Does community-based distribution of HIV self-tests increase uptake of HIV testing? Results of pair-matched cluster randomised trial in Zambia.
Does community-based distribution of HIV self-tests increase uptake of HIV testing? Results of pair-matched cluster randomised trial in Zambia.
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DOI：
10.1136/bmjgh-2020-004543
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发表时间：
2021-07
影响因子：
8.1
通讯作者：
Ayles H
中科院分区：
文献类型：
--
作者：
Neuman M;Hensen B;Mwinga A;Chintu N;Fielding KL;Handima N;Hatzold K;Johnson C;Mulubwa C;Nalubamba M;Otte Im Kampe E;Simwinga M;Smith G;Tsamwa D;Corbett EL;Ayles H
到2030年消除艾滋病毒是全球优先事项。要实现这一目标，就需要采取其他艾滋病毒检测战略，如艾滋病毒自我检测（HIVST），以覆盖所有接受艾滋病毒检测服务（HTS）的个人。我们提出了一项试验的结果，评估以社区为基础的分布在社区和设施环境中的艾滋病毒/艾滋病的影响，在农村和城市赞比亚的HTS的吸收。配对整群随机试验。2016-2017年，OraQuick HIVST试剂盒由社区分销商（CBD）在政府卫生设施的集水区分发了12个月。在匹配的配对中，随机分组接受HIVST干预或标准治疗（SOC）。年龄≥16岁的个体有资格接受HIVST。在社区内，CBD在交通繁忙的地区提供HIVST，挨家挨户和医疗保健设施。主要结果是使用基于人群的调查测量的过去12个月内自我报告的最近测试。在六个干预组群（人口148 541）中，60个社区发展中心分发了65 585个艾滋病毒/艾滋病防治工具包。干预组中66%（1622/2465）的患者报告了近期检查，SOC组中60%（1456/2429）的患者报告了近期检查（调整后风险比1.08，95% CI 0.94 - 1.24; p=0.15）。艾滋病毒/艾滋病防治干预措施的接受率很低：干预组中24%的受访者（585/2493）在过去12个月内使用了艾滋病毒/艾滋病防治工具包。实施过程中未发现社会危害。尽管分发了大量的HIVST试剂盒，但我们没有发现任何证据表明这种以社区为基础的HIVST分发干预措施增加了HTS的摄入。艾滋病毒/艾滋病传播的其他模式，包括二级传播和社区设计的传播模式，提供了接触目标人群的替代战略。ClinicalTrials.gov注册表（NCT 02793804）。
Ending HIV by 2030 is a global priority. Achieving this requires alternative HIV testing strategies, such as HIV self-testing (HIVST) to reach all individuals with HIV testing services (HTS). We present the results of a trial evaluating the impact of community-based distribution of HIVST in community and facility settings on the uptake of HTS in rural and urban Zambia. Pair-matched cluster randomised trial. In catchment areas of government health facilities, OraQuick HIVST kits were distributed by community-based distributors (CBDs) over 12 months in 2016–2017. Within matched pairs, clusters were randomised to receive the HIVST intervention or standard of care (SOC). Individuals aged ≥16 years were eligible for HIVST. Within communities, CBDs offered HIVST in high traffic areas, door to door and at healthcare facilities. The primary outcome was self-reported recent testing within the previous 12 months measured using a population-based survey. In six intervention clusters (population 148 541), 60 CBDs distributed 65 585 HIVST kits. A recent test was reported by 66% (1622/2465) in the intervention arm compared with 60% (1456/2429) in SOC arm (adjusted risk ratio 1.08, 95% CI 0.94 to 1.24; p=0.15). Uptake of the HIVST intervention was low: 24% of respondents in the intervention arm (585/2493) used an HIVST kit in the previous 12 months. No social harms were identified during implementation. Despite distributing a large number of HIVST kits, we found no evidence that this community-based HIVST distribution intervention increased HTS uptake. Other models of HIVST distribution, including secondary distribution and community-designed distribution models, provide alternative strategies to reach target populations. ClinicalTrials.gov Registry (NCT02793804).
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1136/bmj.h1258
发表时间：
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期刊：
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DOI：
10.1097/qai.0000000000001601
发表时间：
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影响因子：
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DOI：
10.1177/1557988318777674
发表时间：
2018-09
期刊：
American journal of men's health
影响因子：
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通讯作者：
Kajula L