定义为在2013年艾滋病毒诊断后≤1个月内进行≥1次CD4或VL检测;治疗留存率,定义为在2012年期间≥2次CD4或VL检测且检测间隔≥3个月;以及病毒载量抑制情况,定义为在2012年最近一次VL检测时<200拷贝/毫升。2013年,74.1%的AI/AN获得了治疗。在2012年年末,46.9%的AI/AN持续接受治疗,45.1%的病毒载量得到抑制。与男性(46.5%)相比,病毒载量得到抑制的女性比例较低(41.3%)。按年龄组划分,病毒载量得到抑制的AI/AN比例最低(37.5%)的是13至34岁年龄组。为改善AI/AN的个人健康状况并预防艾滋病毒感染,必须改善相关结果,尤其是针对女性AI/AN以及年龄在13至34岁的AI/AN。按照疾病控制与预防中心的检测建议进行艾滋病毒感染筛查,可在艾滋病毒治疗连续过程中带来改善。