دورية أكاديمية
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Enhancing HIV positivity yield in southern Mozambique: The effect of a Ministry of Health training module in targeted provider-initiated testing and counselling.

التفاصيل البيبلوغرافية
العنوان: Enhancing HIV positivity yield in southern Mozambique: The effect of a Ministry of Health training module in targeted provider-initiated testing and counselling.
المؤلفون: Saura-Lázaro A; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain., Fernández-Luis S; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique., Nhampossa T; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.; Instituto Nacional de Saúde (INS), Maputo, Mozambique., Fuente-Soro L; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique., López-Varela E; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique., Bernardo E; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.; Manhiça District Health Services, Maputo, Mozambique., Augusto O; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.; Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique.; Department of Global Health, University of Washington, Seattle, Washington, United States of America., Sánchez T; London School of Hygiene and Tropical Medicine, London, United Kingdom., Vaz P; Fundação Ariel Glaser Contra o SIDA Pediatrico, Maputo, Mozambique., Wei SC; Division of Global HIV and Tuberculosis at Centers for Disease Control and Prevention (CDC), Maputo, Mozambique., Kerndt P; U.S Agency for International Development (USAID), Global Health, Washington, United States of America., Honwana N; Division of Global HIV and Tuberculosis at Centers for Disease Control and Prevention (CDC), Maputo, Mozambique., Young P; Division of Global HIV and Tuberculosis at Centers for Disease Control and Prevention (CDC), Maputo, Mozambique., Amane G; National STI-HIV/AIDS Programme, Ministry of Health, Maputo, Mozambique., Boene F; National STI-HIV/AIDS Programme, Ministry of Health, Maputo, Mozambique., Naniche D; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
المصدر: PloS one [PLoS One] 2024 May 23; Vol. 19 (5), pp. e0303063. Date of Electronic Publication: 2024 May 23 (Print Publication: 2024).
نوع المنشور: Journal Article
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: Counseling* , HIV Infections*/diagnosis , HIV Infections*/epidemiology , Health Personnel*/education, Humans ; Mozambique/epidemiology ; Female ; Male ; Adult ; Middle Aged ; HIV Testing/methods ; Young Adult ; Adolescent ; Mass Screening/methods ; Triage/methods ; Emergency Service, Hospital
مستخلص: In Mozambique, targeted provider-initiated HIV testing and counselling (PITC) is recommended where universal PITC is not feasible, but its effectiveness depends on healthcare providers' training. This study aimed to evaluate the effect of a Ministry of Health training module in targeted PITC on the HIV positivity yield, and identify factors associated with a positive HIV test. We conducted a single-group pre-post study between November 2018 and November 2019 in the triage and emergency departments of four healthcare facilities in Manhiça District, a resource-constrained semi-rural area. It consisted of two two-month phases split by a one-week targeted PITC training module ("observation phases"). The HIV positivity yield of targeted PITC was estimated as the proportion of HIV-positive individuals among those recommended for HIV testing by the provider. Additionally, we extracted aggregated health information system data over the four months preceding and following the observation phases to compare yield in real-world conditions ("routine phases"). Logistic regression analysis from observation phase data was conducted to identify factors associated with a positive HIV test. Among the 7,102 participants in the pre- and post-training observation phases (58.5% and 41.5% respectively), 68% were women, and 96% were recruited at triage. In the routine phases with 33,261 individuals (45.8% pre, 54.2% post), 64% were women, and 84% were seen at triage. While HIV positivity yield between pre- and post-training observation phases was similar (10.9% (269/2470) and 11.1% (207/1865), respectively), we observed an increase in yield in the post-training routine phase for women in triage, rising from 4.8% (74/1553) to 7.3% (61/831) (Yield ratio = 1.54; 95%CI: 1.11-2.14). Age (25-49 years) (OR = 2.43; 95%CI: 1.37-4.33), working in industry/mining (OR = 4.94; 95%CI: 2.17-11.23), unawareness of partner's HIV status (OR = 2.50; 95%CI: 1.91-3.27), and visiting a healer (OR = 1.74; 95%CI: 1.03-2.93) were factors associated with a positive HIV test. Including these factors in the targeted PITC algorithm could have increased new HIV diagnoses by 2.6%. In conclusion, providing refresher training and adapting the current targeted PITC algorithm through further research can help reach undiagnosed PLHIV, treat all, and ultimately eliminate HIV, especially in resource-limited rural areas.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Saura-Lázaro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
References: Int J Health Serv. 2013;43(4):639-49. (PMID: 24397231)
AIDS. 2019 Feb 1;33(2):349-352. (PMID: 30557162)
Soc Sci Med. 2006 Nov;63(9):2330-40. (PMID: 16887245)
Glob Health Sci Pract. 2015 Mar 05;3(1):109-16. (PMID: 25745124)
BMJ Open. 2018 Jan 11;8(1):e017405. (PMID: 29330173)
J Int AIDS Soc. 2022 Jul;25(7):e25943. (PMID: 35773959)
Am J Emerg Med. 2015 Apr;33(4):506-11. (PMID: 25727169)
HIV Med. 2012 Nov;13(10):581-8. (PMID: 22500780)
Health Promot Int. 2018 Aug 1;33(4):580-588. (PMID: 28119330)
Ann Emerg Med. 2018 Jul;72(1):41-53.e9. (PMID: 29092761)
PLoS One. 2017 Nov 2;12(11):e0187443. (PMID: 29095899)
J Int AIDS Soc. 2022 Jan;25(1):e25861. (PMID: 35001515)
Int J STD AIDS. 2013 Jan;24(1):42-9. (PMID: 23467293)
JAMA Intern Med. 2017 May 1;177(5):693-700. (PMID: 28319229)
Clin Nurs Res. 2016 Oct;25(5):467-72. (PMID: 27558917)
J Clin Epidemiol. 2014 Mar;67(3):267-77. (PMID: 24275499)
MMWR Morb Mortal Wkly Rep. 2020 Dec 04;69(48):1801-1806. (PMID: 33270608)
PLoS One. 2020 Apr 8;15(4):e0231303. (PMID: 32267866)
Health Serv Res. 2002 Dec;37(6):1603-23. (PMID: 12546288)
AIDS Behav. 2021 Feb;25(2):297-310. (PMID: 32651762)
PLoS Med. 2017 Apr 11;14(4):e1002262. (PMID: 28399122)
PLoS One. 2021 Feb 12;16(2):e0245461. (PMID: 33577559)
AIDS Res Ther. 2019 Apr 9;16(1):8. (PMID: 30967145)
J Acquir Immune Defic Syndr. 2016 Dec 1;73(4):411-418. (PMID: 27243903)
تواريخ الأحداث: Date Created: 20240523 Date Completed: 20240523 Latest Revision: 20240525
رمز التحديث: 20240525
مُعرف محوري في PubMed: PMC11115277
DOI: 10.1371/journal.pone.0303063
PMID: 38781226
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0303063