Stafylis Chrysovalantis, Natoli Lauren J, Murkey Jamie A, Gordon Kristie K, Young Sean D, McGrath Mark R, Klausner Jeffrey D
Department of Medicine, UCLA, Los Angeles, CA, USA.
AIDS Healthcare Foundation Public Health Division, Los Angeles, CA, USA.
Mhealth. 2018 Oct 31;4:51. doi: 10.21037/mhealth.2018.10.03. eCollection 2018.
Commercial sex venues (CSV), bathhouses and sex clubs, have a long history of serving a high-risk population. In those facilities, patrons engage in multiple sexual encounters and often in high-risk sexual behaviors. Designing prevention interventions specifically for CSVs could be an effective way to increase testing and control HIV transmission.
In collaboration with the AIDS Healthcare Foundation (AHF), our team distributed free HIV self-test kits using vending machines located at two CSVs in Los Angeles, California. Test kit dispensing rate was monitored remotely. Patrons receiving a test kit were surveyed regarding their testing experience, test result and follow up. Linkage to care was offered to participants.
During 18 months, 1,398 kits were dispensed. The survey was completed by 110 patrons (response rate =7.9%). Among those who reported that they used the test kit (n=96), 17 (17.7%) participants reported a first-time reactive HIV result. At the time of the survey, six participants with reactive results reported seeking confirmatory testing and linkage to care and four had initiated treatment. Two participants requested linkage-to-care assistance. Participants reported valuing the privacy and convenience of the vending machine but were skeptical on the accuracy of their result. The startup cost, including the purchase of two vending machines, was $10,000 and the recurring cost (monitoring, test kits, personnel) was $33.81 per kit vended.
While survey response was low, our results demonstrate that an intervention using vending machines and HIV self-test kits in CSVs was acceptable, feasible, used by the CSV patrons and can help identify new HIV cases.
商业性交易场所（CSV），如澡堂和性俱乐部，长期以来一直服务于高危人群。在这些场所，顾客会进行多次性接触，且经常从事高危性行为。专门为商业性交易场所设计预防干预措施可能是增加检测和控制艾滋病毒传播的有效方法。
我们的团队与艾滋病医疗基金会（AHF）合作，在加利福尼亚州洛杉矶的两个商业性交易场所使用自动售货机分发免费的艾滋病毒自我检测试剂盒。远程监测检测试剂盒的发放率。对领取检测试剂盒的顾客就其检测经历、检测结果及后续情况进行调查。为参与者提供了与医疗服务的衔接。
在18个月期间，共发放了1398个试剂盒。110名顾客完成了调查（回复率 = 7.9%）。在报告使用了检测试剂盒的人中（n = 96），17名（17.7%）参与者报告首次艾滋病毒检测结果呈阳性。在调查时，6名检测结果呈阳性的参与者报告已寻求确诊检测并与医疗服务进行了衔接，4人已开始治疗。两名参与者请求提供与医疗服务衔接的帮助。参与者表示重视自动售货机的隐私性和便利性，但对检测结果的准确性表示怀疑。启动成本，包括购买两台自动售货机，为10,000美元，经常性成本（监测、检测试剂盒、人员）为每个售出试剂盒33.81美元。
虽然调查回复率较低，但我们的结果表明，在商业性交易场所使用自动售货机和艾滋病毒自我检测试剂盒的干预措施是可接受的、可行的，商业性交易场所的顾客会使用，并且有助于识别新的艾滋病毒病例。
