Piloting an HIV self-test kit voucher program to raise serostatus awareness of high-risk African Americans, Los Angeles.
Piloting an HIV self-test kit voucher program to raise serostatus awareness of high-risk African Americans, Los Angeles.
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DOI：
10.1186/1471-2458-14-1226
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发表时间：
2014-11-26
影响因子：
4.5
通讯作者：
Klausner JD
中科院分区：
文献类型：
--
作者：
Marlin RW;Young SD;Bristow CC;Wilson G;Rodriguez J;Ortiz J;Mathew R;Klausner JD
在洛杉矶，高达一半的新艾滋病毒病例可能是由20-30%的男男性行为者（MSM）引起的，这些人感染了未被识别的艾滋病毒。种族/少数民族的男男性行为者在血清不知情的风险特别高，由于耻辱和医疗保健服务差，可能会受益于新的私人自我检测方法，如最近FDA批准的OraQuick®家庭艾滋病毒检测。从2013年7月至11月，我们进行了一项试点研究，以检查针对洛杉矶非洲裔美国男男性行为者的免费OraQuick®测试代金券计划的可行性。我们基于以下因素确定了可行性：（1）建立代金券兑换和第三方支付系统，（2）社区组织（CBO）传播代金券的意愿，以及（3）通过匿名电话调查收集用户人口统计数据、测试和与护理的联系结果。我们与Walgreens®合作，为免费OraQuick®测试创建了一个代金券和第三方报销系统。其分布可分为两个时期。总共向社区组织提供了641张代金券：274张（42.7%）发给了客户，其中53张（19.3%）被兑换。274名客户中有50名（18.2%）接受了调查：44名（88%）是非洲裔美国人，39名（78%）报告可能重复使用代金券，44名（88%）报告审查了测试前信息，37名（74%）审查了测试后信息。50名调查对象中有3人（6%）报告说，他们新检测出艾滋病毒呈阳性，其中所有人（100%）都报告说曾寻求医疗护理。两人隐瞒了他们的结果，两人也都寻求医疗护理。与一家商业药房合作开发一种凭单制度，以促进艾滋病毒自我检测，并将其与护理联系起来，这是可行的。我们的研究结果表明，代金券计划与增加艾滋病毒感染的新病例的识别率与护理的联系很高有关。有必要扩大对高危群体中艾滋病毒自我检测包代金券方案的研究和评估。
Up to half of all new HIV cases in Los Angeles may be caused by the 20-30% of men who have sex with men (MSM) with unrecognized HIV infection. Racial/ethnic minority MSM are at particularly high risk for being sero-unaware and due to stigma and poor healthcare access might benefit from novel private, self-testing methods, such as the recently FDA-approved OraQuick® In-Home HIV Test. From July-November 2013, we undertook a pilot study to examine the feasibility of a voucher program for free OraQuick® tests targeting African American MSM in Los Angeles. We determined feasibility based on: (1) the establishment of a voucher redemption and third-party payment system, (2) the willingness of community-based organizations (CBOs) to disseminate vouchers, and (3) the collection of user demographics, test and linkage-to-care results with an anonymous telephone survey. We partnered with Walgreens® to create a voucher and third-party reimbursement system for free OraQuick® tests. Voucher distribution was divided into two periods. In total, 641 vouchers were supplied to CBOs: 274 (42.7%) went to clients and of those 53 (19.3%) were redeemed. Fifty (18.2%) of the 274 clients were surveyed: 44 (88%) were African American, 39 (78%) reported being likely to repeat voucher use, 44 (88%) reported reviewing pre-test information, and 37 (74%) the post-test information. Three (6%) of 50 survey respondents reported newly testing HIV-positive of whom all (100%) reported seeking medical care. Two withheld their results, both of whom also sought medical care. Developing and partnering with a commercial pharmacy to institute a voucher system to facilitate HIV self-testing with linkage-to-care was feasible. Our findings suggest the voucher program was associated with increasing the identification of new cases of HIV infection with high rates of linkage to care. Expanded research and evaluation of voucher programs for HIV self-test kits among high-risk groups is warranted.
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