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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

基本信息

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
项目类别：
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

项目摘要

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.

项目标题