Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study.
Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study.
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DOI：
10.1371/journal.pone.0079772
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Dheda K
中科院分区：
文献类型：
--
作者：
Pant Pai N;Behlim T;Abrahams L;Vadnais C;Shivkumar S;Pillay S;Binder A;Deli-Houssein R;Engel N;Joseph L;Dheda K
在南非，污名化、歧视、社会能见度和担心失去保密性阻碍了基于卫生设施的艾滋病毒检测。由于50%的成年人在其一生中曾接受过艾滋病毒检测，因此迫切需要私人的替代检测方案。非侵入性的口服自我检测提供了一种保密、无监督的艾滋病毒自我检测选择，但全球数据有限。2012年1月至6月在南非开普敦大学的卫生保健工作者中进行了一项试点横断面研究。评估了一种创新的、无监督的自测策略的可行性;定义为完成自测过程（即，自检进行、解释和连接）。一个口服的即时艾滋病毒检测，一个互联网和基于纸张的自我检测艾滋病毒的应用程序，和移动的电话协同作用，以创建一个无人监督的战略。通过现场快速检测和实验室检测进一步确认了自检。在270名卫生保健工作者（18岁及以上，艾滋病毒感染状况未知）中，251人同意参加。总体而言，约91%的参与者对该战略的积极体验进行了评价。在251名参与者中，126人成功评估了互联网，125人成功评估了纸质申请，完成率为99.2%。所有血清阳性均与治疗相关（完成率：100%（95% CI，66.0-100））。大约一半的血清阴性者通过移动的电话获得咨询;完成率：44.6%（95% CI，38.0-51.0）。大多数参与者（78.1%）为女性，年龄为18-24岁（61.4%）。9名参与者在确认性试验后发现血清阳性（患病率3.6% 95% CI，1.8-6.9）。9例阳性自测中有6例被准确解释;灵敏度：66.7%（95% CI，30.9-91.0）;特异性：100%（95% CI，98.1-100）。我们的无监督自我检测策略在南非的卫生保健工作者中是可行的。在所有血清反应阳性者中，成功地利用移动的电话建立了联系，约一半血清反应阴性者寻求检测后咨询。在考虑扩大规模之前，需要进行对照试验和实施研究。
In South Africa, stigma, discrimination, social visibility and fear of loss of confidentiality impede health facility-based HIV testing. With 50% of adults having ever tested for HIV in their lifetime, private, alternative testing options are urgently needed. Non-invasive, oral self-tests offer a potential for a confidential, unsupervised HIV self-testing option, but global data are limited. A pilot cross-sectional study was conducted from January to June 2012 in health care workers based at the University of Cape Town, South Africa. An innovative, unsupervised, self-testing strategy was evaluated for feasibility; defined as completion of self-testing process (i.e., self test conduct, interpretation and linkage). An oral point-of-care HIV test, an Internet and paper-based self-test HIV applications, and mobile phones were synergized to create an unsupervised strategy. Self-tests were additionally confirmed with rapid tests on site and laboratory tests. Of 270 health care workers (18 years and above, of unknown HIV status approached), 251 consented for participation. Overall, about 91% participants rated a positive experience with the strategy. Of 251 participants, 126 evaluated the Internet and 125 the paper-based application successfully; completion rate of 99.2%. All sero-positives were linked to treatment (completion rate:100% (95% CI, 66.0–100). About half of sero-negatives were offered counselling on mobile phones; completion rate: 44.6% (95% CI, 38.0–51.0). A majority of participants (78.1%) were females, aged 18–24 years (61.4%). Nine participants were found sero-positive after confirmatory tests (prevalence 3.6% 95% CI, 1.8–6.9). Six of nine positive self-tests were accurately interpreted; sensitivity: 66.7% (95% CI, 30.9–91.0); specificity:100% (95% CI, 98.1–100). Our unsupervised self-testing strategy was feasible to operationalize in health care workers in South Africa. Linkages were successfully operationalized with mobile phones in all sero-positives and about half of the sero-negatives sought post-test counselling. Controlled trials and implementation research studies are needed before a scale-up is considered.
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影响因子：
4.4
作者：
Carballo-Dieguez, Alex;Frasca, Timothy;Balan, Ivan;Ibitoye, Mobolaji;Dolezal, Curtis
通讯作者：
Dolezal, Curtis
影响因子：
3.6
作者：
Kalichman, SC;Simbayi, LC
通讯作者：
Simbayi, LC
影响因子：
7.4
作者：
Hottes TS;Farrell J;Bondyra M;Haag D;Shoveller J;Gilbert M
通讯作者：
Gilbert M
DOI：
10.1097/01.qai.0000151079.33935.79
发表时间：
2005-08-01
影响因子：
3.6
作者：
Marks, G;Crepaz, N;Janssen, RS
通讯作者：
Janssen, RS
影响因子：
6.2
作者：
Gaydos, Charlotte A.;Hsieh, Yu-Hsiang;Rothman, Richard E.
通讯作者：
Rothman, Richard E.