Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe.
Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe.
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DOI：
10.1136/sextrans-2020-054911
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发表时间：
2022-05
影响因子：
3.6
通讯作者：
Tucker JD
中科院分区：
文献类型：
--
作者：
Sri-Pathmanathan C;Nhamo D;Mamvuto T;Chapwanya G;Terris-Prestholt F;Mahaka I;Marks M;Tucker JD
艾滋病毒和梅毒等性传播感染的自我检测可能会增强性少数群体的权能，并扩大性传播感染检测的范围。虽然对艾滋病毒自我检测了解很多，但对梅毒自我检测知之甚少，特别是在低收入环境中。本研究的目的是确定自我检测的具体环境促进因素和障碍，并评估津巴布韦男男性行为者（MSM）梅毒自我检测的可用性。这项混合方法的研究是在哈拉雷进行的，作为一个更大的梅毒自我测试试验的一部分。该研究包括深度访谈（第一阶段），随后是可用性测试和第二次访谈（第二阶段）。在梅毒自检前，对男男性行为者和主要信息提供者进行了深入访谈。然后，这些男男性接触者使用梅毒自测，定量评估其可用性，并参加第二次深度访谈。在适应性社会生态模型概念框架的指导下，使用主题方法分析了第一阶段的数据。使用快速评估程序方法对第二阶段访谈进行了分析，并使用预先建立的指数对可用性进行了评估，该指数改编自现有的hiv - st量表。招募20名男男性行为者和10名关键信息提供者进行第一阶段深度访谈，其中16名男男性行为者通过填写梅毒自检试剂盒参与第二阶段。促进自我测试的因素包括增加隐私、便利、自主和避免社会和医疗保健提供者耻辱的可能性。障碍包括对测试的恐惧以及对护理和治疗联系的不确定。可用性指数的数据表明，在接受自我测试的男性中，可用性很高（在0-100的范围内为89.6%）。津巴布韦的男男性行为者愿意使用梅毒自检试剂盒，而且许多障碍和便利条件与观察到的艾滋病毒感染类似。梅毒自检可能会增加津巴布韦和其他低收入和中等收入国家性少数群体接受梅毒检测的人数。
Self-testing for STIs such as HIV and syphilis may empower sexual minorities and expand uptake of STI testing. While much is known about HIV self-testing (HIVST), less is known about syphilis self-testing, particularly in low-income settings. The objective of this study is to determine context-specific facilitators and barriers for self-testing and to assess the usability of syphilis self-testing in Zimbabwe among men who have sex with men (MSM). This mixed methods study was conducted in Harare as part of a larger syphilis self-testing trial. The study included in-depth interviews (phase I) followed by usability testing and a second interview (phase II). In-depth interviews were conducted with MSM and key informants prior to syphilis self-testing. The same MSM then used the syphilis self-test, quantitatively assessed its usability and participated in a second in-depth interview. Phase I data were analysed using a thematic approach, guided by an adapted social ecological model conceptual framework. Phase II interviews were analysed using rapid assessment procedure methodology, and usability was assessed using a pre-established index, adapted from existing HIVST scales. Twenty MSM and 10 key informants were recruited for phase I in-depth interviews, and 16 of these MSM participated in phase II by completing a syphilis self-test kit. Facilitating factors for self-testing included the potential for increased privacy, convenience, autonomy, and avoidance of social and healthcare provider stigma. Barriers included the fear to test and uncertainty about linkage to care and treatment. Data from the Usability Index suggested high usability (89.6% on a 0–100 scale) among the men who received the self-test. MSM in Zimbabwe were willing to use syphilis self-test kits and many of the barriers and facilitators were similar to those observed for HIVST. Syphilis self-testing may increase syphilis test uptake among sexual minorities in Zimbabwe and other low-income and middle-income countries.
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影响因子：
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