尼泊尔关键人群获得艾滋病毒和结核病服务:一项横断面研究

B. Subba, N. Rimal, B. Shrestha
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摘要

结核被认为是艾滋病毒感染中的机会性感染之一。关键人群中艾滋病毒/结核病合并感染的负担日益加重,给坚持接受抗逆转录病毒治疗和直接督导下的短程化疗服务带来了问题。耐多药结核病的出现是对这两种疾病的控制和管理的最大挑战之一。然而,掌握这两种疾病的知识和信息对于获得现有的艾滋病毒/结核病服务至关重要。方法:对尼泊尔两大流行区HIV/TB合并感染的重点人群进行横断面调查。采用预先测试的半结构化问卷收集数据。采用SPSS 20.0版本进行方差分析。结果:共有343名HIV/TB合并感染者被纳入研究。大多数参与者来自抗逆转录病毒治疗和直接督导下的短程化疗客户。因此,本研究发现,结核病知识(F=4.400, p= 0.005)、结核病病原体(F=3.160, p=0.025)、艾滋病病毒感染者(F=8.491, p=0.001)和重点感染人群的结核病患病风险存在显著性差异。此外,在重点研究人群中,OI治疗的可及性(F=5.113, p=0.002)和病毒载量的可及性(F=4.642, p=0.003)存在显著差异。从性别角度来看,在使用和获得现有艾滋病毒/结核病服务方面没有显著差异。结论:重点人群对HIV/TB合并感染的认知程度存在显著相关性。对艾滋病毒/结核病的了解和获得非政府组织的帮助对获得现有的艾滋病毒和结核病服务有重大影响。
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Access of Key Population to Available HIV and TB Services in Nepal: A Cross Section Study
Introduction: TB is considered one of the opportunistic infection among PLHIV. The increasing burden of HIV/TB co-infection among key population cause problem to maintain adherence to ART and DOTS services. The emergence of MDR-TB is one of the greatest challenge to control and management of both diseases. However, having knowledge and information of both diseases are important role to access the available HIV/TB services. Methods: A cross-sectional survey was conducted among key population who had HIV/TB co-infection in two-epidemic zone of Nepal. A pretested semi-structured questionnaire was used to collect data. ANOVA test was done to analyze the collected data by using SPSS version 20.0. Results: A total of 343 HIV/TB co-infected individuals were enrolled to the study. Most of participants were from ART and DOTS clients. Therefore, the study found that there was significance difference found between knowledge about TB (F=4.400, p= 0.005), causative agent of TB (F=3.160, p=0.025), risk of TB illness among PLHIV (F=8.491, p=0.001) and among key affected population. Moreover, there was significance difference found between access to OI treatment (F=5.113, p=0.002) and access to viral load (F=4.642, p=0.003) among key study population. In gender perspective, there was no significance difference to use and access to available HIV/TB services. Conclusion: The general knowledge on HIV/TB co-infection was significant association with key population. The knowledge on HIV/TB and access to NGOs’ help can significant effect to access the available HIV and TB services.
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