HIV self-testing partially filled the HIV testing gap among men who have sex with men in China during the COVID-19 pandemic: results from an online survey.
HIV self-testing partially filled the HIV testing gap among men who have sex with men in China during the COVID-19 pandemic: results from an online survey.
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HIV 自检部分填补了 COVID-19 大流行期间中国男男性行为者的 HIV 检测缺口：一项在线调查结果
DOI：
10.1002/jia2.25737
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发表时间：
2021-05
影响因子：
6
通讯作者：
Tang W
中科院分区：
文献类型：
--
作者：
Jiang H;Xie Y;Xiong Y;Zhou Y;Lin K;Yan Y;Tucker J;Ong JJ;Wu D;Yang F;Tang W
艾滋病毒自我检测(HIVST)是在重点人群中促进艾滋病毒检测的一项有用的战略。这项研究旨在了解男男性行为者(MSM)中的艾滋病毒检测行为，特别是在中国采取2019年冠状病毒病(新冠肺炎)措施期间，在设施检测受到限制的情况下如何使用HIVST。在新冠肺炎措施放松的2020年5月至6月期间，一项在线横断面研究在中国招募男男性接触者。收集了新冠肺炎措施实施前三个月和实施期间(2020年1月23日)的社会人口学特征、性行为和艾滋病毒检测数据。统计分析采用卡方检验和Logistic回归分析。调查对象来自中国30个省135个城市，平均年龄28.8岁(SD：6.9岁)。大多数参与者自我认同为同性恋(81.9%)，并透露了他们的性取向(66.7%)。在最近三个月中，69.6%的人曾与男性发生过性关系，其中近一半的人有多个性伴侣(47.2%)。虽然新冠肺炎措施实施前和实施期间的总体艾滋病毒检测率具有可比性，但更多的男男性接触者在新冠肺炎措施期间进行了艾滋病毒自我检测(52.1%)，高于实施新冠肺炎措施前的41.6%(p=0.038)。在新冠肺炎措施期间，男男性接触者使用基于设施的艾滋病毒检测的人数(42.9%)比新冠肺炎措施前(54.1%，p=0.038)有所减少。在《新冠肺炎》实施前的138名机房测试员中，有59.4%的人在新冠肺炎期间停止了机房测试。在新冠肺炎监测期间进行自我检测的136人中，58.1%的人在新冠肺炎监测前没有进行过艾滋病病毒自我检测。多因素Logistic回归分析显示，最近3个月与其他男性发生性关系(调整后优势比，AOR=0.2.04，95%CI：1.38~3.03)、自我认同为同性恋(AOR=2.03，95%CI：1.31~3.13)、曾公开自己的性取向(AOR=61.72，95%CI：1.19~2.50)、在新冠肺炎措施实施前3个月内检测过艾滋病病毒(AOR=94.74，95%CI：3.35~6.70)与新冠肺炎期间的艾滋病检测有关。在中国开展新冠肺炎工作期间，男男性接触者中艾滋病病毒检测减少，性病传播活动增加。MSM成功地获得了HIVST，作为基于设施的检测的替代品，艾滋病毒检测率总体上没有下降。
HIV self‐testing (HIVST) is a useful strategy to promote HIV testing among key populations. This study aimed to understand HIV testing behaviours among men who have sex with men (MSM) and specifically how HIVST was used during the coronavirus disease 2019 (COVID‐19) measures in China when access to facility‐based testing was limited. An online cross‐sectional study was conducted to recruit men who have sex with men (MSM) in China from May to June of 2020, a period when COVID‐19 measures were easing. Data on socio‐demographic characteristics, sexual behaviours and HIV testing in the three months before and during COVID‐19 measures (23 January 2020) were collected. Chi‐square test and logistic regression were used for analyses. Overall, 685 MSM were recruited from 135 cities in 30 provinces of China, whose mean age was 28.8 (SD: 6.9) years old. The majority of participants self‐identified as gay (81.9%) and had disclosed their sexual orientation (66.7%). In the last three months, 69.6% ever had sex with men, nearly half of whom had multiple sexual partners (47.2%). Although the overall HIV testing rates before and during COVID‐19 measures were comparable, more MSM self‐tested for HIV during COVID‐19 measures (52.1%) compared to before COVID‐19 measures (41.6%, p = 0.038). Fewer MSM used facility‐based HIV testing during COVID‐19 measures (42.9%) compared to before COVID‐19 measures (54.1%, p = 0.038). Among 138 facility‐based testers before COVID‐19 measures, 59.4% stopped facility‐based testing during COVID‐19 measures. Among 136 self‐testers during COVID‐19 measures, 58.1% had no HIV self‐testing before COVID‐19 measures. Multivariable logistic regression showed that having sex with other men in the last three months (adjusted odds ratio, aOR = 2.04, 95% CI: 1.38 to 3.03), self‐identifying as gay (aOR = 2.03, 95% CI: 1.31 to 3.13), ever disclosing their sexual orientation (aOR = 1.72, 95% CI: 1.19 to 2.50) and tested for HIV in three months before COVID‐19 measures (aOR = 4.74, 95% CI: 3.35 to 6.70) were associated with HIV testing during COVID‐19 measures. Facility‐based HIV testing decreased and HIVST increased among MSM during COVID‐19 measures in China. MSM successfully accessed HIVST as substitute for facility‐based testing, with no overall decrease in HIV testing rates.
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