Self-Conducted HIV Tests - Improving HIV Prevention in Key Populations

自行进行艾滋病毒检测——改善重点人群的艾滋病毒预防

• 批准号: 9282847
• 负责人: Sheri Ann Lippman
• 金额: $ 9.05万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9282847
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adoption; Africa South of the Sahara; African; Attitude; Behavior; Behavioral; Blood; Caring; Clinic; Communities; Controlled Environment; Counseling; Country; Data; Decision Making; Detection; Discrimination; Early Diagnosis; Enrollment; Ensure; Epidemic; Ethnography; Fingers; Frequencies; Fright; General Population; Government; Government Programs; HIV; HIV Infections; HIV Seropositivity; Health Personnel; High Prevalence; Human immunodeficiency virus test; Individual; Infection; Intervention; Life; Light; Liquid substance; Oral; Pattern; Persons; Pharmacy facility; Phase; Pilot Projects; Population; Prevalence; Prevention; Prevention program; Prevention strategy; Province; Recruitment Activity; Research; Risk; Risk Behaviors; Risk Reduction; Safe Sex; Services; Sexual Transmission; South Africa; South African; Stigmatization; Surveys; Test Result; Testing; United States National Institutes of Health; base; burden of illness; cohort; condoms; experience; falls; follow-up; high risk; high risk sexual behavior; improved; men; men who have sex with men; preference; programs; public health relevance; sex; sex risk; social stigma; surveillance data; treatment program; uptake

DESCRIPTION (provided by applicant): HIV testing can decrease risky sexual behavior among HIV-positive men who have sex with men (MSM) and provide a gateway into HIV/AIDS care and treatment. MSM in South Africa, however, do not currently utilize clinic-based HIV testing at a rate commensurate with their risk and too few know their status. In South Africa programs have largely failed to engage Men who have Sex with Men (MSM): a population with an extremely high burden of disease and high rates undiagnosed HIV infections. Recent bio-behavioral surveillance data undertaken by this investigative team in Mpumalanga Province demonstrated prevalence among MSM at above 30%, with 54% of HIV positive MSM unaware of their status prior to survey participation. Urgently needed strategies to expand HIV testing among MSM in South Africa may include new HIV self-testing kits that offer an alternative to clinic-based testing. Self-tests expand testing beyond the clinic, which is of particular significance for MSM and other key populations who require more frequent testing and are less comfortable accessing clinic services. While self-conducted HIV tests could expand the package of testing options in South Africa, thus facilitating earlier HIV detection and treatment, there isa lack of information regarding acceptability, feasibility, or potential behavioral impacts of introducing the HIV self-test among African MSM. To address this gap, we propose to determine the acceptability (Aim 1), the feasibility (Aim 2) and the behavioral impacts (aim 3) of HIV self-testing among South African MSM currently enrolled in NIH-sponsored cohorts (R01AI092892, Lane). We will explore whether self-testing will be used by South African MSM; how, when, where, what kind, and with whom self-tests are utilized; how sexual risk behaviors may be modified by introducing self-test kits into this community; and strategies to ensure linkage to care following self-testing in this underserved and high risk population. We will achieve these aims by first conducting a pre-pilot study to explore initial acceptability of both blood-based and oral fluid self-tests and to understand what is necessary to ensure safe and correct usage of both self-tests in a controlled environment. We will then conduct a pilot study, where we will distribute self-testing kits to HIV-negative MSM and follow their use over the course of 6 months. We will implement this study among MSM participating in cohorts recruited from the high prevalence Gert Sibande and Ehlanzeni districts. This proposal offers a unique opportunity to explore self-testing among MSM within established NIH-supported cohorts where a productive research partnership is already underway. The proposed research will provide information critical to understanding how self-tests would fit into a package of expanded testing options for high risk communities experiencing barriers to clinic-based testing and support future research to determine whether introduction of self-testing can improve early detection and entry to care and facilitate safer sexual behaviors, thus leading to prevention gains.

描述（由申请人提供）：艾滋病毒检测可以减少艾滋病毒阳性男性（男男性行为者）的危险性行为，并提供艾滋病毒/艾滋病护理和治疗的途径。然而，南非的男男性行为者目前没有按照与其风险相称的比率利用基于诊所的艾滋病毒检测，而且很少有人知道他们的状况。在南非，项目在很大程度上未能吸引男男性行为者（MSM）：这一人群的疾病负担极高，未确诊的艾滋病毒感染率也很高。该调查小组最近在姆普马兰加省进行的生物行为监测数据表明，男男性行为者的感染率超过30%，54%的艾滋病毒阳性男男性行为者在参加调查前不知道自己的状况。在南非的男男性行为者中扩大艾滋病毒检测的迫切需要的战略可能包括新的艾滋病毒自我检测试剂盒，以提供一种替代诊所检测的方法。自我检测将检测扩展到诊所之外，这对男同性恋者和其他需要更频繁检测且不太愿意接受诊所服务的关键人群具有特别重要的意义。虽然自我进行的艾滋病毒检测可以扩大南非的一揽子检测选择，从而促进艾滋病毒的早期检测和治疗，但缺乏关于在非洲男男性行为者中引入艾滋病毒自我检测的可接受性、可行性或潜在行为影响的信息。为了解决这一差距，我们建议确定目前在美国国立卫生研究院资助的队列（R01AI092892, Lane）中注册的南非男同性恋者艾滋病毒自我检测的可接受性（目标1）、可行性（目标2）和行为影响（目标3）。我们将探讨南非男同性恋者是否会使用自我检测；如何、何时、何地、以何种方式以及与谁一起进行自我测试；如何通过向该社区引入自我检测试剂盒来改变性风险行为；以及确保在这些服务不足和高风险人群中进行自我检测后与护理联系的战略。为了实现这些目标，我们将首先进行一项预试点研究，探讨血液和血液检测的初步可接受性

项目成果

Increases in HIV status disclosure and sexual communication between South African men who have sex with men and their partners following use of HIV self-testing kits.

• DOI: 10.1080/09540121.2020.1828564
• 发表时间: 2021-10
• 期刊: AIDS care
• 影响因子: 1.7
• 作者: Chen YH;Gilmore HJ;Maleke K;Lane T;Zuma N;Radebe O;Manyuchi AE;McIntyre JA;Lippman SA
• 通讯作者: Lippman SA