Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis.
Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis.
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DOI：
10.1016/j.eclinm.2021.100991
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发表时间：
2021-08
影响因子：
15.1
通讯作者：
Johnson C
中科院分区：
文献类型：
--
作者：
Jamil MS;Eshun-Wilson I;Witzel TC;Siegfried N;Figueroa C;Chitembo L;Msimanga-Radebe B;Pasha MS;Hatzold K;Corbett E;Barr-DiChiara M;Rodger AJ;Weatherburn P;Geng E;Baggaley R;Johnson C
我们更新了2017年的一项系统性综述，并将艾滋病毒自我检测（HIVST）与标准艾滋病毒检测服务的效果进行了比较，以了解普通人群中有效的服务提供模式。我们纳入了随机对照试验（RCT），这些试验将HIVST的检测结果与普通人群的标准检测结果进行了比较，并于2006年1月1日至2019年6月4日发表。进行随机效应荟萃分析，并报告合并风险比（RR）。使用GRADE方法确定证据的确定性。我们确定了14项符合条件的RCT，其中13项在撒哈拉以南非洲进行。向自我测试者提供的支持从没有/基本支持到一对一的亲自支持不等。HIVST总体上增加了检测吸收（RR：2.09; 95%置信区间：1.69-2.58; p < 0.0001;13项RCT;中等确定性证据），并通过服务提供模式，包括基于设施的分配，在设施中使用HIVST，向合作伙伴的二次分配和基于社区的分配。受试者中被诊断为HIV阳性的人数（RR：0.81，0.45-1.47; p = 0.50; 8项RCT;中等确定性证据）和被诊断为HIV护理/治疗的人数（RR：0.95，0.79-1.13; p = 0.52; 6项RCT;中等确定性证据）在HIVST和标准检测之间相似。报告的HIVST伤害/不良事件罕见，似乎与标准试验相似（RR：2.52：0.52-12.13; p = 0.25; 4项RCT;极低确定性证据）。在撒哈拉以南非洲的一般人群中，HIVST似乎是安全和有效的，有一系列的交付模式。它确定了更多的艾滋病毒感染者，并将他们与护理联系起来。这些研究结果支持更广泛地提供艾滋病毒/艾滋病监测服务，以接触那些可能无法获得检测的人。
We updated a 2017 systematic review and compared the effects of HIV self-testing (HIVST) to standard HIV testing services to understand effective service delivery models among the general population. We included randomized controlled trials (RCTs) comparing testing outcomes with HIVST to standard testing in the general population and published between January 1, 2006 and June 4, 2019. Random effects meta-analysis was conducted and pooled risk ratios (RRs) were reported. The certainty of evidence was determined using the GRADE methodology. We identified 14 eligible RCTs, 13 of which were conducted in sub-Saharan Africa. Support provided to self-testers ranged from no/basic support to one-on-one in-person support. HIVST increased testing uptake overall (RR:2.09; 95% confidence interval: 1.69–2.58; p < 0.0001;13 RCTs; moderate certainty evidence) and by service delivery model including facility-based distribution, HIVST use at facilities, secondary distribution to partners, and community-based distribution. The number of persons diagnosed HIV-positive among those tested (RR:0.81, 0.45–1.47; p = 0.50; 8 RCTs; moderate certainty evidence) and number linked to HIV care/treatment among those diagnosed (RR:0.95, 0.79–1.13; p = 0.52; 6 RCTs; moderate certainty evidence) were similar between HIVST and standard testing. Reported harms/adverse events with HIVST were rare and appeared similar to standard testing (RR:2.52: 0.52–12.13; p = 0.25; 4 RCTs; very low certainty evidence). HIVST appears to be safe and effective among the general population in sub-Saharan Africa with a range of delivery models. It identified and linked additional people with HIV to care. These findings support the wider availability of HIVST to reach those who may not otherwise access testing.
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影响因子：
6
作者：
Hatzold, Karin;Gudukeya, Stephano;Corbett, Elizabeth L.
通讯作者：
Corbett, Elizabeth L.
DOI：
10.1097/qai.0000000000001838
发表时间：
2018-12-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Gichangi A;Wambua J;Mutwiwa S;Njogu R;Bazant E;Wamicwe J;Wafula R;Vrana CJ;Stevens DR;Mudany M;Korte JE
通讯作者：
Korte JE
影响因子：
15.8
作者：
Choko, Augustine T.;Corbett, Elizabeth L.;Fielding, Katherine
通讯作者：
Fielding, Katherine
影响因子：
158.5
作者：
Hayes, Richard J.;Donnell, Deborah;Fidler, Sarah
通讯作者：
Fidler, Sarah
影响因子：
4.4
作者：
Figueroa C;Johnson C;Verster A;Baggaley R
通讯作者：
Baggaley R