Background The initiation and expansion of China＇s national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage ...Background The initiation and expansion of China＇s national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage rests upon intensifying HIV screening and efficient linkage of care. Timely CD4 cell count testing after HIV diagnosis is necessary to determine whether a patient meets criteria for antiretroviral treatment, and represents a crucial link to engage HIV-infected patients in appropriate care, which has not been evaluated in China.Methods We evaluated all patients ≥16 years who tested HIV positive from 2005 to 2009 in Yunnan and Guangxi.Multivariate Logistic regression models were applied to identify factors associated with lack of CD4 cell count testing within 6 months after HIV diagnosis.Results A total of 83 556 patients were included. Over the study period, 30 635 （37%） of subjects received a CD4 cell count within 6 months of receiving the HIV diagnosis. The rate of CD4 cell count testing within 6 months of HIV diagnosis increased significantly from 7% in 2005 to 62% in 2009. Besides the earlier years of HIV diagnosis, negative predictors for CD4 cell count testing in multivariate analyses included older age, not married or unclear marriage status,incarceration, diagnosis at sexual transmitted disease clinics, mode of HIV transmission classified as men who have sex with men, intravenous drug users or transmission route unclear, while minority ethnicity, receipt of high school or higher education, diagnosis at voluntary counseling and testing clinics, and having HIV positive parents were protective.Conclusions Significant progress has been made in increasing CD4 testing among newly diagnosed HIV positive patients in Yunnan and Guangxi from 2005-2009. However, a sizable proportion of HIV positive patients still lack CD4testing within 6 months of diagnosis. Improving CD4 testing, particularly among patients with identified risk factors, is essential to link patients with ART services and optimize treatment coverage展开更多
In panel data analysis,the cross-sectional dependence(CD)test has been extensively used to test the cross-sectional dependence.However,this traditional CD test does not take serial correlation into consideration,which...In panel data analysis,the cross-sectional dependence(CD)test has been extensively used to test the cross-sectional dependence.However,this traditional CD test does not take serial correlation into consideration,which commonly occurs in many fields.To solve this problem,we propose an adjusted CD test which is able to effectively handle serial correlation.More specifically,the serial correlation can be of arbitrary form in our work.Furthermore,we establish the theoretical properties of the proposed adjusted CD test.Our extensive Monte Carlo experiments show that the traditional CD test cannot work well under serial correlation,while the proposed adjusted CD test does provide rather satisfactory performance.展开更多
文摘Background The initiation and expansion of China＇s national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage rests upon intensifying HIV screening and efficient linkage of care. Timely CD4 cell count testing after HIV diagnosis is necessary to determine whether a patient meets criteria for antiretroviral treatment, and represents a crucial link to engage HIV-infected patients in appropriate care, which has not been evaluated in China.Methods We evaluated all patients ≥16 years who tested HIV positive from 2005 to 2009 in Yunnan and Guangxi.Multivariate Logistic regression models were applied to identify factors associated with lack of CD4 cell count testing within 6 months after HIV diagnosis.Results A total of 83 556 patients were included. Over the study period, 30 635 （37%） of subjects received a CD4 cell count within 6 months of receiving the HIV diagnosis. The rate of CD4 cell count testing within 6 months of HIV diagnosis increased significantly from 7% in 2005 to 62% in 2009. Besides the earlier years of HIV diagnosis, negative predictors for CD4 cell count testing in multivariate analyses included older age, not married or unclear marriage status,incarceration, diagnosis at sexual transmitted disease clinics, mode of HIV transmission classified as men who have sex with men, intravenous drug users or transmission route unclear, while minority ethnicity, receipt of high school or higher education, diagnosis at voluntary counseling and testing clinics, and having HIV positive parents were protective.Conclusions Significant progress has been made in increasing CD4 testing among newly diagnosed HIV positive patients in Yunnan and Guangxi from 2005-2009. However, a sizable proportion of HIV positive patients still lack CD4testing within 6 months of diagnosis. Improving CD4 testing, particularly among patients with identified risk factors, is essential to link patients with ART services and optimize treatment coverage
基金supported by National Natural Science Foundation of China (Grant Nos. 11001225, 11401482 and 71532001)
文摘In panel data analysis,the cross-sectional dependence(CD)test has been extensively used to test the cross-sectional dependence.However,this traditional CD test does not take serial correlation into consideration,which commonly occurs in many fields.To solve this problem,we propose an adjusted CD test which is able to effectively handle serial correlation.More specifically,the serial correlation can be of arbitrary form in our work.Furthermore,we establish the theoretical properties of the proposed adjusted CD test.Our extensive Monte Carlo experiments show that the traditional CD test cannot work well under serial correlation,while the proposed adjusted CD test does provide rather satisfactory performance.
