Redoschi Bruna Robba Lara, Zucchi Eliana Miura, Barros Claudia Renata Dos Santos, Paiva Vera Silvia Facciolla
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.
Programa de Pós-graduação Stricto Sensu em Saúde Coletiva, Universidade Católica de Santos, Santos, Brasil.
Cad Saude Publica. 2017 May 18;33(4):e00014716. doi: 10.1590/0102-311X00014716.
We conducted a critical review of the literature on recurrent use of HIV testing in men who have sex with men (MSM). We performed a narrative review of the literature in which we analyzed the various conceptions on frequent testing over time, the implications for health programs, and the main social markers that influence the incorporation of HIV testing as routine care. Although it has existed since the 1990s, recurrent testing among MSM was frequently interpreted as increased exposure to HIV due to lack of condom use, and therefore as "unnecessary" testing. Beginning in the 2000s, periodic testing has become a programmatic recommendation and has been interpreted as a goal. Individuals' perception of their use of the test has rarely been considered in order to characterize such use as routine care. On the social and cultural level, individual aspects associated with recent or routine testing were included in contexts of favorable norms for testing and less AIDS stigma. Differences in generation, schooling, and types of affective-sexual partnerships play an important part in testing. Such differences highlight that the epidemiological category "men who have sex with men" encompasses diverse relations, identities, and practices that result in specific uses of the test as a prevention strategy. Thus, dialogue between programs, health professionals, and the persons most affected by the epidemic is crucial for building responses with real potential to confront the HIV epidemic, based on respect for human rights.
我们对男男性行为者（MSM）反复进行HIV检测的文献进行了批判性综述。我们对文献进行了叙述性综述，分析了随着时间推移对频繁检测的各种观念、对健康项目的影响以及影响将HIV检测纳入常规护理的主要社会标志。尽管自20世纪90年代以来就存在MSM反复检测的情况，但由于缺乏使用避孕套，其经常被解释为HIV暴露增加，因此被视为“不必要”的检测。从21世纪初开始，定期检测已成为一项计划性建议，并被视为一个目标。为了将这种检测使用描述为常规护理，很少考虑个人对检测使用的认知。在社会和文化层面，与近期或常规检测相关的个体方面被纳入检测规范有利且艾滋病污名较少的背景中。代际、受教育程度以及情感 - 性伴侣类型的差异在检测中起着重要作用。这些差异凸显出“男男性行为者”这一流行病学类别涵盖了多样的关系、身份和行为，这些导致了检测作为预防策略的特定用途。因此，项目、卫生专业人员与受该流行病影响最严重的人群之间的对话对于基于尊重人权构建真正有潜力应对HIV疫情的应对措施至关重要。
