High Acceptability and Increased HIV-Testing Frequency After Introduction of HIV Self-Testing and Network Distribution Among South African MSM.
High Acceptability and Increased HIV-Testing Frequency After Introduction of HIV Self-Testing and Network Distribution Among South African MSM.
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DOI：
10.1097/qai.0000000000001601
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发表时间：
2018-03-01
期刊：
影响因子：
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通讯作者：
McIntyre JA
中科院分区：
文献类型：
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作者：
Lippman SA;Lane T;Rabede O;Gilmore H;Chen YH;Mlotshwa N;Maleke K;Marr A;McIntyre JA
南非男男性行为者（MSM）在未确诊的艾滋病毒感染和与其风险不相称的艾滋病毒检测率方面负担沉重。艾滋病毒自检（HIVST）可能会增加检测的接受程度、频率和早期的艾滋病毒检测和治疗。南非姆普马兰加省Gert Sibande和Ehlanzeni区。我们在2015年6月至2017年5月期间对男同性恋者进行了一项纵向hiv研究。总共向127名艾滋病毒阴性男男性行为者提供了多达9种他们选择的检测试剂盒——口服液或血指棒——供他们自己使用并分发给他们的网络。在登记后3个月和6个月进行的调查获得了关于艾滋病毒感染经历、偏好、可接受性、利用和分布的信息。我们使用广义估计方程来评估测试频率的变化。91%的参与者进行了自我测试。所有自我检测的参与者都报告有可能再次自我检测，超过80%的人更喜欢艾滋病毒感染检测而不是基于临床的检测。与口服液测试相比，手指测试更受欢迎，比例约为2比1。返回的参与者向性伴侣（18.5%）、朋友（51.6%）和家人（29.8%）分发了728份检测包。在研究期间，有6名参与者血清转化，在接受测试的人中报告了40例新诊断。频繁的（半年一次的）检测从研究前的37.8%增加到随访时的84.5% (p<0.001)，参与者报告说，如果有hiv检测，预期的检测频率为100%，而如果来年只有临床检测，预期的检测频率为84% （p< 0.01）。艾滋病毒感染的使用和网络分布对南非的男男性行为者来说是可以接受和可行的，并且可以增加检测的接受和频率，潜在地改善男男性行为者及其网络的早期发现。
South African men-who-have-sex-with-men (MSM) have a high burden of undiagnosed HIV infection and HIV-testing rates incommensurate with their risk. HIV self-testing (HIVST) may increase testing uptake, frequency, and earlier HIV detection and treatment. Gert Sibande and Ehlanzeni districts, Mpumalanga Province, South Africa. We conducted a longitudinal HIVST study among MSM between June 2015 – May 2017. Overall 127 HIV-negative MSM were provided with up to nine test kits of their choice - oral fluid or blood fingerstick – to use themselves and distribute to their networks. Surveys conducted three and six months post-enrollment elicited information on HIVST experiences, preferences, acceptability, utilization and distribution. We used generalized estimating equations to assess changes in testing frequency. Ninety-one percent of participants self-tested. All participants who self-tested reported being likely to self-test again, with over 80% preferring HIVST to clinic-based testing. Fingerstick was preferred to oral fluid tests by approximately two to one. Returning participants distributed 728 tests to sexual partners (18.5% of kits), friends (51.6%), and family (29.8%). Six participants seroconverted during the study and 40 new diagnoses were reported among test-recipients. Frequent (semi-annual) testing increased from 37.8% prior to the study to 84.5% at follow-up (p<0.001), and participants reported anticipated frequent testing of 100% if HIVST were available compared to 84% if only clinic-testing available in the coming year (p<.01). HIVST use and network-distribution is acceptable and feasible for MSM in South Africa, and can increase testing uptake and frequency, potentially improving early detection among MSM and their networks.