PDF(Pubmed)
Abstract：
The World Health Organization (WHO) recommends same-day initiation (SDI) of antiretroviral therapy (ART) for all individuals diagnosed with HIV irrespective of CD4+ count or clinical stage. Implementation of program is still far from reaching its goals. This study assessed the level of implementation of same day ART initiation. A longitudinal study was conducted at four primary healthcare clinics in eThekwini municipality KwaZulu-Natal. Data was collected between June 2020 to October 2020 using a data extraction form. Data on individuals tested HIV positive, number of SDI of ART; and clinicians working on UTT program were compiled from clinic registers, and Three Interlinked Electronic Registers.Net (TIER.Net). Non-governmental organisations (NGO) supporting the facility and services information was collected. Among the 403 individuals who tested HIV positive, 279 (69.2%) were initiated on ART on the same day of HIV diagnosis from the four facilities. There was a significant association between health facility and number of HIV positive individuals initiated on SDI (chi-square=10.59; P-value=0.008). There was a significant association between facilities with support from all NGOs and ART SDI (chi-square=10.18; P-value=0.015. There was a significant association between staff provision in a facility and SDI (chi-square=7.51; P-value=0.006). Urban areas clinics were more likely to have high uptake of SDI compared to rural clinics (chi-square=11,29; P-value=0.003). Implementation of the Universal Test and Treat program varies by facility indicating the need for the government to monitor and standardize implementation of the policy if the program is to yield success.
摘要：
世界卫生组织（WHO）建议对所有被诊断为HIV的个体，无论CD4计数或临床阶段如何，均应在同一天开始抗逆转录病毒治疗（ART）。方案的实施还远远没有达到其目标。这项研究评估了当天开始ART的实施水平。在eThekwini夸祖鲁-纳塔尔省的四个初级保健诊所进行了纵向研究。数据是在2020年6月至2020年10月之间使用数据提取表收集的。艾滋病毒检测呈阳性的个人数据，ART的SDI数量；从事UTT计划的临床医生是从诊所登记册中编制的，和三个相互连接的电子寄存器。净（层。net）。收集了支持设施和服务的非政府组织（NGO）信息。在HIV检测呈阳性的403人中,279（69.2％）在四个设施的HIV诊断当天开始接受ART。医疗机构与在SDI上启动的HIV阳性个体数量之间存在显着关联（卡方=10.59；P值=0.008）。在所有非政府组织的支持下，设施与ARTSDI之间存在显着关联（卡方=10.18；P值=0.015。设施中的人员配置与SDI之间存在显着关联（卡方=7.51；P值=0.006）。与农村诊所相比，城市地区的诊所更有可能获得较高的SDI（卡方=11,29；P值=0.003）。通用测试和治疗计划的实施因设施而异，表明如果该计划要取得成功，政府需要监督和规范政策的实施。
