男男性行为者（MSM）使用快速 HIV 自我检测后及时寻求人类免疫缺陷病毒（HIV）确认和护理：来自纽约市伙伴服务计划的数据。

Men Who Have Sex With Men Seek Timely Human Immunodeficiency Virus Confirmation and Care After Rapid Human Immunodeficiency Virus Self-Test: Data From Partner Services Program, New York City.

机构信息

From the New York City Department of Health and Mental Hygiene, New York City, NY.

出版信息

Sex Transm Dis. 2017 Oct;44(10):608-612. doi: 10.1097/OLQ.0000000000000648.

DOI:10.1097/OLQ.0000000000000648

PMID:28876324

Abstract

BACKGROUND

The rapid human immunodeficiency virus (HIV) self-test in the United States has expanded opportunities for HIV testing in nonclinical settings which may increase early diagnosis of HIV infection. However, broad application may be limited by the cost of the test and concerns that self-testers who test positive will not seek timely HIV care.

METHODS

We used data from HIV partner services program to compare the sociodemographic characteristics, transmission risk, and clinical stage of persons diagnosed with HIV by report of rapid self-test. Among self-tested persons, we assessed timeliness of seeking definitive testing after self-test and linkage to care.

RESULTS

From January 2013 to August 2016, 8032 HIV-positive persons were interviewed. Compared with the 7905 persons who did not self-test, self-tested persons were significantly (all P = <0.0001) male (96% vs 78%), white/non-Hispanic (46% vs 16%), men who have sex with men (92% vs 58%), college educated (67% vs 35%), and residing in medium-high income NYC neighborhoods (51% vs 44%). Higher proportions of self-tested (91%) than non-self-tested persons (81%) linked to care within three months of diagnosis. Significantly (P = <0.0001) more persons that self-tested positive (39/44, 89%) than persons that self-tested negative (14/36, 39%) sought laboratory-based HIV test within 1 month of last self-testing; and negative than positive self-tested persons were diagnosed with acute HIV infection (44% vs. 9%, P = <0.0001).

CONCLUSIONS

Our findings suggest that men who have sex with men sought timely HIV confirmatory testing and linkage to care after self-test. However, the cost of self-test kit may be an important barrier to its wide adoption across sociodemographic groups.

摘要

背景

美国快速艾滋病毒（HIV）自检的广泛应用增加了在非临床环境中进行 HIV 检测的机会，这可能有助于提高 HIV 感染的早期诊断率。然而，由于检测费用较高，以及自测试阳性者可能不会及时寻求 HIV 护理，因此其广泛应用可能会受到限制。

方法

我们利用 HIV 伙伴服务项目的数据，比较了通过快速自检报告诊断出的 HIV 感染者的社会人口统计学特征、传播风险和临床分期。在自测试者中，我们评估了自测试后寻求明确检测和与护理机构联系的及时性。

结果

从 2013 年 1 月至 2016 年 8 月，共采访了 8032 名 HIV 阳性者。与未进行自检的 7905 名感染者相比，自测试者显著（均 P<0.0001）为男性（96%比 78%）、白种人/非西班牙裔（46%比 16%）、男男性行为者（92%比 58%）、受过大学教育（67%比 35%）和居住在中高收入的纽约市社区（51%比 44%）。与诊断后三个月内取得联系的比例（91%比 81%）相比，自测试阳性者（39/44，89%）显著高于自测试阴性者（14/36，39%）。与自测试阴性者相比，自测试阳性者更有可能在最后一次自检后 1 个月内进行实验室 HIV 检测（39/44，89%比 14/36，39%）；并且自测试阳性者比自测试阴性者更有可能被诊断为急性 HIV 感染（44%比 9%，P<0.0001）。