Association of anticipated HIV testing stigma and provider mistrust on preference for HIV self-testing among cisgender men who have sex with men in the Philippines.
Association of anticipated HIV testing stigma and provider mistrust on preference for HIV self-testing among cisgender men who have sex with men in the Philippines.
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DOI：
10.1186/s12889-022-14834-x
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发表时间：
2022-12-16
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
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菲律宾新的艾滋病毒感染病例正在以惊人的速度增加。然而，超过四分之三的男男性行为者从未接受过艾滋病毒检测。艾滋病毒自我检测（HIVST）可以通过消除障碍，特别是对污名化的恐惧和对提供者的不信任，提高总体检测率。本研究旨在确定这些因素是否与菲律宾顺性别男男性接触者（cis-MSM）对HIVST的偏好有关，以及预期的艾滋病毒检测耻辱感和对HIVST偏好的提供者不信任之间是否存在相互作用。我们进行了二次分析的一次性调查803顺男男性接触者招募使用有目的的抽样从网上男男性接触者约会网站和男男性接触者为主题的酒吧地点在大马尼拉，菲律宾。计算汇总统计量以描述参与者特征。多变量改良泊松回归分析进行，以确定是否预期的艾滋病毒检测耻辱和供应商的不信任与偏好之间的顺式男男性接触者的艾滋病毒检测。其他变量，如年龄，教育，月收入，关系状况，艾滋病毒血清状态，并知道在哪里获得艾滋病毒检测是分析中的最小充分调整集。参与者的平均年龄为28.6岁（SD = 8.0）;大多数人获得大学学位（73%），并就业（80%）。大多数受访者（81%）更喜欢基于设施的测试，而19%的人更喜欢艾滋病毒/艾滋病。高比例的参与者报告了预期的艾滋病毒检测耻辱（66%）和提供者不信任（44%）。预期HIV检测耻辱（aPR = 1.51; 95%CI = 1.01-2.25，p = 0.046）和提供者不信任（aPR = 1.49; 95%CI = 1.07-2.09，p = 0.020）与HIVST偏好独立相关。有一个积极的，加性的交互作用之间的不信任提供者和预期的艾滋病毒检测耻辱的偏好HIVST（RERI = 1.13，95%CI：0.20-2.06; p = 0.017），表明预期的艾滋病毒检测耻辱和偏好HIVST之间的关联是更大的提供者之间的不信任相比，那些没有提供者的不信任。在菲律宾，应提供艾滋病毒检测服务，作为传统的基于设施的艾滋病毒检测服务的补充，以扩大检测范围，并覆盖因预期的艾滋病毒检测耻辱和提供者不信任而可能不接受检测的个人。在线版本包含补充材料，可通过10.1186/s12889-022-14834-x获得。
New HIV infections in the Philippines are increasing at an alarming rate. However, over three quarters of men who have sex with men (MSM) have never been tested for HIV. HIV self-testing (HIVST) may increase overall testing rates by removing barriers, particularly fear of stigmatization and mistrust of providers. This study aimed to determine if these factors are associated with preference for HIVST among Filipino cisgender MSM (cis-MSM), and whether there is an interaction between anticipated HIV testing stigma and provider mistrust on preference for HIVST. We conducted secondary analysis of a one-time survey of 803 cis-MSM who were recruited using purposive sampling from online MSM dating sites and MSM-themed bar locations in Metro Manila, Philippines. Summary statistics were computed to describe participant characteristics. Multivariable modified Poisson regression analyses were conducted to determine if anticipated HIV testing stigma and provider mistrust were associated with preference for HIVST among cis-MSM. Other variables such as age, education, monthly income, relationship status, HIV serostatus, and knowing where to get HIV testing were the minimal sufficient adjustment set in the analyses. Average age of participants was 28.6 years (SD = 8.0); most had received college degrees (73%) and were employed (80%). Most respondents (81%) preferred facility-based testing, while 19% preferred HIVST. A high percentage of participants reported anticipated HIV testing stigma (66%) and provider mistrust (44%). Anticipated HIV testing stigma (aPR = 1.51; 95% CI = 1.01–2.25, p = 0.046) and provider mistrust (aPR = 1.49; 95% CI = 1.07–2.09, p = 0.020) were independently associated with a preference for HIVST. There was a positive, additive interaction between provider mistrust and anticipated HIV testing stigma on preference for HIVST (RERI = 1.13, 95% CI: 0.20–2.06; p = 0.017), indicating that the association between anticipated HIV testing stigma and preference for HIVST is greater among those with provider mistrust compared to those without provider mistrust. HIVST should be offered as a supplement to traditional facility-based HIV testing services in the Philippines to expand testing and reach individuals who may not undergo testing due to anticipated HIV testing stigma and provider mistrust. The online version contains supplementary material available at 10.1186/s12889-022-14834-x.
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作者：
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