多渠道联合干预提升HIV阳性初筛快速转介率
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龚世江，韦湘霞
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1.广西壮族自治区胸科医院，广西柳州，545005；2.平南县人民医院，广西贵港，537300
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摘要：目的 评估多渠道联合干预对一年内 68 例 HIV 阳性初筛者快速转介率的提升效果。方法 采用标准化阳性初筛–确诊流程、双轨检测、空间－流程－服务改造、关爱门诊闭环追踪、强制 48h 转介、绩效考核、宣教去敏感化等组合策略。以干预前后 24 个月内全部初筛阳性者为观察对象；快速转介定义为初筛阳性至接受确证并完成首次 ART 的时间≤7 日；应用独立样本 t 检验对比均数，χ2检验对比比例。结果 干预组 68 例转介率 93.6%，对照阶段同期 62%（χ2=21.38，P<0.05）；中位转介时间由 15 日压至 2 日（t=9.12，P<0.01）；确诊后第 90 日病毒学抑制率 94.12%，较对照 73.68%回调（χ2=5.11，P=0.024）。结论 多渠道联合策略可显著压缩转介周期、提高治疗启动率，为基层 HIV 防控提供可复制范式。
关健词：HIV；阳性初筛；快速转介；多渠道联合干预；抗病毒治疗
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Multi-Channel Joint Intervention to Improve the Rapid Referral Rate of HIV-Positive Initial Screening
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Shijiang Gong,Xiangxia Wei
1. Guangxi Zhuang Autonomous Region Chest Hospital, Liuzhou, Guangxi 545005, China；2. Pingnan County People's Hospital, Guigang, Guangxi,537300, China
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Abstract: Objective To evaluate the effect of multi-channel combined intervention on improving the rapid referral rate of 68 HIV-positive primary screeners within one year.Methods Combined strategies were adopted, including standardized primary screening-confirmation process for positive cases, dual-track testing, space-process-service transformation, closed-loop follow-up in care clinics, mandatory 48-hour referral, performance assessment, and desensitization in health education. All individuals with positive primary screening results within 24 months before and after the intervention were selected as the observation objects. Rapid referral was defined as the time from positive primary screening to receiving confirmation and completing the first antiretroviral therapy (ART) being ≤ 7 days. Independent samples t-test was used to compare the means, and chi-square test (χ2) was used to compare the proportions.Results The referral rate of 68 cases in the intervention group was 93.6%, compared with 62% in the control period during the same period (χ2=21.38, P<0.05); the median referral time was reduced from 15 days to 2 days (t=9.12, P<0.01); the virological suppression rate on the 90th day after confirmation was 94.12%, which was higher than 73.68% in the control group (χ2=5.11, P=0.024).Conclusion The multi-channel combined strategy can significantly shorten the referral cycle and increase the treatment initiation rate, providing a replicable model for primary HIV prevention and control.
Keywords : HIV; Positive Primary Screening; Rapid Referral; Multi-channel Combined Intervention; Antiretroviral Therapy ( ART)
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