Kelvin Elizabeth A, George Gavin, Mwai Eva, Nyaga Eston, Mantell Joanne E, Romo Matthew L, Odhiambo Jacob O, Starbuck Lila, Govender Kaymarlin
a Department of Epidemiology and Biostatistics & Institute for Implementation Science in Population Health , CUNY Graduate School of Public Health and Health Policy, City University of New York , New York , NY , USA.
b Health Economics and HIV and AIDS Research Division , University of KwaZulu-Natal , Durban , South Africa.
AIDS Care. 2018 Jan;30(1):47-55. doi: 10.1080/09540121.2017.1360997. Epub 2017 Aug 21.
We conducted a randomized controlled trial among 305 truck drivers from two North Star Alliance roadside wellness clinics in Kenya to see if offering HIV testing choices would increase HIV testing uptake. Participants were randomized to be offered (1) a provider-administered rapid blood (finger-prick) HIV test (i.e., standard of care [SOC]) or (2) a Choice between SOC or a self-administered oral rapid HIV test with provider supervision in the clinic. Participants in the Choice arm who refused HIV testing in the clinic were offered a test kit for home use with phone-based posttest counseling. We compared HIV test uptake using the Mantel Haenszel odds ratio (OR) adjusting for clinic. Those in the Choice arm had higher odds of HIV test uptake than those in the SOC arm (OR = 1.5), but the difference was not statistically significant (p = 0.189). When adding the option to take an HIV test kit for home use, the Choice arm had significantly greater odds of testing uptake (OR = 2.8, p = 0.002). Of those in the Choice arm who tested, 26.9% selected the SOC test, 64.6% chose supervised self-testing in the clinic, and 8.5% took a test kit for home use. Participants varied in the HIV test they selected when given choices. Importantly, when participants who refused HIV testing in the clinic were offered a test kit for home use, an additional 8.5% tested. Offering truck drivers a variety of HIV testing choices may increase HIV testing uptake in this key population.
我们在肯尼亚两家北极星联盟路边健康诊所的305名卡车司机中进行了一项随机对照试验，以了解提供HIV检测选择是否会提高HIV检测率。参与者被随机分为两组，一组接受（1）由医护人员操作的快速血液（手指采血）HIV检测（即标准护理[SOC]），另一组接受（2）在诊所中由医护人员监督，可在SOC检测和自行操作的口服快速HIV检测之间进行选择。选择组中在诊所拒绝HIV检测的参与者可获得家用检测试剂盒，并接受电话检测后咨询。我们使用Mantel Haenszel优势比（OR）并对诊所进行校正来比较HIV检测率。选择组的HIV检测率高于SOC组（OR = 1.5），但差异无统计学意义（p = 0.189）。当增加家用HIV检测试剂盒这一选项时，选择组的检测率优势显著更大（OR = 2.8，p = 0.002）。在选择组中进行检测的参与者中，26.9%选择了SOC检测，64.6%选择了在诊所接受监督的自我检测，8.5%选择了家用检测试剂盒。当有选择时，参与者选择的HIV检测方式各不相同。重要的是，当为在诊所拒绝HIV检测的参与者提供家用检测试剂盒时，又有8.5%的人进行了检测。为卡车司机提供多种HIV检测选择可能会提高这一关键人群的HIV检测率。
