Njau Bernard, Damian Damian J, Abdullahi Leila, Boulle Andrew, Mathews Catherine
School of Public Heath and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa.
Vaccines for Africa Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7925, South Africa.
Syst Rev. 2016 Apr 5;5:52. doi: 10.1186/s13643-016-0230-8.
BACKGROUND: HIV is still a global public health problem. More than 75 % of HIV-infected people are in Africa, and most of them are unaware of their HIV status, which is a barrier to accessing antiretroviral treatment. Our review aims, firstly, to determine whether HIV self-testing is an effective method to increase the uptake of testing, the yield of new HIV-positive diagnoses, and the linkage to antiretroviral treatment. Secondly, we aim to review the factors that facilitate or impede the uptake of HIV self-testing. METHODS/DESIGN: Participants will be adults living in Africa. For the first aim, the intervention will be HIV self-testing either alone or in addition to HIV testing standard of care. The comparison will be HIV testing standard of care. The primary outcomes will be (i) uptake of HIV testing and (ii) yield of new HIV-positive diagnoses. The secondary outcomes will be (a) linkage to antiretroviral (ARV) treatment and (b) incidence of social harms. For the second aim, we will review barriers and facilitators to the uptake of self-testing. We will search PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, WHOLIS, Africa Wide, and CINAHL for eligible studies from 1998, with no language limits. We will check reference lists of included studies for other eligible reports. Eligible studies will include experimental and observational studies. Two authors will independently screen the search output, select studies, and extract data, resolving discrepancies by consensus and discussion. Two authors will use Cochrane risk of bias tools for experimental studies, the Newcastle-Ottawa Quality Assessment Scale for observational studies, and the Critical Appraisal Skills Programme (CASP) quality assessment tool for qualitative studies. DISCUSSION: Innovative and cost-effective community-based HIV testing strategies, such as self-testing, will contribute to universal coverage of HIV testing in Africa. The findings from this systematic review will guide development of self-testing policy in African countries. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015023935.
背景：艾滋病病毒（HIV）仍然是一个全球性的公共卫生问题。超过75%的HIV感染者在非洲，其中大多数人并不知道自己感染了HIV，这成为他们获得抗逆转录病毒治疗的障碍。我们的综述旨在，首先，确定HIV自我检测是否是一种有效的方法，能够提高检测的接受率、新HIV阳性诊断的检出率以及与抗逆转录病毒治疗的联系。其次，我们旨在综述促进或阻碍HIV自我检测接受度的因素。 方法/设计：参与者将是生活在非洲的成年人。对于第一个目标，干预措施将是单独进行HIV自我检测，或在HIV检测标准护理之外增加自我检测。对照将是HIV检测标准护理。主要结局将是：（i）HIV检测的接受率；（ii）新HIV阳性诊断的检出率。次要结局将是：（a）与抗逆转录病毒（ARV）治疗的联系；（b）社会危害的发生率。对于第二个目标，我们将综述自我检测接受度的障碍和促进因素。我们将检索PubMed、Cochrane对照试验中心注册库、Scopus、科学引文索引、世界卫生组织图书馆信息系统、非洲全文数据库和护理学与健康领域数据库，以查找1998年以来符合条件的研究，无语言限制。我们将检查纳入研究的参考文献列表，以查找其他符合条件的报告。符合条件的研究将包括实验性和观察性研究。两位作者将独立筛选检索结果、选择研究并提取数据，通过共识和讨论解决分歧。两位作者将对实验性研究使用Cochrane偏倚风险工具，对观察性研究使用纽卡斯尔-渥太华质量评估量表，对定性研究使用批判性评估技能计划（CASP）质量评估工具。 讨论：创新且具有成本效益的基于社区的HIV检测策略，如自我检测，将有助于在非洲实现HIV检测的普遍覆盖。本系统综述的结果将指导非洲国家自我检测政策的制定。 系统综述注册：PROSPERO CRD42015023935
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