Elliot E, Rossi M, McCormack S, McOwan A
HIV/GUM directorate, Chelsea and Westminster Hospital, London, UK.
Sex Transm Infect. 2016 Sep;92(6):470-3. doi: 10.1136/sextrans-2015-052090. Epub 2016 May 24.
BACKGROUND: An estimated one in eight men who have sex with men (MSM) in London lives with HIV, of which 16% are undiagnosed. It is a public health priority to minimise time spent undiagnosed and reduce morbidity, mortality and onward HIV transmission. 'Dean Street at Home' provided an online HIV risk self-assessment and postal home HIV sampling service aimed at hard-to-reach, high-risk MSM. OBJECTIVES: This 2-year service evaluation aims to determine the HIV risk behaviour of users, the uptake of offer of home sampling and the acceptability of the service. METHODS: Users were invited to assess their HIV risk anonymously through messages or promotional banners on several gay social networking websites. Regardless of risk, they were offered a free postal HIV oral fluid or blood self-sampling kit. Reactive results were confirmed in clinic. A user survey was sent to first year respondents. RESULTS: 17 361 respondents completed the risk self-assessment. Of these, half had an 'identifiable risk' for HIV and a third was previously untested. 5696 test kits were returned. 121 individuals had a reactive sample; 82 (1.4% of returned samples) confirmed as new HIV diagnoses linked to care; 14 (0.25%) already knew their diagnosis; and 14 (0.25%) were false reactives. The median age at diagnosis was 38; median CD4 505 cells/µL and 20% were recent infections. 61/82 (78%) were confirmed on treatment at the time of writing. The post-test email survey revealed a high service acceptability rate. CONCLUSIONS: The service was the first of its kind in the UK. This evaluation provides evidence to inform the potential roll-out of further online strategies to enhance community HIV testing.
背景:据估计,伦敦每八名男男性行为者(MSM)中就有一人感染艾滋病毒,其中16%未被诊断出来。尽量缩短未被诊断的时间,降低发病率、死亡率以及艾滋病毒的进一步传播,是一项公共卫生重点工作。“迪安街居家服务”提供了一项在线艾滋病毒风险自我评估和邮寄式居家艾滋病毒采样服务,目标人群是难以接触到的高风险男男性行为者。 目的:这项为期两年的服务评估旨在确定用户的艾滋病毒风险行为、居家采样服务的接受情况以及该服务的可接受性。 方法:通过在几个同性恋社交网站上发送信息或宣传横幅,邀请用户匿名评估自己的艾滋病毒风险。无论风险如何,都向他们提供免费的邮寄式艾滋病毒口腔液或血液自我采样试剂盒。检测结果呈阳性的,在诊所进行确认。向第一年的受访者发送了用户调查问卷。 结果:17361名受访者完成了风险自我评估。其中,一半人有感染艾滋病毒的“可识别风险”,三分之一的人此前未接受过检测。共返还了5696个检测试剂盒。121人的样本检测呈阳性;82人(占返还样本的1.4%)被确诊为新感染艾滋病毒并接受治疗;14人(0.25%)已知自己感染;还有14人(0.25%)为假阳性。确诊时的中位年龄为38岁;中位CD4细胞计数为505个/微升,20%为近期感染。截至撰写本文时,61/82(78%)的确诊者已开始接受治疗。检测后电子邮件调查显示该服务的接受率很高。 结论:该服务在英国尚属首次。这项评估为进一步推广在线策略以加强社区艾滋病毒检测提供了参考依据。
J Acquir Immune Defic Syndr. 2018-3-1