دورية أكاديمية
أعرض في EDS

High patient acceptability but low coverage of provider-initiated HIV testing among adult outpatients with symptoms of acute infectious illness in coastal Kenya.

التفاصيل البيبلوغرافية
العنوان: High patient acceptability but low coverage of provider-initiated HIV testing among adult outpatients with symptoms of acute infectious illness in coastal Kenya.
المؤلفون: Agutu CA; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Oduor TH; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Kombo BK; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Mugo PM; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Chira SM; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Ogada FW; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Rinke de Wit TF; Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands., Chege W; Prevention Sciences Program, Division of AIDS (DAIDS), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland, United States of America., van der Elst EM; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Graham SM; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.; Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, Washington, United States of America., Sanders EJ; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.; Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
المصدر: PloS one [PLoS One] 2021 Feb 05; Vol. 16 (2), pp. e0246444. Date of Electronic Publication: 2021 Feb 05 (Print Publication: 2021).
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: HIV Infections*/diagnosis , HIV Infections*/epidemiology , HIV Testing* , Patient Acceptance of Health Care*/statistics & numerical data, Counseling/*statistics & numerical data , Health Facilities/*statistics & numerical data , Mass Screening/*methods, Adolescent ; Adult ; Female ; HIV-1/isolation & purification ; Health Knowledge, Attitudes, Practice ; Health Personnel/education ; Humans ; Kenya/epidemiology ; Male ; Surveys and Questionnaires ; Young Adult
مستخلص: Background: Only approximately one in five adults are offered HIV testing by providers when seeking care for symptoms of acute illness in Sub-Saharan Africa. Our aims were to estimate testing coverage and identify predictors of provider-initiated testing and counselling (PITC) and barriers to PITC implementation in this population.
Methods: We assessed HIV testing coverage among adult outpatients 18-39 years of age at four public and two private health facilities in coastal Kenya, during a 3- to 6-month surveillance period at each facility. A subset of patients who reported symptoms including fever, diarrhoea, fatigue, body aches, sore throat or genital ulcers were enrolled to complete a questionnaire independently of PITC offer. We assessed predictors of PITC in this population using generalised estimating equations and identified barriers to offering PITC through focus group discussion with healthcare workers (HCW) at each facility.
Results: Overall PITC coverage was 13.7% (1600 of 11,637 adults tested), with 1.9% (30) testing positive. Among 1,374 participants enrolled due to symptoms, 378 (27.5%) were offered PITC and 352 (25.6%) were tested, of whom 3.7% (13) tested positive. Among participants offered HIV testing, 93.1% accepted it; among participants not offered testing, 92.8% would have taken an HIV test if offered. The odds of completed PITC were increased among older participants (adjusted odds ratio [aOR] 1.7, 95% confidence interval [CI] 1.4-2.1 for 30-39 years, relative to 18-24 years), men (aOR 1.3, 95% CI 1.1-1.7); casual labourers (aOR 1.3, 95% CI 1.0-1.7); those paying by cash (aOR 1.2, 95% CI 1.0-1.4) or insurance (aOR 3.0, 95% CI 1.5-5.8); participants with fever (aOR 1.5, 95% CI 1.2-1.8) or genital ulcers (aOR 4.0, 95% CI 2.7-6.0); and who had tested for HIV >1 year ago (aOR 1.4, 95% CI 1.0-2.0) or had never tested (aOR 2.2, 95% CI 1.5-3.1). Provider barriers to PITC implementation included lack of HCW knowledge and confidence implementing guidelines, limited capacity and health systems constraints.
Conclusion: PITC coverage was low, though most patients would accept testing if offered. Missed opportunities to promote testing during care-seeking were common and innovative solutions are needed.
Competing Interests: The authors have declared that no competing interests exist.
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust; P30 AI027757 United States AI NIAID NIH HHS; R01 AI124968 United States AI NIAID NIH HHS; 107752/Z/15/Z United Kingdom WT_ Wellcome Trust
تواريخ الأحداث: Date Created: 20210205 Date Completed: 20210803 Latest Revision: 20210803
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC7864413
DOI: 10.1371/journal.pone.0246444
PMID: 33544736
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0246444