Secondary distribution of HIV self-tests: an innovative strategy for promoting male partner testing and reducing risk

HIV自检的二次分发：促进男性伴侣检测和降低风险的创新策略

• 批准号: 9762633
• 负责人: HARSHA THIRUMURTHY
• 金额: $ 65.36万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9762633
• 关键词: AIDS prevention; Affect; Africa South of the Sahara; Awareness; Client; Clinic; Coercion; Communities; Counseling; Country; Couples; Data; Decision Making; Development; Disclosure; Effectiveness; Effectiveness of Interventions; Ensure; Environment; Face; General Population; Goals; HIV; HIV Infections; HIV risk; Health system; Human immunodeficiency virus test; Incidence; Individual; International; International AIDS; Intervention; Interview; Investments; Kenya; Knowledge; Liquid substance; Measures; Modality; Oral; Outcome; Participant; Persons; Pilot Projects; Policies; Population; Prevention; Process; Randomized; Randomized Controlled Trials; Reporting; Research; Research Methodology; Resources; Risk; Safe Sex; Safety; Sensitivity and Specificity; Services; Sex Behavior; Sexual Partners; Sexual Transmission; Social Network; Structure; Technology; Test Result; Testing; Time; Training; Unsafe Sex; Woman; antiretroviral therapy; base; comparison group; condoms; cost; cost effective; cost effectiveness; empowered; experience; falls; female sex worker; group intervention; high risk; high risk men; high risk population; high risk sexual behavior; improved; incremental cost-effectiveness; innovation; interest; male; meetings; men; novel; prevent; randomized trial; scale up; secondary outcome; sex; success; symposium; testing services; treatment arm; uptake; voucher

Project Title Secondary distribution of HIV self-tests by female sex workers: an innovative strategy for promoting male partner testing and reducing HIV risk. Project Summary/Abstract Greater uptake of HIV testing among those likely to be HIV-infected is vital for meeting the first of the UNAIDS “90-90-90” targets. However, roughly 55% of HIV-infected individuals in sub-Saharan Africa remain unaware of their serostatus, with men having lower awareness than women. While community-based HIV testing strategies have had considerable success in promoting HIV testing in the general population, there is a need for innovative HIV testing strategies that can reach key populations and high-risk individuals such as male partners of female sex workers. Interventions are also needed to promote couples testing, which can result in improved sexual decision-making, including increased condom use and increased antiretroviral therapy use to prevent sexual transmission. HIV self-testing is a promising approach that has the potential to substantially increase access to testing in a manner that is confidential and empowering for users. Data from across the globe demonstrate high interest in and acceptability of self-testing among a wide range of populations. Although HIV self-testing can be a good alternative for those not engaged in regular repeat testing, little is known about the optimal distribution strategies for facilitating self-test use by the hardest-to-reach individuals. One innovative strategy is `secondary distribution' of HIV self-tests, whereby an individual who is given multiple self-tests can distribute them to sexual partners or to others in their social network. This project will evaluate whether secondary distribution of self-tests by female sex workers in Kenya can be used to fulfill multiple HIV prevention goals, including the promotion of HIV testing among high-risk men and the facilitation of mutual disclosure of serostatus, couples testing, and safer sexual decision making. By facilitating safer sexual decision-making, secondary distribution of self-tests has the potential to reduce HIV incidence among female sex workers, a population that faces an especially high risk of HIV infection. Building on preliminary data in demonstrating that female sex workers can safely distribute oral self-tests to their sexual partners and make safer sexual behavior decisions following self-testing, we will conduct a randomized controlled trial in which female sex workers are randomized to receive multiple self-tests or a voucher to refer partners to clinic-based HIV testing. In Aim 1, we will test whether secondary distribution of self-tests by female sex workers results in greater identification of HIV-infected men and safer sexual behaviors. In Aim 2, we will conduct in-depth interviews to assess study participants' experiences distributing self-tests to their sexual partners. In Aim 3, we will determine the cost-effectiveness of secondary distribution of self-tests by female sex workers. The project will help determine whether HIV self-testing can be useful in furthering multiple HIV prevention goals. It will also provide guidance on optimal distribution strategies for self-tests as countries in sub-Saharan Africa develop HIV self-testing policies and scale-up the availability of self-tests.

项目名称 女性性工作者艾滋病毒自我检测的二次分发：促进男性性行为的创新策略 伴侣检测和降低艾滋病毒风险。 项目概要/摘要 在可能感染艾滋病毒的人群中更多地接受艾滋病毒检测对于实现联合国艾滋病规划署的第一个目标至关重要 “90-90-90”目标。然而，撒哈拉以南非洲地区大约 55% 的艾滋病毒感染者仍然不知道 他们的血清状况，男性的意识低于女性。虽然基于社区的艾滋病毒检测 战略在促进普通人群中艾滋病毒检测方面取得了相当大的成功，因此有必要 创新的艾滋病毒检测策略，可以覆盖重点人群和高危人群，例如男性 女性性工作者的伴侣。还需要采取干预措施来促进夫妻检测，这可能会导致 改善性决策，包括增加安全套的使用和增加抗逆转录病毒治疗的使用 防止性传播。 HIV 自我检测是一种很有前途的方法，有可能大大提高 以保密且授权给用户的方式增加测试的机会。数据来自各地 全球范围内的广大人群对自我测试表现出浓厚的兴趣和接受度。 尽管对于那些不定期重复检测的人来说，艾滋病毒自我检测可能是一个很好的选择，但几乎没有什么作用。 了解促进最难接触到的个人进行自测的最佳分配策略。 一项创新策略是艾滋病毒自检的“二次分发”，即向一个人提供多次检测 自我测试可以将它们分发给性伴侣或社交网络中的其他人。本项目将评估 肯尼亚女性性工作者二次分发自检是否可用于履行多重艾滋病毒检测 预防目标，包括促进高危男性中的艾滋病毒检测以及促进相互 血清状况的披露、夫妻检测和更安全的性决策。通过促进更安全的性行为 决策、二次分发自检有可能降低女性艾滋病毒感染率 性工作者是艾滋病毒感染风险特别高的人群。以初步数据为基础 证明女性性工作者可以安全地向其性伴侣分发口头自我测试，并做出 为了在自我测试后做出更安全的性行为决定，我们将进行一项随机对照试验，其中 女性性工作者被随机接受多项自我测试或一张凭证，以将伴侣转介至诊所 艾滋病毒检测。在目标 1 中，我们将测试女性性工作者二次分发自我测试是否会导致 更好地识别艾滋病毒感染者并提供更安全的性行为。在目标2中，我们将深入开展 访谈以评估研究参与者向其性伴侣分发自我测试的经历。在目标 3 中，我们 将确定女性性工作者二次分发自我测试的成本效益。项目 将有助于确定艾滋病毒自我检测是否有助于推进多项艾滋病毒预防目标。它将 还为撒哈拉以南非洲国家的自测最佳分配策略提供指导 制定艾滋病毒自检政策并扩大自检范围。