Department of Community and Family Medicine, Duke University, 2200 W Main St, Durham, NC, 27705, USA.
Carolina Population Center, University of North Carolina, Chapel Hill, USA.
BMC Public Health. 2019 Jan 29;19(1):123. doi: 10.1186/s12889-019-6402-4.
BACKGROUND: The uptake of HIV self-testing (HIVST) could address socio-structural barriers that prevent South African youth from utilizing the testing resources available in their communities. However, to facilitate this, we must tailor components of the HIVST kit and process to ensure that we reach and encourage youth to test. The purpose of this study to elucidate concerns and issues regarding HIVST rollout among South African youth. METHODS: This study was conducted in two phases: 1) focus group discussions with rural, South African youth aged 18-24 and 2) direct observations of participants completing with an oral HIVST kit and/or a blood based HIVST kit. In phase 2a participants were invited to try both an oral and blood-based HIVST kit. In phase 2b, participants selected the HIVST kit of their choice. RESULTS: We enrolled 35 unique participants in phase 1, 20 participants in phase 2a, and 40 participants in phase 2b. While the focus group discussions highlighted hypothetical HIVST use only, participants appreciated the privacy that the HIVST could afford them. However, they expressed concerns about whether HIVST could be trusted due to false positives and negatives, as well as whether a person would be able to emotionally handle the results if they tested alone. They suggested that the kits be used alongside someone who could provide support. In phases 2a and 2b, participants were overwhelmingly positive about both kits regarding ease of use and whether their results could be trusted. The participants, however, experienced more challenges with the blood-based versus oral test. When given the choice in phase 2b, most participants (80%) chose the oral HIVST over the blood-based HIVST. CONCLUSIONS: During the focus group discussions, participants raised concerns about the validity of HIVST, lack of emotional support when testing alone, and the cost of HIVST kits, all of which could be addressed through current testing campaigns. Most of those who actually tested had positive experiences with HIVST and would recommend it to their friends. When offered a choice, most preferred the oral test. TRIAL REGISTRATION: NCT03162965 , registered 19th May 2017.
背景：艾滋病病毒自我检测（HIVST）的采用可以解决阻碍南非青年利用社区现有检测资源的社会结构性障碍。然而，要做到这一点，我们必须调整 HIVST 检测包和检测流程的组成部分，以确保我们能够接触到并鼓励青年进行检测。本研究旨在阐明南非青年中推广 HIVST 时的关注点和问题。
方法：本研究分两个阶段进行：1）对 18-24 岁的南非农村青年进行焦点小组讨论；2）观察参与者使用口腔 HIVST 检测包和/或血液 HIVST 检测包的情况。在第二阶段 a，邀请参与者尝试使用口腔和血液 HIVST 检测包。在第二阶段 b，参与者选择他们选择的 HIVST 检测包。
结果：我们在第一阶段招募了 35 名独特的参与者，在第二阶段 a 招募了 20 名参与者，在第二阶段 b 招募了 40 名参与者。虽然焦点小组讨论仅强调了假设的 HIVST 使用情况，但参与者欣赏 HIVST 能为他们提供的隐私。然而，他们对 HIVST 的可信度表示担忧，因为可能会出现假阳性和假阴性，以及如果独自检测，他们是否能够在情感上处理检测结果。他们建议将这些检测包与能够提供支持的人一起使用。在第二阶段 a 和第二阶段 b，参与者对两种检测包的易用性和检测结果的可信度都给予了压倒性的积极评价。然而，参与者在使用血液检测包方面遇到了更多的挑战。在第二阶段 b 中，当被给予选择时，大多数参与者（80%）选择口腔 HIVST 检测包而不是血液 HIVST 检测包。
结论：在焦点小组讨论中，参与者对 HIVST 的有效性、独自检测时缺乏情感支持以及 HIVST 检测包的成本表示担忧，所有这些都可以通过当前的检测宣传活动来解决。大多数实际接受过 HIVST 检测的人对此检测有积极的体验，并会向他们的朋友推荐。当提供选择时，大多数人更喜欢口腔检测。
临床试验注册：NCT03162965，于 2017 年 5 月 19 日注册。
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