Riadenie integrovaného prístupu testovania HIV, HCV a syfilisu v komunitných dobrovoľných poradenských a testovacích službách na Slovensku

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Autoři: D. Valkovičová Staneková ¹ ; S. Wimmerová ¹ ; L. Fernàndez-López ² ; M. Hábeková ¹ ; A. Kovářová ¹; M. Takáčová ¹ ; J. Casabona ³
Působiště autorů: Slovak Medical University, Bratislava, Slovakia ¹; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain ²; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain ³
Vyšlo v časopise: Epidemiol. Mikrobiol. Imunol. 73, 2024, č. 3, s. 117-123
Kategorie: Původní práce
doi: https://doi.org/10.61568/emi/11-6352/20240726/138062

Souhrn

Ciele: Cieľom pilotného projektu bolo zvýšiť testovanie ako aj prepojenie so zdravotnou starostlivosťou o novodiagnostikované osoby s infekciou HIV/HCV/syfilisu a tiež zlepšiť zber a prenos údajov pomocou štandardných nástrojov zberu údajov z komunitných centier poskytujúcich dobrovoľné poradenstvo a testovanie (CBVCT) do národného epidemiologického a monitorovacieho systému.

Metódy: Integrované dobrovoľné anonymné testovanie z krvi na HIV, HCV a syfilis bolo realizované pomocou rýchlych testov v období 6 mesiacov (03/2019 až 8/2019). Účastníkom s reaktívnymi výsledkami sa odporučilo, aby navštívili špecialistu za účelom potvrdenia diagnózy a nasadenia terapie.

Výsledky: Otestovaných bolo 675 klientov na HIV, 410 na HCV a 457 na syfilis. Medián veku účastníkov sa pohyboval od 24 do 35,6 (IQR:24), 75,3 % z nich bolo mužov, 23,7 % žien a 0,6 % transrodových ľudí. Z hľadiska rizika akvírovania testovaných infekcii 48,9 % zo 675 klientov boli muži majúci styk s mužmi (MSM), 0,3 % osoby pracujúce v sex-biznise (SW), 9,0 % injekční užívatelia drog (PWID), 2,4 % migranti (Mi) a 8,3 % klientov uvádzalo kombináciu týchto rizík. Pilotný projekt odhalil infekciu HIV u 0,4 %, HCV u 2,4 % a T. pallidum u 1,8 % klientov. Len 2 klienti, s potvrdenou HIV infekciou boli prepojení s následnou zdravotnou starostlivosťou. Najvyššia prevalencia HIV bola zistená u MSM/Mi (4,2 %), HCV u PWID (30,8 %) a syfilisu u SW/PWID (7,1 %). Bezkondómový styk so SW, PWID, MSM a HIV pozitívnymi za posledných 12 mesiacov uviedlo 5/92, 41/82, 3/78 a 0/88 odpovedajúcich klientov. Výsledky štúdie boli zahrnuté do ročnej národnej epidemiologickej správy.

Záver: Pilotný projekt odhalil potrebu podpory integrovaného testovania v CBVCT, prekonania prekážok pri potvrdzujúcom testovaní a prepojení so zdravotnou starostlivosťou ako aj potrebu integrácie základných údajov v rámci monitorovania a hodnotenia (M&E) testovania v CBVCT do národných systémov surveillance na Slovensku.

Klíčová slova:

Slovensko – HCV – HIV – syfilis – integrované testovanie

Zdroje

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Acknowledgement

The research reported was supported by the Joint Action INTEGRATE funded by the European Union’s Third Health Programme for Research and Innovation (Grant Agreement No: 761319). This article was also created by the realization of the project “Centre of excellence of environmental health” ITMS No. 26240120033 based on the supporting operational Research and development programme funded from the European Regional Development Fund.”

We want to acknowledge the contribution of the following people and organisations to the implementation of the pilots in Slovakia: Jiří Pavlát, NGO Dom svetla Slovensko; Dominika Jašeková, NGO Odyseus; Barbora Kuchárová, NGO Prima.

We also thank the steering committee of the EU project Integrate for its intellectual support: Dorthe Raben, Anne Raahauge, Stine Finne Jakobsen, Centre of Excellence for Health, Immunity and Infections (CHIP), Denmark; Christine Kakalou, Centre for Research & Technology Hellas, Institute of Applied Biosciences, Information Technologies institute, Greece; Lella Cosmaro, Fondazione LILA Milano Onlus – Italian League for Fighting AIDS, Italy; Aljona Kurbatova & Julia Hristojeva, National Institute for Health Development, Estonia; Michele Mommi & Manuel Maffeo, Arcigay Associazione LGBTI Italiana, Italy; Valerie Delpech & Meaghan Kall, Public Health England, UK; Jordi Casabona & Laura Fernandez-Lopez, Centre for Epidemiological Studies on STI/ HIV/AIDS in Catalonia (CEEISCAT), Health Department, Generalitat of Catalonia, Badalona, Catalonia, Spain; Irena Klavs, National Institute of Public Health, Slovenia; Jack Lambert, University College Dublin, Ireland; Nadia Gasbarrini, Fondazione Villa Maraini Onlus, Italy; Piotr Wysocki & Iwona Wawer, National AIDS Centre Agency of the Ministry of Health, Poland.

The authors contributed equally to this work and share first/last authorship.

Do redakce došlo dne 19. 9. 2023.

Adresa pro korespondenci:
doc. RNDr. Danica Valkovičová Staneková, PhD.
Slovenská zdravotnická univerzita
Limbová 14
833 03 Bratislava Slovenská republika
e-mail: danica.valk.stanek@gmail.com