Jamil Muhammad S, Guy Rebecca J, Bavinton Benjamin R, Fairley Christopher K, Grulich Andrew E, Holt Martin, Smith Kirsty S, Chen Marcus, McNulty Anna M, Conway Damian P, Keen Phillip, Bradley Jack, Russell Darren, Kaldor John M, Prestage Garrett
The Kirby Institute, UNSW Australia, Wallace Wurth Building, Sydney, NSW 2052, Australia.
Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Vic. 3053, Australia.
Sex Health. 2017 Apr;14(2):170-178. doi: 10.1071/SH16100.
Background Regular testing of individuals at higher-risk of HIV is central to current prevention strategies. The aim of the present study was to examine the extent to which confidence in one's perceived ability to undertake various aspects of HIV testing and self-testing (self-efficacy) affected HIV testing outcomes. We assessed factors, including self-efficacy, associated with HIV testing frequency and the likelihood to self-test among gay and bisexual men (GBM).
Participants were HIV-negative GBM at an increased risk of HIV (more than five partners or condomless anal intercourse in the previous 3 months) enrolled in a randomised controlled trial of HIV self-testing. The baseline questionnaire captured data regarding sociodemographic characteristics, HIV and/or sexually transmissible infection testing history, sexual behaviour, beliefs and attitudes towards HIV and eight items capturing confidence in HIV testing ability that were combined as a single broad measure of HIV testing self-efficacy (α=0.81). Factors associated with three or more HIV tests in the past year and the likelihood of self-testing in the future were determined using logistic regression.
Of 354 GBM, 34% reported three or more HIV tests in the past year, and 64% reported being 'very likely' to self-test. Factors independently associated with three or more HIV tests in the past year were: higher self-efficacy (adjusted odds ratio (aOR) 1.08 per unit increase; 95% confidence interval (CI) 1.02-1.14; P=0.004); >10 male partners in the past 6 months (aOR 1.79; 95% CI 1.05-3.04; P=0.031) and higher optimism regarding the effects of HIV treatments on HIV transmission (aOR 1.14; 95% CI 1.00-1.29; P=0.044). Only higher self-efficacy was independently associated with reporting a greater likelihood to self-test in the future (aOR 1.10; 95% CI 1.05-1.15; P < 0.001).
Improving self-efficacy by enhancing GBM's knowledge and experience may lead to higher testing frequency. The self-efficacy measure used in the present study could be useful in identifying GBM likely to face difficulties with HIV testing and self-testing.
背景 对艾滋病毒高风险个体进行定期检测是当前预防策略的核心。本研究的目的是检验对自身进行艾滋病毒检测和自我检测（自我效能）各方面能力的信心在多大程度上会影响艾滋病毒检测结果。我们评估了包括自我效能在内的与艾滋病毒检测频率以及男同性恋者和双性恋男性（GBM）自我检测可能性相关的因素。
参与者为艾滋病毒阴性的GBM，他们感染艾滋病毒的风险增加（在过去3个月内有超过5个性伴侣或无保护肛交），参与了一项艾滋病毒自我检测的随机对照试验。基线调查问卷收集了有关社会人口学特征、艾滋病毒和/或性传播感染检测史、性行为、对艾滋病毒的信念和态度以及8项关于艾滋病毒检测能力信心的项目的数据，这些项目合并为一项对艾滋病毒检测自我效能的单一综合测量指标（α = 0.81）。使用逻辑回归确定与过去一年进行三次或更多次艾滋病毒检测以及未来自我检测可能性相关的因素。
在354名GBM中，34%报告在过去一年进行了三次或更多次艾滋病毒检测，64%报告“非常有可能”进行自我检测。与过去一年进行三次或更多次艾滋病毒检测独立相关的因素有：更高的自我效能（每单位增加调整优势比（aOR）为1.08；95%置信区间（CI）为1.02 - 1.14；P = 0.004）；在过去6个月内有超过10名男性性伴侣（aOR为1.79；95% CI为1.05 - 3.04；P = 0.031）以及对艾滋病毒治疗对艾滋病毒传播影响的更高乐观度（aOR为1.14；95% CI为1.00 - 1.29；P = 0.044）。只有更高的自我效能与报告未来自我检测可能性更大独立相关（aOR为1.10；95% CI为1.05 - 1.15；P < 0.001）。
通过增强GBM的知识和经验来提高自我效能可能会导致更高的检测频率。本研究中使用的自我效能测量指标可能有助于识别在艾滋病毒检测和自我检测方面可能面临困难的GBM。
Zotero 插件