Internet-Based HIV Self-Testing Among Men Who Have Sex With Men Through Pre-exposure Prophylaxis: 3-Month Prospective Cohort Analysis From China (Preprint)-猫眼课题宝

DOI：

10.2196/preprints.23978

发表时间：

2020-09

期刊：

AIDS

影响因子：

3.8

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

Jing Zhang;J. Tucker;W. Tang;Hongyi Wang;Zhenxing Chu;Q. Hu;Xiaojie Huang;Yaokai Chen;Hui Wang;Xiaoqing He;Yao Li;Lukun Zhang;Zhili Hu;R. Bao;Shangcao Li;Hang Li;Haibo Ding;Yongjun Jiang;W. Geng;Junjie Xu;H. Shang

背景：常规艾滋病毒检测伴随暴露前预防（PrEP）需要在现实环境中提供创新支持。目的：在2018年至2019年的一项观察性研究中，旨在确定中国使用PrEP的男男性接触者（MSM）中艾滋病毒自我检测（HIV）试剂盒的使用情况及其向伴侣的二次分发情况。方法在中国4个主要城市，我们对参与中国真实世界口服PrEP示范研究的男男性接触者进行前瞻性随访，该研究每天或按需提供PrEP 12个月，并在季度随访中评估hiv的使用情况和二次分布情况。一半的PrEP使用者被随机分配每月接受2次艾滋病毒治疗，并每季度进行一次基于设施的艾滋病毒检测。我们评估了向PrEP使用者提供艾滋病毒传播的可行性。结果共招募939名男男性接触者，随机471名接受hiv - st治疗，其中每日接受hiv - st治疗的235名（49.9%），按需接受hiv - st治疗的236名（50.1%）。在基线时，中位年龄为29岁，390名（82.0%）男性至少受过大学教育，119名（25.3%）从未接受过基于设施的艾滋病毒检测。在开始使用PrEP 3个月后，341名（74.5%）男性使用了提供给他们的hiv - st，并发现它非常容易使用。其中，341名男性中有180名（52.8%）向其他男男性行为者分发了艾滋病毒检测试剂盒，256名返回艾滋病毒检测结果的男性中有132名（51.6%）报告在性交开始时与性伴侣使用了艾滋病毒检测试剂盒。每日PrEP的参与者比按需PrEP的参与者更有可能使用hiv - st（校正风险比=1.3,95% CI 1.0-1.6）和分发hiv - st试剂盒（校正风险比=1.3,95% CI 1.1-1.7）。结论使用PrEP的男男性接触者hiv - st试剂盒的使用率和二次分发率较高，特别是在每日PrEP的人群中，这表明PrEP开始后进行hiv - st的可行性和必要性较高。假设第四代艾滋病毒检测试剂盒可用，艾滋病毒检测可能在一定程度上取代基于设施的艾滋病毒检测。中国临床试验注册中心ChiCTR1800020374；https://www.chictr.org.cn/showprojen.aspx?proj=32481国际注册报告RR2-10.1136/bmjopen-2019-036231

BACKGROUND Routine HIV testing accompanied with pre-exposure prophylaxis (PrEP) requires innovative support in a real-world setting. OBJECTIVE This study aimed to determine the usage of HIV self-testing (HIVST) kits and their secondary distribution to partners among men who have sex with men (MSM) in China, who use PrEP, in an observational study between 2018 and 2019. METHODS In 4 major cities in China, we prospectively followed-up MSM from the China Real-world oral PrEP demonstration study, which provides daily or on-demand PrEP for 12 months, to assess the usage and secondary distribution of HIVST on quarterly follow-ups. Half of the PrEP users were randomized to receive 2 HIVSTs per month in addition to quarterly facility-based HIV testing. We evaluated the feasibility of providing HIVST to PrEP users. RESULTS We recruited 939 MSM and randomized 471 to receive HIVST, among whom 235 (49.9%) were daily and 236 (50.1%) were on-demand PrEP users. At baseline, the median age was 29 years, 390 (82.0%) men had at least college-level education, and 119 (25.3%) had never undergone facility-based HIV testing before. Three months after PrEP initiation, 341 (74.5%) men had used the HIVST provided to them and found it very easy to use. Among them, 180 of 341 (52.8%) men had distributed the HIVST kits it to other MSM, and 132 (51.6%) among the 256 men who returned HIVST results reported that used it with their sexual partners at the onset of intercourse. Participants on daily PrEP were more likely to use HIVST (adjusted hazard ratio=1.3, 95% CI 1.0-1.6) and distribute HIVST kits (adjusted hazard ratio=1.3, 95% CI 1.1-1.7) than those using on-demand PrEP. CONCLUSIONS MSM who used PrEP had a high rate of usage and secondary distribution of HIVST kits, especially among those on daily PrEP, which suggested high feasibility and necessity for HIVST after PrEP initiation. Assuming that fourth-generation HIVST kits are available, HIVST may be able to replace facility-based HIV testing to a certain extent. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1800020374; https://www.chictr.org.cn/showprojen.aspx?proj=32481 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-036231

Internet-Based HIV Self-Testing Among Men Who Have Sex With Men Through Pre-exposure Prophylaxis: 3-Month Prospective Cohort Analysis From China (Preprint)

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