Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany.
Charité University Medicine, Berlin, Germany.
PLoS One. 2018 Apr 11;13(4):e0194244. doi: 10.1371/journal.pone.0194244. eCollection 2018.
In 2015, 3,674 new HIV diagnoses were notified in Germany; 16% of those newly diagnosed cases originated from sub-Saharan Africa (sSA). One quarter of the newly diagnosed cases among migrants from sSA (MisSA) are notified as having acquired the HIV infection in Germany. In order to reach MisSA with HIV testing opportunities, we aimed to identify which determinants influence the uptake of HIV testing among MisSA in Germany.
To identify those determinants, we conducted a quantitative cross-sectional survey among MisSA in Germany. The survey was designed in a participatory process that included MisSA and other stakeholders in HIV-prevention. Peer researchers recruited participants to complete standardized questionnaires on HIV knowledge and testing. We conducted multivariable analyses (MVA) to identify determinants associated with ever having attended voluntary HIV testing; and another MVA to identify determinant associated with having had the last voluntary HIV test in Germany.
Peer researchers recruited 2,782 participants eligible for inclusion in the MVA. Of these participants, 59.9% (1,667/2,782) previously had an HIV test. For each general statement about HIV that participants knew prior to participation in the study, the odds of having been tested increased by 19% (OR 1.19; 95%-CI: 1.11-1.27). Participants reporting that HIV is a topic that is discussed in their community had 92% higher odds of having been tested for HIV (OR 1.92; 95%-CI: 1.60-2.31). Migrants living in Germany for less than a year had the lowest odds of having had their last HIV test in Germany (OR 0.17; 95%-CI: 0.11-0.27). Additionally, MisSA 18 to 25 years (OR 0.55; 95%-CI: 0.42-0.73) and participants with varied sexual partners and inconsistent condom use (OR 0.75; 95%-CI: 0.44-0.97) had significantly lower odds of having had their last HIV test in Germany.
Through participatory research, we were able to show that knowledge about HIV and discussing HIV in communities increased the odds of having attended HIV testing among MisSA. However, recent migrants and young sexually active people are among the least reached by testing offers in Germany. Community-based interventions may present opportunities to reach such migrants and improve knowledge and increase discussion about HIV.
2015 年，德国新报告了 3674 例艾滋病毒新诊断病例；其中 16%的新诊断病例来自撒哈拉以南非洲（sSA）。从 sSA 移民到德国的新诊断病例中，有四分之一的人被报告在德国感染了艾滋病毒。为了让 MisSA 有机会接受艾滋病毒检测，我们旨在确定哪些决定因素会影响德国 MisSA 接受艾滋病毒检测的情况。
为了确定这些决定因素，我们对德国的 MisSA 进行了定量横断面调查。该调查是在一个参与式过程中设计的，其中包括 MisSA 和其他艾滋病毒预防方面的利益相关者。同行研究人员招募参与者完成关于艾滋病毒知识和检测的标准化问卷。我们进行了多变量分析（MVA），以确定与曾经接受过自愿艾滋病毒检测相关的决定因素；并进行了另一个 MVA，以确定与在德国进行最后一次自愿艾滋病毒检测相关的决定因素。
同行研究人员招募了 2782 名符合纳入 MVA 条件的参与者。在这些参与者中，59.9%（1667/2782）之前曾接受过艾滋病毒检测。对于参与者在参与研究之前已知的每一个关于艾滋病毒的一般陈述，接受检测的几率增加了 19%（OR 1.19；95%CI：1.11-1.27）。报告艾滋病毒是他们所在社区讨论话题的参与者接受艾滋病毒检测的几率高 92%（OR 1.92；95%CI：1.60-2.31）。在德国居住不到一年的移民接受最后一次德国艾滋病毒检测的几率最低（OR 0.17；95%CI：0.11-0.27）。此外，18 至 25 岁的 MisSA（OR 0.55；95%CI：0.42-0.73）和有多种性伴侣且经常不使用安全套的参与者（OR 0.75；95%CI：0.44-0.97）在德国进行最后一次艾滋病毒检测的几率显著较低。
通过参与式研究，我们能够表明，关于艾滋病毒的知识以及社区内对艾滋病毒的讨论增加了 MisSA 接受艾滋病毒检测的几率。然而，最近移民和年轻的性活跃者是德国检测服务覆盖最少的人群。基于社区的干预措施可能为接触这些移民并提高知识水平和增加对艾滋病毒的讨论提供机会。
