Assessing the acceptability, feasibility, and a potential distribution model of HIV oral self-testing (HST) among men who have sex with men (MSM) in Lagos, Nigeria

评估尼日利亚拉各斯男男性行为者 (MSM) 中 HIV 口腔自检 (HST) 的可接受性、可行性和潜在分布模型

• 批准号: 9261476
• 负责人: ADEKEMI SEKONI
• 金额: $ 10.29万
• 依托单位: POPULATION COUNCIL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-15 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9261476
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adult; Affect; Africa; Behavioral; Caring; Cities; Collaborations; Communities; Counseling; Department of Defense; Discrimination; Early treatment; Ensure; Environment; Face; Focus Groups; Funding; Goals; Guidelines; HIV; HIV Seropositivity; HIV diagnosis; High Prevalence; Homophobia; Human Rights Abuses; Human immunodeficiency virus test; Influentials; Institution; Instruction; Intervention; Interview; Link; Measures; Modeling; Nigeria; Nigerian; Outcome; Participant; Persons; Policies; Policy Maker; Population; Prevalence; Preventive Intervention; Research Activity; SERPINI2 gene; Safety; Sampling; Services; Sexual Partners; Social Network; Stigmatization; Subgroup; Surveys; Test Result; Testing; Time; United States National Institutes of Health; Universities; Ursidae Family; Viral; care seeking; cohort; evidence base; experience; follow-up; high risk population; implementation science; improved; innovation; interest; learning materials; male; member; men who have sex with men; men' s group; oral HIV; outreach; peer; post intervention; programs; public health relevance; response; service utilization; social; social stigma; success; uptake; willingness

 DESCRIPTION (provided by applicant): The Population Council and University of Lagos propose to conduct a feasibility and acceptability study of HIV self-testing (HST) among men who have sex with men (MSM) in Lagos, Nigeria. MSM in Nigeria bear a disproportionately high burden of HIV (17%) and face high levels of stigma, discrimination, and criminalization. In such a hostile and homophobic environment where human rights abuses are rife, MSM have poor access to HIV prevention, care and treatment services, including HIV testing and counselling (HTC). In addition, 55% of Nigerian MSM and 62% of MSM in Lagos have never tested for HIV, suggesting that many HIV-positive MSM are not linked to care and treatment. The goal of this study is to address a critical barrier to MSM accessing HIV testing and treatment by testing the acceptability, feasibility, and a potential peer-driven distribution model of HST among MSM in Nigeria. The aims of this proposal are: 1) To investigate the acceptability, feasibility, and operational aspects of an HST distribution through the use of key opinion leaders (KOLs; or MSM peer educators) in Lagos, Nigeria; and 2) To examine real-world distribution feasibility, product uptake and utilization, and linkages to post-test counselling and treatment by implementing a distribution model wherein KOLs are deployed to distribute HST kits to MSM in their social networks. Outcomes of interest are uptake of HST, use of HST by sex partners, and linkage to post-test counselling and treatment. To meet Aim 1, in-depth interviews (IDI) with MSM and focus group discussions (FGD) with KOLs will be conducted to understand how MSM perceive HST, assess willingness to use and potential barriers to uptake of HST, and identify operational and contextual issues that might affect the demonstration, distribution, and utilization of HST kits among MSM. Observations of a small sample of MSM conducting HIV self-testing on will also be conducted to assess accurate use of the product, and revise product instructions accordingly. To meet Aim 2, a quantitative survey with a cohort of HIV negative or unknown status MSM (N=300) who are reached by KOLs will be conducted. Follow-up interviews will be conducted after three months to allow for sufficient time for those who test positive to seek care and treatment. IDIs with a subsample of the cohort will be conducted post-intervention to assess acceptability, ease of and barriers to use, unintended consequences, reasons for use or non-use, and facilitators of and barriers to linkages to care and treatment. FGDs with KOLs will also be conducted at endline to assess operational aspects and challenges to HST kit distribution. The proposed study builds on Population Council's existing PEPFAR-funded (Department of Defense) service delivery program that has successfully been using KOLs to deliver important HIV services to MSM in Lagos. The study will provide critical information on how self-testing can be offered to a high-risk group with low rates of HIV testing. It will also bridge evidence gaps and facilitate policy changes to include HST into national HIV testing guidelines.

 描述（申请人提供）：人口理事会和拉各斯大学提议在尼日利亚的拉各斯对男男性行为者（MSM）进行艾滋病毒自我检测（HST）的可行性和可接受性研究。尼日利亚的男男性行为者（MSM）感染艾滋病毒的比例高得不成比例（17%），并面临严重的耻辱、歧视和刑事定罪。在这种充满敌意和仇视同性恋的环境中，侵犯人权的行为比比皆是，男男性行为者很难获得艾滋病毒预防、护理和治疗服务，包括艾滋病毒检测和咨询（HTC）。此外，55%的尼日利亚男男性行为者和62%的拉各斯男男性行为者从未进行过艾滋病毒检测，这表明许多艾滋病毒阳性的男男性行为者与护理和治疗无关。本研究的目的是解决一个关键的障碍，男男性接触者获得艾滋病毒检测和治疗的可接受性，可行性，并在尼日利亚的男男性接触者之间的HST潜在的同伴驱动的分布模式。本建议的目的是：1）通过使用关键意见领袖来调查HST分发的可接受性，可行性和操作方面（KOL;或MSM同伴教育者）在拉各斯，尼日利亚;和2）检查现实世界的分销可行性，产品吸收和利用，以及通过实施分配模式与检测后咨询和治疗挂钩，在分配模式中，部署KOL在其社交网络中向男男性行为者分发HST工具包。感兴趣的结果是HST的吸收，HST的性伴侣的使用，以及与检测后咨询和治疗的联系。为了实现目标1，深入访谈（IDI）与男男性接触者和焦点小组讨论（FGD）与KOL将进行了解如何男男性接触者认为HST，评估使用意愿和潜在的障碍，以摄取HST，并确定操作和上下文的问题，可能会影响示范，分配，和利用HST套件中男男性接触者。此外，亦会对一小部分进行爱滋病病毒自我测试的男男性接触者进行观察，以评估产品的正确使用，并相应修订产品说明。为了满足目标2，将对KOL接触的HIV阴性或未知状态MSM（N=300）队列进行定量调查。三个月后将进行后续面谈，以便让检测呈阳性的人有足够的时间寻求护理和治疗。将在干预后对队列的子样本进行IDI，以评估可接受性、易用性和使用障碍、非预期后果、使用或不使用的原因以及与护理和治疗联系的促进因素和障碍。还将在终端进行KOL的FGD，以评估HST试剂盒分发的操作方面和挑战。拟议的研究建立在人口理事会现有的PEPFAR资助的（国防部）服务提供计划的基础上，该计划已成功地使用KOL向拉各斯的MSM提供重要的艾滋病毒服务。这项研究将提供关键信息，说明如何向艾滋病毒检测率低的高危群体提供自我检测。它还将弥合证据差距，促进政策变化，将HST纳入国家艾滋病毒检测指南。

项目成果

Operationalizing the distribution of oral HIV self-testing kits to men who have sex with men (MSM) in a highly homophobic environment: the Nigerian experience.

• DOI: 10.1186/s12889-021-12378-0
• 发表时间: 2022-01-06
• 期刊: BMC public health
• 影响因子: 4.5
• 作者: Sekoni A;Tun W;Dirisu O;Ladi-Akinyemi T;Shoyemi E;Adebajo S;Ogunsola F;Vu L
• 通讯作者: Vu L