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（由适用提供）：人口委员会和拉各斯大学提案，以对尼日利亚拉各斯发生性关系的男性（MSM）进行艾滋病毒自我测试（HST）的可行性和可接受性研究。尼日利亚的MSM承担着艾滋病毒的高负担（17％），面临高水平的污名，歧视和定罪。在这样一个敌对和同性恋侵犯人权侵害的环境中，MSM无法获得预防艾滋病毒，护理和治疗服务，包括艾滋病毒测试和咨询（HTC）。此外，拉各斯中有55％的尼日利亚MSM和62％的MSM从未对HIV进行测试，这表明许多HIV阳性MSM与护理和治疗无关。这项研究的目的是通过测试尼日利亚MSM中HST的可接受性，可行性和潜在的同行驱动分配模型来解决MSM访问HIV测试和治疗的关键障碍。该提案的目的是：1）通过使用尼日利亚拉各斯的主要意见领导者（KOLS； KOLS； KOLS； KOLS； KOLS； KOLS； KOLS； KOLS； KOLS； KOLS； MSM同伴教育者）来调查HST分配的可接受性，可行性和运营方面； 2）通过实施分配模型，在其社交网络中部署了HST套件，以检查现实世界的可行性，产品吸收和利用以及与测试后咨询和治疗的联系。感兴趣的结果是HST的吸收，性伴侣使用HST以及与测试后咨询和治疗的联系。为了满足目标1，将对MSM和焦点小组讨论（FGD）进行深入的访谈（IDI），以了解MSM如何感知HST，评估意愿以及潜在的使用HST的障碍，并识别可能影响HST HST KITS中HST的表现，分配和利用的操作和上下文问题。还将对进行HIV自我测试的一小部分MSM样本进行观察，以评估对产品的准确使用，并相应地修改产品指令。为了满足AIM 2，将进行与KOL达到的艾滋病毒阴性或未知状态MSM（n = 300）的定量调查。在干预后，将对同队的子样本进行后续访谈，以评估可接受性，易用性和使用障碍，意外后果，使用或不使用的原因，以及与护理和治疗联系的障碍和障碍。具有KOLS的FGD还将在评估运营方面和HST套件分布的挑战时进行。拟议的研究基于人口委员会现有的PEPFAR资助（国防部）服务提供计划，该计划已成功地使用KOLS向拉各斯的MSM提供重要的HIV服务。这项研究将提供有关如何向具有较低艾滋病毒测试率的高风险群体提供自我测试的关键信息。它还将弥合证据差距，并促进政策变更，将HST纳入国家艾滋病毒测试指南中。

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