Grésenguet Gérard, Longo Jean de Dieu, Tonen-Wolyec Serge, Mboumba Bouassa Ralph-Sydney, Belec Laurent
Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic.
Faculté de Médecine et de Pharmacie, Université de Bunia and Université de Kisangani, Democratic Republic of Congo.
Open AIDS J. 2017 Nov 21;11:101-118. doi: 10.2174/1874613601711010101. eCollection 2017.
Opportunities for HIV testing could be enhanced by offering HIV self-testing (HIVST) in populations that fear stigma and discrimination when accessing conventional HIV counselling and testing. Field experience with HIVST was poorly reported in French-speaking African countries.
To investigate the usability of HIVST in Bangui, Central African Republic.
The prototype self-test Exacto Test HIV (Biosynex, Strasbourg, France) was used to assess the usability of HIVST in 300 adults living in Bangui, according to WHO technical recommendations. Simplified and easy-to-read leaflet was translated in French and Sango.
Preliminary survey in 3,484 adult volunteers including students, men who have sex with men and female sex workers living in Bangui showed that previous HIV testing in conventional centres for HIV counselling and testing was relatively infrequent and that acceptability of HIVST was elevated, although high heterogeneity could be observed between groups. The notice in French and Sango of Exacto Test HIV were chosen in 242/300 (80.6%) and 58/300 (19.4%), respectively. It was correctly understood in 273/300 (91.0%). The majority (275/300; 91.6%) correctly performed the HIV self-test; however, 71/300 (23.0%) asked for oral assistance. Most of the participants (273/300; 91.0%) found that performing of the self-test was very easy or easy, and less than Most of participants (273/300; 91.0%) found that performing of the self-test was very easy or easy and less than 1.0% (2/300) found it difficult. Overall the result were correctly interpreted in 96.9% (3,782/3,900), the reading/interpretion errors concerned the positive (96/1,800;5.3%), invalid (17/600;2.8%) and negative (5/1,500; 0.3%) self-test. The Cohen's coefficient κwas 0.94. The main obstacle for HIVST was the educational level, with interpretation difficulties in poorly educated people.
Our observations on profane adults living in Central African Republic, demonstrate: (i) the need to adapt the notice of instruction to African public, including educational pictograms as well as notice in vernacular language(s); (ii) the frequent difficulties in understanding the notice with frequent misinterpretation of test results; (iii) and the generally good usability of the HIV self-test despite these latter pitfalls. More research on exploring the best strategy (. supervised unsupervised strategies) for different high- and low- risk populations in resource-constrained settings remains needed.
对于那些在接受传统HIV咨询和检测时担心受到耻辱和歧视的人群，提供HIV自我检测（HIVST）可以增加HIV检测的机会。在非洲法语国家，关于HIVST的实地经验报道较少。
调查HIVST在中非共和国班吉的可用性。
根据世界卫生组织的技术建议，使用HIV自我检测原型Exacto Test HIV（法国斯特拉斯堡的Biosynex公司）评估其在300名居住在班吉的成年人中的可用性。将简化且易于阅读的说明书翻译成法语和桑戈语。
对包括学生、男男性行为者和居住在班吉的女性性工作者在内的3484名成年志愿者进行的初步调查显示，以前在传统HIV咨询和检测中心进行HIV检测的情况相对较少，尽管不同群体之间存在很大异质性，但HIVST的可接受性较高。在300人中，分别有242人（80.6%）和58人（19.4%）选择了法语和桑戈语的Exacto Test HIV说明书。273人（91.0%）正确理解了说明书。大多数人（275/300；91.6%）正确进行了HIV自我检测；然而，71人（23.0%）寻求口头帮助。大多数参与者（273/300；91.0%）发现进行自我检测非常容易或容易，不到1.0%（2/300）的人觉得困难。总体而言，96.9%（3782/3900）的结果得到了正确解读，阅读/解读错误涉及阳性（96/1800；5.3%）、无效（17/600；2.
