Impact of Expanded HIV Testing and Rapid Antiretroviral Therapy Initiation in Southwest China: An Interrupted Time-Series Analysis.

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES AIDS patient care and STDs Pub Date : 2024-11-15 DOI:10.1089/apc.2024.0205
Zhiwen Pi, Ticheng Xiao, Ningjun Ren, Biao Yu, Jinyu Chen, Jingbo Zhang, Lingxi He, Yingming Wang, Huachun Zou, Run Chen, Xiaoxue Chen, Fuli Huang, Yanhua Chen, Hang Chen, Ailing Li, Song Fan
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Abstract

This study evaluates the impact of an expanded HIV testing initiative, launched in June 2018 in Luzhou, Sichuan, China, on antiretroviral therapy (ART) initiation rates among people living with HIV (PLWH). Using an uncontrolled interrupted time-series design, we analyzed data from 11,040 PLWH between June 2016 and December 2022, extracted from 108 health facilities via the Center for Disease Control and Prevention's ART database. The primary outcome measures were ART initiation rates within 7 and 30 days of HIV diagnosis. Results showed a significant improvement in the 30-day ART initiation rate following expanded testing, increasing from 46.1% to 90.9% by the study's end. The 7-day initiation rate also improved but remained below 30%. The study found that expanded testing enhanced the role of primary health care institutions in ART initiation. However, the COVID-19 pandemic, beginning January 2020, negatively impacted ART initiation rates, with a slight effect on 30-day rates but a persistent negative impact on 7-day rates. Despite these challenges and an increased HIV burden, Luzhou's ART initiation rates surpassed the national average. This study emphasizes the effectiveness of expanded HIV testing in ensuring timely ART access, crucial for HIV epidemic control, and improved patient outcomes. It also reveals challenges in maintaining HIV services during public health crises, offering insights into health care system resilience. Future research should focus on evaluating long-term treatment outcomes and strategies to support ending the AIDS epidemic.

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中国西南地区扩大 HIV 检测和快速抗逆转录病毒疗法的影响:中断时间序列分析
本研究评估了 2018 年 6 月在中国四川泸州启动的扩大艾滋病检测倡议对艾滋病病毒感染者(PLWH)抗逆转录病毒疗法(ART)启动率的影响。我们采用非对照间断时间序列设计,分析了2016年6月至2022年12月期间11040名艾滋病病毒感染者的数据,这些数据是通过疾病预防控制中心的ART数据库从108家医疗机构中提取的。主要结果指标是艾滋病毒确诊后 7 天和 30 天内的抗逆转录病毒疗法启动率。结果显示,扩大检测范围后,30 天内开始接受抗逆转录病毒疗法的比例有了明显提高,从 46.1% 提高到研究结束时的 90.9%。7 天启动率也有所提高,但仍低于 30%。研究发现,扩大检测范围增强了基层医疗机构在抗逆转录病毒疗法启动中的作用。然而,从 2020 年 1 月开始的 COVID-19 大流行对抗病毒疗法的启动率产生了负面影响,对 30 天的启动率影响轻微,但对 7 天的启动率产生了持续的负面影响。尽管面临这些挑战和艾滋病负担的增加,泸州的抗逆转录病毒疗法启动率仍超过了全国平均水平。这项研究强调了扩大艾滋病检测范围在确保及时获得抗逆转录病毒疗法方面的有效性,这对控制艾滋病疫情和改善患者预后至关重要。它还揭示了在公共卫生危机期间维持艾滋病服务所面临的挑战,为医疗保健系统的恢复能力提供了启示。未来的研究应侧重于评估长期治疗结果和支持结束艾滋病流行的战略。
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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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