PATH, Viet Nam.
Ministry of Health/Vietnam Administration of HIV/AIDS Control, Viet Nam.
J Int AIDS Soc. 2018 Jul;21 Suppl 5(Suppl Suppl 5):e25127. doi: 10.1002/jia2.25127.
INTRODUCTION: HIV prevalence among men who have sex with men (MSM) in Vietnam is increasing, while annual HIV testing uptake has remained consistently low, posing a significant challenge to reaching the 90-90-90 goals. Barriers to MSM seeking HIV testing include concerns regarding confidentiality and lack of convenient testing options. Two new HIV testing strategies-HIV lay provider and HIV self-testing (HIVST)-were piloted alongside intensive social media outreach to increase access to and uptake of HIV testing among MSM not actively engaged in services. METHODS: We measured the proportion of first-time MSM HIV testers opting for HIV lay or self-testing, and factors that were associated with first-time testing, as part of a larger HIV lay and self-testing study among key populations in Vietnam. We also assessed MSM satisfaction with HIV lay or self-testing, and testing location and provider preferences. Finally, we calculated linkage to care cascade among MSM that were diagnosed and enrolled in anti-retroviral therapy (ART) services. RESULTS: Among MSM that sought HIV lay and self-testing, 57.9% (n = 320) and 51.3% (n = 412) were first-time testers respectively. In the final adjusted models, the odds of being a first-time tester and opting for HIV lay testing were higher among MSM who were young, had lower levels of income and had never exchanged sex for money; for HIVST, the odds of being a first-time HIV tester were higher among MSM that had attained lower levels of education. HIV lay and self-testing resulted in higher detection of new HIV cases (6.8%) compared to conventional HIV testing among key populations (estimated at 1.6% in 2016), while MSM linked to testing through social media interventions presented with even higher HIV-positivity (11%). Combined, 1655 HIV cases were diagnosed and more than 90% were registered for ART services. CONCLUSIONS: Our findings suggest that MSM-delivered HIV testing and self-testing, promoted through online or face-to-face interactions, offer important additions to MSM HIV testing services in Vietnam, and could significantly contribute to epidemic control by increasing HIV testing among harder-to-reach and higher-risk MSM, effectively enrolling them in ART, and reducing onward transmission.
简介:在越南,男男性行为人群(MSM)中的艾滋病毒感染率不断上升,而每年的艾滋病毒检测率仍然很低,这给实现 90-90-90 目标带来了巨大挑战。MSM 寻求艾滋病毒检测的障碍包括对保密性的担忧以及缺乏方便的检测选择。两种新的艾滋病毒检测策略——艾滋病毒检测员和艾滋病毒自我检测(HIVST)——与密集的社交媒体外展活动一起进行试点,以增加未积极参与服务的 MSM 获得和接受艾滋病毒检测的机会。
方法:我们测量了首次接受艾滋病毒检测的 MSM 选择艾滋病毒检测员或自我检测的比例,以及与首次检测相关的因素,这是越南关键人群中艾滋病毒检测员和自我检测研究的一部分。我们还评估了 MSM 对艾滋病毒检测员或自我检测的满意度,以及检测地点和提供者的偏好。最后,我们计算了被诊断并登记接受抗逆转录病毒治疗(ART)服务的 MSM 中向护理服务衔接的比例。
结果:在寻求艾滋病毒检测员和自我检测的 MSM 中,分别有 57.9%(n=320)和 51.3%(n=412)为首次检测者。在最终调整后的模型中,年轻、收入较低和从未以性换钱的 MSM 首次检测者和选择艾滋病毒检测员的可能性更高;对于 HIVST,受教育程度较低的 MSM 首次接受艾滋病毒检测的可能性更高。与关键人群中的常规艾滋病毒检测相比(2016 年估计为 1.6%),艾滋病毒检测员和自我检测导致新的艾滋病毒病例的检出率更高(6.8%),而通过社交媒体干预联系检测的 MSM 的艾滋病毒阳性率更高(11%)。共有 1655 例艾滋病毒病例被诊断,超过 90%的病例登记接受了抗逆转录病毒治疗服务。
结论:我们的研究结果表明,通过在线或面对面互动推广的 MSM 提供的艾滋病毒检测和自我检测,为越南的 MSM 艾滋病毒检测服务提供了重要补充,通过增加更难接触到和风险更高的 MSM 的艾滋病毒检测,有效地将他们纳入抗逆转录病毒治疗,并减少传播,从而对疫情控制做出重要贡献。
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