PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Service Workers IN Group (SWING) Foundation, Bangkok, Thailand.
J Int AIDS Soc. 2018 Jul;21 Suppl 5(Suppl Suppl 5):e25118. doi: 10.1002/jia2.25118.
INTRODUCTION: HIV testing coverage remains low among men who have sex with men (MSM) and transgender women (TGW). We studied characteristics of Thai MSM and TGW who chose online and/or offline platforms for HIV counselling and testing and the feasibility of integrating online technologies and HIV self-testing to create service options. METHODS: From December 2015 to June 2017, MSM and TGW enrolled from Bangkok Metropolitan Region and Pattaya could choose between: offline HIV counselling and testing (Offline group), online pre-test counselling and offline HIV testing (Mixed group), and online counselling and online, supervised, HIV self-testing (Online group). Sociodemographic data, risk behaviour and social network use characteristics were collected by self-administered questionnaires. Logistic regression models identified covariates for service preferences. RESULTS: Of 472 MSM and 99 TGW enrolled, 202 self-selected the Offline group, 158 preferred the Mixed group, and 211 chose the Online group. The Online group had the highest proportion of first-time testers (47.3% vs. 42.4% vs. 18.1%, p < 0.001) and reported highest HIV prevalence (15.9% vs. 13.0% vs. 3.4%, p = 0.001) as compared to Offline and Mixed groups, respectively. Having tested for HIV twice or more (OR 2.57, 95% CI 1.03 to 6.41, p = 0.04) increased the likelihood to choose online pre-test counselling. Being TGW (OR 6.66, 95% CI 2.91 to 15.25, p < 0.001) and using social media from four to eight hours (OR 2.82, 95% CI 1.48 to 5.37, p = 0.002) or >8 hours (OR 2.33, 95% CI 1.05 to 5.16, p = 0.04) increased selection of online, supervised, HIV self-testing. Providers primarily used smartphones (79.2%) and laptops (37.5%) to deliver online services. Self-testing strip image sharpness and colour quality were rated "good" to "excellent" by all providers. Most participants (95.1%) agreed that online supervision and HIV self-testing guidance offered were satisfactory and well delivered. CONCLUSIONS: Online HIV services among MSM and TGW are feasible in Thailand and have the potential to engage high proportions of first-time testers and those with high HIV prevalence. When designing public health interventions, integrating varied levels of online HIV services are vital to engage specific sections of MSM and TGW populations in HIV services. CLINICAL TRIAL NUMBER: NCT03203265.
简介：男男性行为者（MSM）和跨性别女性（TGW）中的艾滋病毒检测覆盖率仍然很低。我们研究了选择在线和/或离线平台进行艾滋病毒咨询和检测的泰国 MSM 和 TGW 的特征，以及整合在线技术和艾滋病毒自我检测以创建服务选择的可行性。 方法：从 2015 年 12 月至 2017 年 6 月，曼谷大都市区和芭堤雅的 MSM 和 TGW 可以选择以下两种方式之一：线下艾滋病毒咨询和检测（线下组）、线上预检测咨询和线下艾滋病毒检测（混合组）以及在线咨询和在线、监督、艾滋病毒自我检测（在线组）。通过自我管理问卷收集社会人口统计学数据、风险行为和社交网络使用特征。逻辑回归模型确定了服务偏好的协变量。 结果：在纳入的 472 名 MSM 和 99 名 TGW 中，有 202 名自行选择了线下组，158 名更喜欢混合组，211 名选择了在线组。在线组中首次检测者的比例最高（47.3%比 42.4%比 18.1%，p<0.001），报告的艾滋病毒感染率也最高（15.9%比 13.0%比 3.4%，p=0.001），与线下组和混合组相比。曾经两次或两次以上接受过艾滋病毒检测（OR 2.57，95%CI 1.03-6.41，p=0.04）增加了选择在线预检测咨询的可能性。跨性别女性（OR 6.66，95%CI 2.91-15.25，p<0.001）和使用社交媒体四到八小时（OR 2.82，95%CI 1.48-5.37，p=0.002）或超过八小时（OR 2.33，95%CI 1.05-5.16，p=0.04）会增加对在线、监督、艾滋病毒自我检测的选择。服务提供者主要使用智能手机（79.2%）和笔记本电脑（37.5%）提供在线服务。所有服务提供者均对自我检测条的清晰度和颜色质量评价为“好”至“优”。大多数参与者（95.1%）认为在线监督和艾滋病毒自我检测指导是令人满意和良好的。 结论：泰国 MSM 和 TGW 的在线艾滋病毒服务是可行的，有可能吸引大量首次检测者和高艾滋病毒流行率者。在设计公共卫生干预措施时，整合不同层次的在线艾滋病毒服务对于吸引 MSM 和 TGW 人群的特定部分参与艾滋病毒服务至关重要。 临床试验注册号：NCT03203265。
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