Schnall Rebecca, John Rita Marie, Carballo-Dieguez Alex
Columbia University, School of Nursing, 617 W. 168th Street, New York, NY, 10032, USA.
Columbia University Medical Center, HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute, Unit 15, 1051 Riverside Drive, New York, NY, 10032, USA.
AIDS Behav. 2016 Apr;20(4):939-48. doi: 10.1007/s10461-015-1240-6.
The purpose of this study was to understand high-risk young adults' use of the rapid human immunodeficiency virus (HIV) self-test. The highest rate of new HIV infections occurs in people between 15 and 24 years. Improving identification of young people infected with HIV is a critical public health priority. The first rapid HIV self-testing kit was approved in the US in 2012. Despite the product's promise, its use by untrained young adults is not well-understood. We conducted a mixed methods study using surveys, a think-aloud protocol, observations, and in-depth interviews. A systematic checklist was developed to assess participants' use of the test. A total of 21 racial and/or ethnic minority young adults aged 18-24 participated in this study. Analysis of our interview data was guided by the theory of reasoned action (TRA). Participants completed the initial procedures of the test with a mean time of 8:36 min (range of 2:04'-16:33'). On a 14-point checklist, participants had a mean score of 10.8 (SD 2.26, range 3-14). In the qualitative analysis of the participants' interviews, guided by the theoretical constructs of the TRA, the following themes emerged: "Did I use it correctly?", "Can I trust the results?" (attitude); "How will my partner react?!", "What will people think?" (subjective norm); "Quick, easy and blood free," and "Avoids the hassle of dealing with the healthcare system" (behavioral intention). This study provided evidence of the usefulness of the test perceived by young adults, especially in light of their concerns about lack of privacy in medical settings. Since many participants did not follow all of the instructions while using the test, it is not evident that young adults can correctly use the HIV self-test. Development of instructions manuals that are understandable and guide proper use of medical devices is a great need, especially in the context of home testing technology.
本研究的目的是了解高危青年成年人对快速人类免疫缺陷病毒（HIV）自检的使用情况。新增HIV感染率最高的人群是15至24岁的人。提高对感染HIV的年轻人的识别是一项关键的公共卫生优先事项。首个快速HIV自检试剂盒于2012年在美国获批。尽管该产品前景可期，但未经培训的青年成年人对其使用情况却了解不足。我们采用了调查、出声思考法、观察和深度访谈等混合方法进行研究。制定了一份系统的检查表来评估参与者对检测的使用情况。共有21名年龄在18 - 24岁的少数种族和/或少数民族青年成年人参与了本研究。我们的访谈数据分析以理性行动理论（TRA）为指导。参与者完成检测初始程序的平均用时为8分36秒（范围为2分04秒至16分33秒）。在一份14项的检查表上，参与者的平均得分为10.8分（标准差为2.26，范围为3至14分）。在以TRA的理论架构为指导对参与者访谈进行的定性分析中，出现了以下主题：“我使用方法正确吗？”“我能相信结果吗？”（态度）；“我的伴侣会作何反应？！”“人们会怎么想？”（主观规范）；“快速、简便且无需采血”以及“避免了与医疗系统打交道的麻烦”（行为意图）。本研究提供了证据，证明青年成年人认为该检测是有用的，尤其是考虑到他们对医疗环境中缺乏隐私的担忧。由于许多参与者在使用检测时并未遵循所有说明，所以青年成年人是否能够正确使用HIV自检并不明确。非常需要编写易于理解并指导正确使用医疗设备的使用说明书，尤其是在家庭检测技术的背景下。
