Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study
Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study
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DOI：
10.1371/journal.pone.0170868
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发表时间：
2017-01-26
期刊：
影响因子：
3.7
通讯作者：
Sanders, Eduard J.
中科院分区：
文献类型：
--
作者：
Mugo, Peter M.;Micheni, Murugi;Sanders, Eduard J.
虽然艾滋病毒检测和咨询是治疗作为预防的一个关键切入点，但肯尼亚超过一半的艾滋病毒感染成年人不知道他们已被感染。在社区药店提供艾滋病毒自我检测（HST）可以提高未确诊感染的检测。我们评估了基于药店的HST在沿海Kenya.MethodsStaff的可行性，在五个药店，现场研究助理的支持下，招募成年客户（>= 18岁）寻求服务的艾滋病毒风险的指示。向参加者提供口服HST试剂盒（OraQuick（R）），每次测试1美元。在购买测试后的一周内，参与者被联系进行测试后数据收集和咨询。主要结果是测试吸收率，定义为购买测试的受邀客户的比例。在反馈会议期间和之后的study.ResultsBetween 2015年11月和2016年4月，463名客户被邀请参加; 174（38%）被招募;和161（35% [95%置信区间（CI）31-39%]）买了一个测试。与寻求其他服务的人相比，寻求艾滋病毒检测的客户的接受率更高（84%对11%，调整后的风险比6.9 [95% CI 4.9-9.8]）。只有4%的非测试者（11/302）表示，无力支付的原因，他们没有采取的测试。除一名测试人员外，所有测试人员都报告该过程很容易（29%）或非常容易（70%）。HST试剂盒的需求持续后，研究和参与的服务提供商表示有兴趣继续提供service.ConclusionsPharmacy HST在肯尼亚是可行的，可能是在高需求。观察到的吸收模式表明，与药房发起的检测相比，客户发起的方法更可行。如果将价格定在每项测试1美元左右，就不太可能成为障碍。需要进一步开展实施研究，以评估更大规模的吸收、产出和与护理的联系。
BackgroundWhile HIV testing and counselling is a key entry point for treatment as prevention, over half of HIV-infected adults in Kenya are unaware they are infected. Offering HIV self-testing (HST) at community pharmacies may enhance detection of undiagnosed infections. We assessed the feasibility of pharmacy-based HST in Coastal Kenya.MethodsStaff at five pharmacies, supported by on-site research assistants, recruited adult clients (>= 18 years) seeking services indicative of HIV risk. Participants were offered oral HST kits (OraQuick (R)) at US$ 1 per test. Within one week of buying a test, participants were contacted for post-test data collection and counselling. The primary outcome was test uptake, defined as the proportion of invited clients who bought tests. Views of participating pharmacy staff were solicited in feedback sessions during and after the study.ResultsBetween November 2015 and April 2016, 463 clients were invited to participate; 174 (38%) were enrolled; and 161 (35% [95% Confidence Interval (CI) 31-39%]) bought a test. Uptake was higher among clients seeking HIV testing compared to those seeking other services (84% vs. 11%, adjusted risk ratio 6.9 [95% CI 4.9-9.8]). Only4% of non-testers (11/302) stated inability to pay as the reason they did not take up the test. All but one tester reported the process was easy (29%) or very easy (70%). Demand for HST kits persisted after the study and participating service providers expressed interest in continuing to offer the service.ConclusionsPharmacy HST is feasible in Kenya and may be in high demand. The uptake pattern observed suggests that a client-initiated approach is more feasible compared to pharmacy-initiated testing. Price is unlikely to be a barrier if set at about US$ 1 per test. Further implementation research is required to assess uptake, yield, and linkage to care on a larger scale.