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。尼日利亚男男性接触者的艾滋病毒负担高得不成比例(17%)，并面临高度的污名、歧视和刑事化。在这样一个充满敌意和仇视同性恋的环境中，侵犯人权行为比比皆是，男男性接触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，拉各斯55%的尼日利亚MSM和62%的MSM从未进行过艾滋病毒检测，这表明许多HIV阳性的MSM与护理和治疗无关。这项研究的目标是通过测试尼日利亚男男性行为者中HST的可接受性、可行性和潜在的同行驱动的分配模式，来解决MSM获得艾滋病毒检测和治疗的关键障碍。这项建议的目的是：1)通过使用尼日利亚拉各斯的关键意见领袖(KOL；或MSM同伴教育者)，调查HST分发的可接受性、可行性和可操作性；2)通过实施分发模式，通过部署KOL向MSM社交网络中的MSM分发HST试剂盒，检查现实世界分发的可行性、产品的吸收和利用以及与检测后咨询和治疗的联系。令人感兴趣的结果是HST的摄取，性伴侣使用HST，以及与检测后咨询和治疗的联系。为实现目标1，将与男男性接触者进行深入访谈(IDI)，并与KOL进行焦点小组讨论(FGD)，以了解男男性接触者如何看待HST，评估使用HST的意愿和潜在的接受HST的障碍，并确定可能影响在MSM中示范、分发和使用HST试剂盒的操作和背景问题。还将对进行艾滋病毒自我检测的一小部分男男性接触者进行观察，以评估该产品的准确使用情况，并相应地修改产品说明。为了实现目标2，将对KOL联系到的艾滋病毒阴性或未知状态的男男性行为者(N=300)进行定量调查。三个月后将进行后续面谈，以便测试呈阳性反应的患者有足够的时间寻求护理和治疗。将在干预后进行具有分组样本的IDIS，以评估可接受性、使用的难易程度和障碍、意外后果、使用或不使用的原因，以及护理和治疗联系的促进者和障碍。还将在终点线上进行具有KOL的FGD，以评估HST试剂盒分发的操作方面和挑战。这项拟议的研究建立在人口理事会现有的由PEPFAR资助的(国防部)服务交付计划的基础上，该计划一直成功地使用KOL向拉各斯的MSM提供重要的艾滋病毒服务。这项研究将提供关于如何向艾滋病毒检测率低的高危群体提供自我检测的关键信息。它还将弥合证据差距，并促进政策变化，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