A qualitative study of secondary distribution of HIV self-test kits by female sex workers in Kenya.
A qualitative study of secondary distribution of HIV self-test kits by female sex workers in Kenya.
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DOI：
10.1371/journal.pone.0174629
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Thirumurthy H
中科院分区：
文献类型：
--
作者：
Maman S;Murray KR;Napierala Mavedzenge S;Oluoch L;Sijenje F;Agot K;Thirumurthy H
提高对血清状态的认识和频繁进行艾滋病毒检测对于女性性工作者 (FSW) 及其性伴侣等高危人群尤其重要。艾滋病毒自我检测是一种在撒哈拉以南非洲地区逐渐普及的方法，作为增加对艾滋病毒状况的了解和促进更安全的性决定的战略。然而，对于最适合增加难以接触到的高风险个体的测试机会的自测分发策略知之甚少。我们对 18 名 FSW 进行了一项定性研究，他们参与了一项更大规模的研究，为他们提供了五次基于口腔液体的自我测试，培训了如何使用测试，并鼓励他们酌情向性伴侣提供自我测试。女性在向伴侣进行自我测试并避免与伴侣发生冲突的策略中表现出了代理性。他们仔细考虑与谁分享自我测试，经常评估合作伙伴负面反应的可能性，作为决策过程的一部分。当女性面对伴侣的负面反应时，她们会利用以前使用过的策略来避免来自伴侣的冲突和身体伤害，例如不回应愤怒的伴侣以及放弃付款以迅速离开愤怒的伴侣。一些女性还通过自我测试来与伴侣做出更明智的性决定。
Promoting awareness of serostatus and frequent HIV testing is especially important among high risk populations such as female sex workers (FSW) and their sexual partners. HIV self-testing is an approach that is gaining ground in sub-Saharan Africa as a strategy to increase knowledge of HIV status and promote safer sexual decisions. However, little is known about self-test distribution strategies that are optimal for increasing testing access among hard-to-reach and high risk individuals. We conducted a qualitative study with 18 FSW who participated in a larger study that provided them with five oral fluid-based self-tests, training on how to use the tests, and encouragement to offer the self-tests to their sexual partners using their discretion. Women demonstrated agency in the strategies they used to introduce self-tests to their partners and to avoid conflict with partners. They carefully considered with whom to share self-tests, often assessing the possibility for negative reactions from partners as part of their decision making process. When women faced negative reactions from partners, they drew on strategies they had used before to avoid conflict and physical harm from partners, such as not responding to angry partners and forgoing payment to leave angry partners quickly. Some women also used self-tests to make more informed sexual decisions with their partners.