Arguments for and against HIV self-testing.
Arguments for and against HIV self-testing.
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支持和反对艾滋病毒自我检测的论点。
DOI：
10.2147/hiv.s49083
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Stekler JD
中科院分区：
文献类型：
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作者：
Wood BR;Ballenger C;Stekler JD
大约 60% 的人类免疫缺陷病毒 (HIV) 感染者不知道自己受到感染，而耻辱和歧视继续威胁着全世界对艾滋病毒检测服务的接受度。 HIV 自我检测多年来一直引起争议，随着 2012 年美国批准在非处方药销售的即时检测检测重新引发争论。在此，我们提出支持和反对 HIV 自我检测的论点。支持艾滋病毒自我检测的案例认为： 这种方式是高度可接受的，特别是在高危人群中；自测试赋予用户权力，从而有助于规范测试；相互伴侣测试有可能提高风险意识并避免不和谐伴侣之间的无安全套性行为。反对艾滋病毒自我检测的论点包括： 成本限制了最需要检测的人；假阴性结果，尤其是在窗口期，可能会导致错误的保证，并可能促进在传染性最高时不一致的伴侣之间发生性行为；可能会错过咨询、护理和诊断其他性传播感染的机会；自我测试可能会导致合作伙伴之间存在强制行为。需要进行研究来更好地定义自检的风险，特别是随着检测性能的提高，并描述旨在改善自检套件获取的计划的好处，因为这种测试方式有许多潜在的优点和缺点。
Approximately 60% of human immunodeficiency virus (HIV)-infected individuals are unaware of their infection, and stigma and discrimination continue to threaten acceptance of HIV testing services worldwide. Self-testing for HIV has garnered controversy for years and the debate reignited with the approval of a point-of-care test for over-the-counter sale in the US in 2012. Here, we present arguments for and against HIV self-testing. The case in support of HIV self-testing contends that: the modality is highly acceptable, especially among the most at-risk individuals; self-testing empowers users, thus helping to normalize testing; and mutual partner testing has the potential to increase awareness of risk and avert condomless sex between discordant partners. Arguments against HIV self-testing include: cost limits access to those who need testing most; false-negative results, especially during the window period, may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity; opportunities for counseling, linkage to care, and diagnosis of other sexually transmitted infections may be missed; and self-testing leads to potential for coercion between partners. Research is needed to better define the risks of self-testing, especially as performance of the assays improves, and to delineate the benefits of programs designed to improve access to self-test kits, because this testing modality has numerous potential advantages and drawbacks.