Co-infection of HIV and HBV in voluntary counseling and testing center in Abidjan

ObjectiveTo evaluate the co-infection of hepatitis B virus (HBV) and immune deficiency virus (HIV) among clients consulting at the Voluntary Counseling and Testing Center (VCT Center) of the Institut Pasteur de Côte d’Ivoire (IPCI).MethodsA cross-sectional study was conducted from April to June 2010 at the VCT of IPCI. All clients attending the VCT of IPCI for HIV test after having signed the informed consent form were included in the study. Venous blood samples were collected from the clients after an interview. Then the rapid tests for screening of HIV infection (Determine HIV 1/2 of Abbott and Genie II HIV-1/HIV-2, Bio-Rad) were performed. As for hepatitis B surface antigen (HBsAg) test, it was performed using ELISA test system using Monolisa HBsAg Ultra-Bio-Rad.ResultsOf 278 samples analyzed, 30 were positive to antibody against HIV-1, giving a seroprevalence of about 10.8%, and 35 were positive to HBsAg, giving a seroprevalence of 12.6%. As for co-infection of HIV and HBV, it was 7/278 cases about 2.5%.ConclusionsIt can be concluded that co-infection of HBV and HIV is relatively low among clients consulting at the VCT of the IPCI. Serological surveillance should be systematic in various HIV testing centers in the country. The use of rapid tests for detection of HBsAg allows a lot of tests to be realized. However, the choice of these tests depends on the evaluation results in reference laboratories and situation on ground.     

HIV voluntary counseling and testing: an experience from India

Despite proof of voluntary counseling and testing (VCT) effectiveness in HIV disease prevention and management, there are limited reports on experience with pre- and post-HIV-test counseling in developing countries. In view of this, we aimed to bring to the fore the voluntary counseling and testing experience at a tertiary healthcare center. The present study was conducted at the voluntary counseling and testing center of a tertiary healthcare center and the National HIV Reference Center. Participants were 1169 men and 581 females attending the VCT clinic from February 2005 to March 2006. Odds ratios were calculated for each of the variable to analyze the strength of association with HIV sero-status. Out of 1750 patients, 322 (27.5%) males and 156 females (26.9%) tested HIV-positive. HIV-sero-positivity was observed to be associated to participant age (approximately 1.5 for 25-44 yrs age group), marital status (2.3 times in married patients), primary or lower education level (1.5 times), citing spouse death/HIV-infected spouse as the reason for seeking VCT (2.2 times) and reporting a history of risk behavior as reason for getting tested. This study aims to evaluate the effectiveness of existing client initiated voluntary counseling and testing facility in the light of a recent recommendation by WHO/UNAIDS for the implementation of provider initiated voluntary counseling services. Through this study, we could also highlight socio-demographic factors, like education and age, and reasons stated by participants for seeking VCT, which were associated with HIV-positive status and put an individual at a higher risk of HIV infection.     

西藏某VCT门诊自愿咨询检测者HIV感染状况分析

目的分析艾滋病自愿咨询检测（VCT）门诊,自愿咨询检测者的艾滋病病毒（HIV）感染状况,为西藏预防HIV传播提供科学依据。方法收集整理2003-2012年西藏某VCT门诊自愿咨询者的人口学信息及HIV抗体检测结果,用描述性方法进行统计分析。结果1929名自愿咨询检测者中,检出HIV抗体阳性188例,阳性率9．75％;女性阳性率（12．94％）高于男性（8．40％）;15～44岁年龄组阳性率达9．92％,其阳性人数占所有阳性者中的94．15％（177／188）。小学及以下文化程度HIV阳性率较高,为17．92％,无业者高于其他职业;静脉注射吸毒阳性率高达62．50％。性传播占总数的89．89％。结论青壮年、小学及以下文化程度者及无业者是感染HIV的高危人群,性接触是主要的传播方式,应针对高危人群的特点,加强艾滋病的宣传教育以及行为干预工作,阻断HIV传播。     

适合VCT的HIV抗体检测替代策略研究

目的 探求适合在艾滋病自愿咨询检测(VCT)点应用的检测艾滋病病毒(HIV)抗体的替代策略.方法 从河南、安徽和山西省的27个VCT检测点日常工作中采集样品10 310份,离心分离血浆后,全部用HIV快速检测试剂1(RT1)和HIV快速检测试剂2(RT2)进行检测,其中任何一种试剂的检测.结果 为阳性时,分别用酶联免疫吸附试验(ELISA)试剂和免疫印迹试验(WB)试剂复检.当两种快速检测均为阴性时,保留血浆,集中用ELISA试剂复检,复检为阳性者,进一步用WB确认检测.结果 RT1检测为阳性的样品418份,WB确认阳性的样品386份;RT2检测为阳性的样品427份,WB确认阳性的样品388份;RT1和RT2均为阳性的样品391份,WB确认阳性的样品386份.RT1和RT2检测.结果 不一致的样品共63份,57份为ELISA阴性,6份为ELISA阳性.结论 使用任何一种HIV快速检测试剂可以筛查出99%以上的阴性样品;两种HIV快速检测试剂的检测.结果 均为阳性时,可以筛查出98%以上的阳性样品;两种HIV快速检测试剂的检测.结果 不一致时,ELISA复检为阴性的样品可按HIV抗体阴性咨询,ELISA复检为阳性的样品应进一步做WB确认检测.使用RT1 RT2 ELISA策略,可以替代98.54%的WB确认检测,并且与WB确认检测.结果 的符合率为99.94%,因而可以在保证检测.结果 质量的同时,大大减少检测费用,提高检测效率和成本效益.     

Tuberculosis skin testing and preventive therapy

Tuberculin skin testing is a reliable tool for the detection of tuberculous infection and the eventual prevention of tuberculous disease. False-negative tests may occur in individuals with a compromised immune system, including those with human immunodeficiency virus (HIV) infection, persons taking immunosuppressive drugs (eg. corticosteroids), the severely malnourished, and the elderly. Nevertheless, it still is useful in detecting infection in those persons who are in close contact with patients with tuberculous disease, including family members, hospital personnel, and those from high risk areas. Once a skin test is found to be reactive, further diagnostic studies should be done to rule out tuberculous disease. Once ruled out, preventive therapy with isoniazid should be instituted. Suitable candidates for prophylaxis include all individuals with reactive tuberculin skin tests who are (1) household contacts of patients with tuberculous disease, (2) recent tuberculin test convertors, (3) individuals with prior tuberculosis (TB) who did not receive adequate chemotherapy, (4) all individuals under the age of 35, and (5) individuals in special clinical circumstances who are over the age of 35. Newer, shorter course regimens are currently being studied. TB cannot be eliminated until the importance of preventive therapy is recognized by all.     

艾滋病自愿咨询检测的影响因素

目的了解高危(重点)人群中艾滋病自愿咨询检测(VCT)状况及影响因素,并为今后政府制定高危行为人群的VCT干预对策提供科学依据。方法采用匿名自填问卷的方式,对深圳市特种服务行业女性从业人员进行了有关VCT的认知、态度、行为现状及影响因素的问卷调查。结果61.3%的人不知道VCT免费;95.4%的人没有做过艾滋病病毒(HIV)抗体检测,其中有65.9%的人认为自己不会得艾滋病,没有必要检测;54.6%的人不知道在哪里检测HIV抗体。当怀疑自己感染了HIV时有16.5%的人表示不会去检测,其中有84.4%的人担心被别人知道曾经做过HIV检测而被瞧不起,53.1%的人害怕检测结果阳性,本人和家人遭受歧视。结论社会宣传和干预力度不够,求询者的畏惧心理和侥幸心理、社会歧视是影响高危(重点)人群自愿接受HIV检测的主要原因,应进一步加强对艾滋病知识和"四免一关怀"政策的宣传,把VCT作为在高危(重点)人群中开展行为干预的重点。     

Uptake of an HIV voluntary counseling and testing program for pregnant women in Georgia

From 2002 to 2005 the Elizabeth Glaser Pediatric AIDS Foundation prevention of mother-to-child transmission of HIV project operated in Georgia and was managed by the Maternal and Child Care Union. The project covered Tbilisi, the capital, and included 34 clinics that provide women's healthcare. Out of 35,385 pregnant women starting prenatal care in clinics involved in the project, 91% (32,262) had received HIV counseling and, among those counseled, 94% (30,330) were tested for HIV antibodies; 14 pregnant women (<0.001%) were found to be HIV-infected.     

Effectiveness of antenatal group HIV voluntary counseling and testing services in rural India.

This study assessed HIV attitudes among pregnant women attending antenatal clinics in the Namakkal district of Tamilnadu, India, as well as HIV knowledge before and after group counseling sessions. Two hundred thirteen women (97%) attending five antenatal clinics in July 2004 accepted HIV counseling and testing and completed precounseling and postcounseling questionnaires. Although the majority of women had heard of HIV, precounseling knowledge was low (mean precounseling score; 6.9/18, SD: 4.53), with scores correlating with the women's educational level and the number of sources from which they had received information about HIV. Posttest scores increased by 21%, however, understanding of modalities to prevent HIV infection remained poor. Group counseling sessions achieve small gains in HIV knowledge, but there is a continued need for ongoing and multifaceted HIV education in rural India.     

北京市怀柔区艾滋病自愿咨询检测情况

目的分析北京市怀柔区艾滋病自愿咨询检测(VCT)人群的社会人口学特征和艾滋病感染状况,有针对性地制定怀柔区艾滋病健康教育和高危干预措施。方法对2009年怀柔区疾病预防控制中心艾滋病自愿咨询门诊求询者的调查及检测结果进行分析。结果 408名求询者接受咨询和艾滋病病毒(HIV)抗体检测,其中15~40岁年龄组占97.1%,男女比例为1∶1.07;求询原因是发生危险性行为,占96.1%;HIV抗体阳性检出率为1.2%(5/408),均为男男性行为者。结论求询者中的HIV感染者,在青壮年男男性行为人群中检出率较高,提示应对男性青壮年人群进行广泛的艾滋病健康教育,加强针对男男性行为人群的行为干预措施。     

贵阳市908名艾滋病自愿咨询检测者的情况分析

目的分析贵阳市908名艾滋病自愿咨询检测(VCT)者的相关情况、艾滋病病毒(HIV)感染情况、VCT求询者抑郁状况,为艾滋病预防和干预提供科学依据。方法对贵阳市疾病预防控制中心VCT门诊2010-2012年908名VCT求询者的基本信息及HIV感染率进行分析,运用抑郁自评量表(SDS)对2012年237名VCT求询者进行调查,了解其心理抑郁状况。结果 908名VCT求询者中,HIV感染者160人,感染率17.62%;性接触为主要传播途径。男女比例为3.2∶1,青壮年是接受VCT的主体人群,文化程度低的人群感染率较高。HIV感染率较高的求询者分别是有注射吸毒史者(36.84%)、配偶/固定性伴阳性史者(33.77%)和男男性行为人群(MSM)(26.84%)。237名求询者中,有67.51%的人有抑郁症状,女性和文化程度低的人群抑郁症状较明显。结论 VCT门诊在发现HIV感染者、宣传和干预中起到重要作用。应加强对有注射吸毒史、男男性行为史和配偶/固定性伴阳性史者的干预。可在VCT服务中开展心理咨询及疏导。     

湖州市2011年艾滋病自愿咨询检测结果分析

目的了解湖州市接受艾滋病自愿咨询检测（VCT）服务人群的现状,为艾滋病防治措施的制定提供科学依据。方法对2011年在湖州市接受VCT服务的人员的人口学状况、求询原因、危险行为等进行统计学分析。结果3 778名求询者中,3 759人（99.5%）接受了HIV抗体检测,检出阳性9例,HIV检出率为0.24%。求询者男女性别比为0.8∶1;年龄主要集中在20～49岁,占90.3%;初中学历占38.6%。各类高危行为中,有性乱史者占58.8%。结论青壮年和性接触是湖州市艾滋病传播的高危人群及方式;加强艾滋病知识宣传和VCT服务、提高求询者阳性者转介率,是今后VCT工作的重点。     

新疆维吾尔自治区人民医院VCT检测服务情况分析

目的在新疆维吾尔自治区人民医院,通过开设艾滋病自愿咨询检测(Voluntary counseling and testing,VCT)门诊,向求询者提供艾滋病相关咨询检测服务,并及时发现艾滋病病毒(Human immunodeficiency virus,HIV)感染者和艾滋病病人。方法在VCT门诊对求询者免费进行HIV咨询和抗体检测,对咨询情况和检测结果进行描述和统计分析。结果自2007年开设VCT门诊至2010年底,共向2 546名求询者提供了免费艾滋病咨询,其中接受HIV检测者有1 865人,占73.2%,检测出HIV抗体阳性者160人,阳性率为8.6%。求询原因,男性以吸毒为主,女性则以高危性接触为主。结论新疆维吾尔自治区人民医院VCT门诊求询者HIV感染率较高,有必要在新疆地区充分利用VCT平台,特别是利用大型综合性医院的优势,开展艾滋病相关健康教育、行为干预和HIV检测监测工作。     

High uptake of home-based, district-wide, HIV counseling and testing in Uganda

More than 80% of the people infected with HIV in low-income countries of sub-Saharan Africa do not know their HIV serostatus. Innovative measures of increasing access to HIV counseling and testing (HCT) are urgently needed so as to improve care and prevention. We implemented a home-based HCT program in Bushenyi District from September 2004 to March 2007, in Uganda where approximately 90% of people aged older than 14 years had never tested for HIV to gauge whether it was acceptable and increased uptake of HCT. Twenty-nine teams comprising a counselor and a laboratory assistant systematically visited homes offering HCT for all people older than 14 years of age and at-risk children (mother deceased or HIV infected) using a rapid HIV testing three-test algorithm. HIV-infected people received cotrimoxazole prophylaxis, were supplied with long-lasting insecticide-treated bed nets and equipment for treatment of drinking water at home, and were referred for assessment for antiretroviral therapy. The program reached 92,984 (63%) of all the homes in the district. Of these, 32,3621 people were eligible for HCT, and 28,2857 (87%) were present at home and were offered pretest counseling. A total of 264,966 (94%) accepted testing and received their results, of whom 11,359 (4.3%) were HIV-infected. Ninety percent of those testing had never tested before. The cost of testing was $7.83 per previously untested client. Ninety-seven percent of HIV-infected people initiated cotrimoxazole prophylaxis, 74% received bed nets, 70% received water treatment equipment, and 11% began antiretroviral therapy. Forty-four percent of people who were in an HIV-discordant relationship were infected. These results demonstrate that home-based HCT was well-accepted, feasible, and effective in identifying HIV-infected individuals who did not know their HIV status in rural Uganda.     

Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania

It is estimated that 5.6% of the Tanzanian population ages 15-49 are infected with HIV, but only 30% of adults have ever had an HIV test. Couples' testing has proven to increase testing coverage and introduce HIV prevention, but barriers include access to testing services and unequal gender dynamics in relationships. Innovative approaches are needed to address barriers to couple's testing and increase uptake of HIV testing. Using qualitative data collection methods, a formative study was conducted to assess the acceptability of a home-based couples counseling and testing (HBCCT) approach. Eligible study participants included married men and women, HIV-infected individuals, health care and home-based care providers, voluntary counseling and testing counselors, and community leaders. A total of 91 individuals participated in focus group discussions (FGDs) and in-depth interviews conducted between September 2009 and January 2010 in rural settings in Northern Tanzania. An HBCCT intervention appears to be broadly acceptable among participants. Benefits of HBCCT were identified in terms of access, confidentiality, and strengthening the relationship. Fears of negative consequences from knowing one's HIV status, including stigma, blame, physical abuse, or divorce, remain a concern and a potential barrier to the successful provision of the intervention. Lessons for implementation highlighted the importance of appointments for home visits, building relationships of confidence and trust between counselors and clients, and assessing and responding to a couple's readiness to undergo HIV testing. HBCCT should addresses HIV stigma, emphasize confidentiality, and improve communication skills for disclosure and decision-making among couples.     

江西省艾滋病自愿咨询检测现状分析

目的更好地做好江西省艾滋病防治工作。方法采用描述性方法分析江西省艾滋病自愿咨询检测(VCT)现状。结果从事艾滋病咨询工作的专职人员较少。接受检测后咨询及转介服务人数占检测前咨询人数的比例分别为5.22%、1.39%。接受检测的人以20~29岁人数最多,其次30~39岁。萍乡、南昌市检测初筛阳性构成比较高,分别为39.13%、26.09%。结论建立健全VCT服务网络,提高咨询服务质量。广泛开展对目标人群的VCT服务宣传和外展活动,有效开展VCT服务,遏制艾滋病的传播。     

德宏州2005-2006年艾滋病自愿咨询检测结果分析

目的了解德宏州疾病预防控制中心艾滋病自愿咨询检测（VCT）情况。方法采用回顾性方法，收集整理2005年1月-2006年11月，到VCT门诊求询者的基本信息及艾滋病病毒（HIV）抗体检测情况。结果两年来VCT门诊求询者共578人次，HIV抗体总阳性率20．59％；2005年与2006年阳性率比较差别无统计学意义。缅甸籍求询者HIV抗体阳性率高于本地及云南省其他地州的求询者。求询者以15～49岁青壮年为主，男女检测比例为1．4：1，女性HIV抗体阳性率高于男性。求询原因主要是性行为，以婚外性行为为主。静脉吸毒人群的HIV抗体阳性率最高。结论 VCT门诊是发现HIV感染者／病人及实施干预的重要窗口。     

Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda

OBJECTIVE: To assess the acceptance of voluntary HIV counseling and testing (VCT) and the effects of VCT on sexual risk behavior and HIV acquisition in Rakai, Uganda. METHODS: In a rural cohort, 10 694 consenting adults were interviewed, provided blood for HIV testing and were offered free VCT by community resident counselors. The proportions receiving VCT and the adjusted risk ratio (adj. RR) of VCT acceptance were estimated by log binomial regression. Risk behaviors and HIV incidence per 100 person-years (PY) in HIV-negative acceptors and non-acceptors of VCT were assessed prospectively. RESULTS: Although 93% initially requested HIV results, 62.2% subsequently accepted VCT. VCT acceptance was lower among persons with no prior VCT [Adj. RR = 0.88; 95% confidence interval (CI), 0.85-0.90], individuals with primary education (adj. RR = 0.94; 95% CI, 0.90-0.99) or higher (adj. RR = 0.91; 95% CI, 0.87-0.97), individuals who were HIV-positive (adj. RR = 0.72; 95% CI, 0.68-0.76), and persons reporting condom use in the past 6 months (inconsistent users, adj. RR = 0.95; 95% CI, 0.90-0.99; consistent users, adj. RR = 0.88; 95% CI, 0.82-0.95). VCT acceptance was higher among the currently married (adj. RR = 1.14; 95% CI, 1.08-1.20) and previously married (adj. RR = 1.11; 95% CI, 1.04-1.18). Receipt of results was not significantly associated with age, gender, and self-perception of HIV risk. There were no significant differences in sexual risk behaviors, or in HIV incidence between acceptors (1.6/100 PY) and non-acceptors (1.4/100 PY) of VCT. CONCLUSION: In this rural cohort where VCT services are free and accessible, there is self-selection of individuals accepting VCT, and no impact of VCT on subsequent risk behaviors or HIV incidence.     

深圳市VCT状况及影响因素分析

目的分析深圳市2008-2010年艾滋病自愿咨询检测(VCT)实施的现状,并探讨其影响因素,为调整VCT策略提供依据。方法对2008-2010年求询者相关资料及实验室检测结果进行分析。结果 3年总共有45 135名求询者接受咨询,求询类型主要包括商业异性性行为史27 952例(61.9%),男男性行为史1 763例(3.9%),献血浆及输血/血制品史共1 120例(2.5%),注射毒品史286例(0.6%),其他14 014例(31.0%)。3年中共有44 239例(98.0%)接受了艾滋病病毒(HIV)抗体检测,共检出428例HIV阳性,阳性率为0.97%。65.8%的求询者接受了检测前咨询,82.7%的检测者接受了检测后咨询及告知服务。多因素Logistic回归分析显示,性别、年龄、文化程度、求询类型和既往检测等五个因素,与求询者HIV阳性率有关。结论深圳市VCT在HIV发现方面起着重要作用,但应加强对高危人群检测咨询后的行为转变的健康教育。