Olusegun BUSARI, Adedayo ADEYEMİ, Olufemi DESALU, Ahmed JIMOH, Martha NAKAYIMA, Abidemi FASAE

Nijerya'da yatan hastaların aile üyelerinin rutin HIV testi

GİRİŞ: HIV pozitif hastaların aile fertleri için HIV testi, eşlerin durumunun anlaşılmasını, ailevi sosyal desteğin teşvik edilmesini ve HIV hizmetlerine erişimin artırılmasını sağlayabilir. Amaç, Batı Nijerya'da HIV tedavisi için belirlenen federal bir hastanede yatan hem HIV pozitif ve negatif hastaların aile üyeleri arasında HIV yaygınlığının belirlenmesi için rutin HIV testi yaklaşımının kullanılmasıdır. YÖNTEM: Bu prospektif çalışma, Ocak 2006 ile Haziran 2009 tarihleri arasında gerçekleştirilmiştir. Etik izni çalışma öncesinde hastane araştirma ve etik komitesinden alınmıştır. Her katılımcıdan aydınlatılmış onam alınmıştır. HIV testi, HIV pozitif ve negatif hastaların çalışmaya katılmayı kabul etmiş aile üyelerine yapılmıştır. Aile üyelerinden kasıt; eşler, hastaların çocukların, çocuk hastaların ebevyni ve diğer aile bireyleridir. Analiz olarak frekans ve yüzdelik yapılmıştır. BULGULAR: 184 hasta ile 162 aile üyesi teste sokulmuştur. Aile üyelerinin dağılımı eşler 81 (%50,0), babalar 14 (%8,6), anneler 20 (%12,3), çocuklar 19 (%11,7) ve diğer aile üyeleri 28 (%17,3) kişi şeklindedir. 151 (%93,2) kişi teste ilk kez katılmıştır. Test edilen kişilerin çoğunluğu (%82,1) test sonrası danışmanlık almıştır. Genel olarak HIV yaygınlığı %12,3 (20/162) idi. Farklı aile bireyleri içinde HIV prevalansı eşlerde %14,8 (12/81), annelerde %20 (4/20), babalarda %7,1 (1/14), çocuklarda %10,5 (2/19) ve diğer aile üyeleri %3,6 (1/28) şeklindedir. HIV pozitif ve negatif bireylerin aile üyelerinde HIV prevalansı sırasıyla %15,6 (14/90) ve %8,3 (6/72) idi. 12 eş pozitif, 7 (%13,5) eş HIV-uyumsuz bulunmuştur ve HIV-uyumsuz çiftlerin %71,4 (5/7) inde hasta negatif iken eş pozitifdir. SONUÇ: Sonuçlar, hastaların aile üyelerine rutin HIV testi yapılamasının, çok sayıda HIV enfekte kişinin belirlenmesi için bir strateji olduğunu göstermektedir. Bu yöntem sadece yenilikçi değil ayrıca, HIV önleme, Nijerya ve Sahra-altı Afrika'nın geri kalanında bakım ve tedavi hizmetlerine erişimi arttırmak için yeni bir yaklaşımdır.

Routine HIV testing of family members of hospitalized patients in Nigeria

Background: HIV testing for family members of HIV-positive patients may enhance disclosure of status of spouses, encourage family social support and improve access to HIV services. Objective was to employ the approach of routine HIV testing to determine the prevalence of HIV among family members of both HIV positive and negative patients on admission in a federal HIV treatment designated hospital in Western Nigeria Methodology: This prospective study was conducted between January 2006 and June 2009. Ethical clearance was obtained from the Research and Ethics committee of the hospital prior to the study. Informed consent was obtained from each participant. HIV testing was offered to consenting family members of HIV positive and negative patients on admission. The family members included spouses, children of patients, parents of paediatric patients and other family members. Analysis was done in frequencies and percentages Results: 162 family members of 184 patients were tested. Spouses were, 81 (50.0%); fathers, 14 (8.6%); mothers, 20 (12.3%); children, 19 (11.7%) and others family members, 28 (17.3%). 151 (93.2%) of testers were first timers. Majority of those tested (82.1%) had post-test counseling. The overall HIV prevalence was 12.3% (20/162). HIV prevalence within different family members was 14.8% (12/81), 20% (4/20), 7.1% (1/14), 10.5% (2/19) and 3.6% (1/28) for spouses, mothers, fathers, children and others respectively.In addition, the prevalence of HIV among family members of HIV positive and negative patients was 15.6% (14/90) and 8.3% (6/72) respectively. Of 12 spouses that were positive, 7 (13.5%) were HIV-discordant; and in 71.4% (5/7) of discordant couples, the spouse was positive while the patient on admission was negative. Conclusion: The results indicate that routine HIV testing of family members of patients on admission is a strategy for identification of vast number of HIV infected persons. This method is not only innovative, but also a novel approach for scaling up of access to HIV prevention, care and treatment services in Nigeria and the rest of sub-Sahara Africa

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