Implementation of a Test, Treat, and Prevent HIV program among men who have sex with men and transgender women in Thailand, 2015-2016

作者：Sumet Ongwandee, Cheewanan Lertpiriyasuwat, Thana Khawcharoenporn, Ploenchan Chetchotisak, Ekkachai Thiansukhon, Niramon Leerattanapetch, Banlang Leungwaranan, Chomnad Manopaiboon, Thanongsri Phoorisri, Prin Visavakum, Bongkoch Jetsawang, Monsicha Poolsawat, Somboon Nookhai, Monthinee Vasanti-Uppapokakorn, Samart Karuchit, Chonticha Kittinunvorakoon, Philip A. Mock, Dimitri Prybylski, Akechittra Sukkul, Thierry H. Roels, Michael Martin · 发表于：PLoS ONE · 年份：2018 · DOI：10.1371/journal.pone.0201171 · 被引用次数：34 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、HIV/AIDS drug development and treatment

INTRODUCTION: Antiretroviral therapy reduces the risk of serious illness among people living with HIV and can prevent HIV transmission. We implemented a Test, Treat, and Prevent HIV Program among men who have sex with men (MSM) and transgender women at five hospitals in four provinces of Thailand to increase HIV testing, help those who test positive start antiretroviral therapy, and increase access to pre-exposure prophylaxis (PrEP). METHODS: We implemented rapid HIV testing and trained staff on immediate antiretroviral initiation at the five hospitals and offered PrEP at two hospitals. We recruited MSM and transgender women who walked-in to clinics and used a peer-driven intervention to expand recruitment. We used logistic regression to determine factors associated with prevalent HIV infection and the decision to start antiretroviral therapy and PrEP. RESULTS: During 2015 and 2016, 1880 people enrolled. Participants recruited by peers were younger (p<0.0001), less likely to be HIV-infected (p<0.0001), and those infected had higher CD4 counts (p = 0.04) than participants who walked-in to the clinics. Overall, 16% were HIV-positive: 18% of MSM and 9% of transgender women; 86% started antiretroviral therapy and 46% of eligible participants started PrEP. A higher proportion of participants at hospitals with one-stop HIV services started antiretroviral therapy than other hospitals. Participants who started PrEP were more likely to report sex with an HIV-infected partner (p = 0.00...