Bangkok Online Testing on MSM

 描述(申请人提供)：在曼谷，艾滋病毒在男男性行为者(18至24岁)中的流行正在加速，据报道，那里的艾滋病毒发病率为每100人年8.8至12.2人，是亚洲有记录以来最高的此类发病率。在定期(至少每年一次)艾滋病毒检测中接触和保留未知或艾滋病毒阴性血清状态的YMSM，对于及时与艾滋病毒预防服务相联系，如降低风险咨询和艾滋病毒化学预防至关重要。在不知道现有的或新的艾滋病毒感染的YMSM中，有必要及时识别，以增加联系和启动抗逆转录病毒治疗和护理，以改善疾病前景，防止艾滋病毒的进一步传播。然而，结构、后勤和心理社会障碍限制了泰国男男性接触者在定期艾滋病毒检测中的吸收和留存，阻碍了针对这一人群推出急需的艾滋病毒预防和治疗服务。这项研究建议使用在线艾滋病毒检测(OHT)作为一种替代的艾滋病毒检测方式，以增加青年男性接触者在艾滋病毒预防、治疗和护理服务中的参与度、保留率和联系。这项研究建议的具体目的是1)定性地探索曼谷基督教男同性恋者中艾滋病毒检测的障碍和促进者；2)定量检查曼谷基督教男同性恋者目前对艾滋病毒检测的认知、障碍和促进者，估计可能接受艾滋病毒检测的比例，确定与获得艾滋病毒检测意愿相关的因素，并参与这一新的艾滋病毒检测模式的试点研究；以及3)使用新的艾滋病毒快速诊断抗体/基于抗原的实时自我检测和自我采集的干血点(DBS)进行集中的艾滋病毒DNA检测，以确定OHT的可接受性和可行性。将宣读快速测试的结果，以及集中测试的结果 在为期6个月的试点研究中，通过视频会议提供，随后进行讨论、测试后咨询以及与护理和治疗挂钩。特别是，将评估后勤问题、对艾滋病毒快速自我检测、星展银行自我收集和实验室检测、通过视频会议阅读或报告结果的关切，以及OHT如何帮助克服艾滋病毒检测的一些现有障碍。利用新的艾滋病毒诊断和在线技术，OHT可能是一种很有前途的战略，可以增加泰国基督教青年会与艾滋病毒预防、治疗和护理服务的接触、保留和联系。

 DESCRIPTION (provided by applicant): The HIV epidemic is accelerating among young men who have sex with men (YMSM, 18 to 24 years) in Bangkok where HIV incidence was reported to be 8.8 to 12.2 per 100 person-years, the highest such incidence documented in Asia. Engagement and retention of YMSM of unknown or HIV negative serostatus in regular (at least annual) HIV testing is essential for timely linkage to HIV prevention services, such as risk reduction counseling and HIV chemoprophylaxis. Among YMSM unaware of an existing or new HIV infection, timely identification is necessary to increase linkage and initiation of antiretrovial treatment and care to improve disease outlook and prevent onward HIV transmission. However, structural, logistical and psychosocial barriers limit the uptake and retention of Thai MSM in regular HIV testing, hindering the rollout of much needed HIV prevention and treatment services targeting this population. This study proposes the use of online HIV testing (OHT) as an alternative HIV testing modality to increase engagement, retention and linkage of YMSM in HIV prevention, treatment and care services. The specific aims of this research proposal are 1) To qualitatively explore barriers and facilitators to OHT among Bangkok YMSM; 2) To quantitatively examine current perceptions, barriers, facilitators to HIV testing among Bangkok YMSM and estimate the proportion likely to undergo OHT, identify factors associated with willingness to access OHT and to participate in a pilot study of this new HIV testing modality; and 3) To determine the acceptability and feasibility of OHT using a new HIV rapid diagnostic antibody/antigen-based self-test in real time and a self-collected dried blood spot (DBS) with centralized HIV DNA testing. Results of rapid testing will be read- and of centralized testing will be delivered by video conference, followed by discussion, post-test counseling and linkage to care and treatment, in a 6-month pilot study. Particularly, logistical issues, concerns over rapid HIV self-testing, DBS self-collection and laboratory testing, reading or reporting of results by video conferencing will be assessed, as well as how OHT may help to overcome some of the existing barriers to HIV testing. Using new HIV diagnostic and online technologies, OHT may be a promising strategy to increase engagement, retention and linkage to HIV prevention, treatment and care services among Thai YMSM.