Maman Suzanne, Murray Katherine R, Napierala Mavedzenge Sue, Oluoch Lennah, Sijenje Florence, Agot Kawango, Thirumurthy Harsha
University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, North Carolina, United States of America.
FHI360, Durham, North Carolina, United States of America.
PLoS One. 2017 Mar 27;12(3):e0174629. doi: 10.1371/journal.pone.0174629. eCollection 2017.
Promoting awareness of serostatus and frequent HIV testing is especially important among high risk populations such as female sex workers (FSW) and their sexual partners. HIV self-testing is an approach that is gaining ground in sub-Saharan Africa as a strategy to increase knowledge of HIV status and promote safer sexual decisions. However, little is known about self-test distribution strategies that are optimal for increasing testing access among hard-to-reach and high risk individuals. We conducted a qualitative study with 18 FSW who participated in a larger study that provided them with five oral fluid-based self-tests, training on how to use the tests, and encouragement to offer the self-tests to their sexual partners using their discretion. Women demonstrated agency in the strategies they used to introduce self-tests to their partners and to avoid conflict with partners. They carefully considered with whom to share self-tests, often assessing the possibility for negative reactions from partners as part of their decision making process. When women faced negative reactions from partners, they drew on strategies they had used before to avoid conflict and physical harm from partners, such as not responding to angry partners and forgoing payment to leave angry partners quickly. Some women also used self-tests to make more informed sexual decisions with their partners.
提高血清学状态知晓率和频繁进行艾滋病毒检测在女性性工作者（FSW）及其性伴侣等高风险人群中尤为重要。艾滋病毒自我检测作为一种提高艾滋病毒感染状况知晓率并促进更安全性行为决策的策略，在撒哈拉以南非洲地区正逐渐流行。然而，对于如何制定最佳的自我检测分发策略，以增加难以接触到的高风险人群的检测机会，我们却知之甚少。我们对18名女性性工作者进行了一项定性研究，她们参与了一项更大规模的研究，该研究为她们提供了五次基于口腔液的自我检测、如何使用检测的培训，并鼓励她们自行决定是否将自我检测提供给其性伴侣。女性在向伴侣介绍自我检测以及避免与伴侣发生冲突的策略上展现出了自主性。她们会仔细考虑与谁分享自我检测，在决策过程中通常会评估伴侣产生负面反应的可能性。当女性面对伴侣的负面反应时，她们会采用之前用过的策略来避免与伴侣发生冲突和身体伤害，比如不回应愤怒的伴侣，放弃报酬以便尽快离开愤怒的伴侣。一些女性还利用自我检测与伴侣做出更明智的性行为决策。
