莱索托少女和年轻妇女艾滋病毒检测的趋势和相关因素:2004年至2014年莱索托人口与健康调查结果

Onalethata Ntshadi Sonny, A. Musekiwa
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引用次数: 0

摘要

艾滋病毒/艾滋病在莱索托的少女和年轻妇女中很普遍,是非洲造成高死亡率的五大传染病之一。艾滋病毒的最高管理是基于筛查、预防和治疗干预,其中艾滋病毒检测和咨询是其中的门户。AGYW对HTC服务的利用受到限制,因为这一群体遇到了许多障碍。本研究的目的是评估莱索托AGYW中与HTC相关的趋势和因素。二次数据分析用于分析从2004年、2009年和2014年莱索托人口健康调查(LDHS)中提取的数据集。LDHS采用横断面研究设计进行,抽取的样本代表莱索托全体人口。我们使用描述性分析来确定HTC的趋势。在确定与HTC摄取相关的因素时,对2014年LDHS应用了单变量和多变量逻辑回归模型。所有分析都使用调查权重对不相等的抽样概率进行了调整。分析的AGYW数量在2004年为2743个,2009年为2393个,2014年为2842个。HTC摄取的总体患病率估计值分别为12%、62.2%和72.5%。在15-19岁的AGYW中,HTC的摄取率从6.2%(2004年)、46.3%(2009年)上升到57.9%(2014年),而在20-24岁的年龄组中,摄取率分别为18.7%、80.2%和88.3%。在2014年的2842名AGYW中,20-24岁(aOR 2.15,95%CI 1.61至2.87,p<0.001)、联合(aOR 3.21,95%CI 2.25至4.58,p<001)、母婴传播艾滋病毒(MTCT)知识(aOR 1.53,95%CI 1.21至1.94,p<.001)、艾滋病毒非歧视态度,以及那些曾经怀孕的人(aOR 11.53,95%CI 7.46至17.84,p<0.001)。莱索托AGYW的HTC摄取量低于预期目标,因此我们建议优化HTC服务的使用,尤其是15-19岁的AGYW。
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Trends and Factors Associated with HIV Testing among Adolescent Girls and Young Women in Lesotho: Results from 2004 to 2014 Lesotho Demographic and Health Surveys
HIV/AIDS is prevalent among adolescent girls and young women (AGYW) in Lesotho, and among the top five infectious diseases causing a high mortality rate in Africa. The paramount management of HIV is based on screening, prevention, and therapeutic interventions, of which HIV testing and counselling (HTC) is the gateway. The utilization of HTC services among AGYW is limited owing to numerous barriers encountered by this population group. The aim of this study was to assess trends and factors associated with HTC among AGYW in Lesotho. A secondary data analysis was used to analyze data sets extracted from the 2004, 2009, and 2014 Lesotho Demographic Health Surveys (LDHS). The LDHS was conducted using a cross-sectional study design and samples drawn were representative of the whole population of Lesotho. We used descriptive analysis to determine trends in HTC. In determining factors associated with the uptake of HTC, univariate and multivariable logistic regression models were applied on the 2014 LDHS. All analyses were adjusted for unequal sampling probabilities using survey weights. The number of AGYWs analyzed were 2743 in 2004, 2393 in 2009, and 2842 in 2014. The overall prevalence estimates of HTC uptake were 12%, 62.2%, and 72.5%, respectively. For the 15–19 years AGYW, HTC uptake rose from 6.2% (2004), 46.3% (2009), to 57.9% (2014), while for the 20–24 years age group, the rates were 18.7%, 80.2%, and 88.3%, respectively. For the 2842 AGYW in 2014, the odds of ever having an HIV test were significantly higher for those aged 20–24 years (aOR 2.15, 95% CI 1.61 to 2.87, p < 0.001), in a union (aOR 3.21, 95%CI 2.25 to 4.58, p < 0.001), with Mother-to-child transmission of HIV (MTCT) knowledge (aOR 1.53, 95%CI: 1.21 to 1.94, p < 0.001), with HIV non-discriminatory attitudes (aOR 2.50, 95%CI 1.87 to 3.34, p < 0.001), and those who had ever been pregnant (aOR 11.53, 95%CI 7.46 to 17.84, p < 0.001). HTC uptake among AGYW in Lesotho is below expected targets, hence we recommend optimizing access to HTC services, especially for AGYW aged 15–19 years.
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