Division of Prevention Sciences, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA.
Division of Communicable Disease Control & Prevention, Alameda County Public Health Department, Oakland, CA.
J Acquir Immune Defic Syndr. 2018 Sep 1;79(1):38-45. doi: 10.1097/QAI.0000000000001726.
BACKGROUND: Men who have sex with men (MSM) continue to be disproportionately impacted globally by the HIV epidemic. Studies suggest that HIV self-testing (HIVST) is highly acceptable among MSM. Social network strategies to increase testing are effective in reaching MSM, particularly MSM of color, who may not otherwise test. We tested a social network-based strategy to distribute HIVST kits to African American MSM (AAMSM) and Latino MSM (LMSM). SETTING: This study was conducted in Alameda County, California, a large, urban/suburban county with an HIV epidemic mirroring the national HIV epidemic. METHODS: From January 2016 to March 2017, 30 AAMSM, LMSM, and transgender women were trained as peer recruiters and asked to distribute 5 self-test kits to MSM social network members and support those who test positive in linking to care. Testers completed an online survey after their test. We compared peer-distributed HIVST testing outcomes to outcomes from Alameda County's targeted, community-based HIV testing programs using χ tests. RESULTS: Peer-distributed HIVST to 143 social and sexual network members, of whom 110 completed the online survey. Compared with MSM who used the County's sponsored testing programs, individuals reached through the peer-based self-testing strategy were significantly more likely to have never tested for HIV (3.51% vs. 0.41%, P < 0.01) and to report a positive test result (6.14% vs. 1.49%, P < 0.01). CONCLUSION: Findings suggest that a network-based strategy for self-test distribution is a promising intervention to increase testing uptake and reduce undiagnosed infections among AAMSM and LMSM.
背景:男男性行为者(MSM)在全球范围内继续受到艾滋病流行的不成比例影响。研究表明,HIV 自我检测(HIVST)在 MSM 中高度可接受。利用社交网络策略增加检测是接触 MSM 的有效方法,特别是那些可能不会接受检测的有色人种男男性行为者(MSM)和拉丁裔 MSM(LMSM)。我们测试了一种基于社交网络的策略,向非裔美国男男性行为者(AAMSM)和拉丁裔男男性行为者(LMSM)分发 HIVST 检测包。
地点:本研究在加利福尼亚州阿拉米达县进行,该县是一个拥有大型城市/郊区的县,其艾滋病流行情况与全国艾滋病流行情况相似。
方法:从 2016 年 1 月到 2017 年 3 月,30 名 AAMSM、LMSM 和跨性别女性接受了同伴招募培训,并被要求向 MSM 社交网络成员分发 5 个自我检测包,并支持那些检测呈阳性的人联系护理。测试者在测试后完成了在线调查。我们使用 χ 检验比较了同伴分发 HIVST 检测结果与阿拉米达县有针对性的基于社区的 HIV 检测项目的结果。
结果:向 143 名社交和性网络成员分发了同伴分发的 HIVST,其中 110 人完成了在线调查。与使用县资助检测项目的 MSM 相比,通过基于同伴的自我检测策略接触到的个体从未接受过 HIV 检测的可能性显著更高(3.51%比 0.41%,P<0.01),并且报告阳性检测结果的可能性也更高(6.14%比 1.49%,P<0.01)。
结论:研究结果表明,基于网络的自我检测分发策略是一种有前途的干预措施,可以提高检测率,并减少 AAMSM 和 LMSM 中的未确诊感染。
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