The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia.
PLoS One. 2019 Apr 8;14(4):e0214987. doi: 10.1371/journal.pone.0214987. eCollection 2019.
In many Asian countries, men who purchase sex account for the largest single network of people which often face elevated HIV risk in relation to the general population. However, high proportions of these men have never undertaken HIV testing. We assessed barriers to and facilitators of HIV testing among men who purchase sex in Indonesia, including the acceptability of HIV self-testing. A qualitative study was conducted during December 2016-January 2017 at fourteen sex-work venues and one voluntary HIV counselling and testing (VCT) clinic in Bali. Interviews were conducted with men who purchase sex exploring the men's views on HIV testing. Data were examined using thematic analysis. Twenty-nine men participated in the study. The themes that emerged regarding the barriers to HIV testing included fear of potential shame, embarrassment, and confidentiality breach in accessing HIV testing; fear of social exclusion if the test result was positive; self-treatment and prevention; the distance to a clinic; time constraints; and fear of an invasive testing method. Factors that were seen as facilitating a test were the convenience of time and place; the provision of speedy results; and privacy. Participants expressed interest in HIV self-testing and preferred it to clinic-based testing due to the privacy and confidentiality of the results. The findings support the introduction of an HIV self-testing strategy among this group to improve access to HIV testing.
在许多亚洲国家,购买性服务的男性构成了最大的单一人群网络,他们往往面临比一般人群更高的 HIV 感染风险。然而,这些男性中有很大一部分从未接受过 HIV 检测。我们评估了印度尼西亚购买性服务的男性进行 HIV 检测的障碍和促进因素,包括 HIV 自我检测的可接受性。这项定性研究于 2016 年 12 月至 2017 年 1 月在巴厘岛的 14 个性工作场所和 1 个自愿艾滋病毒咨询和检测(VCT)诊所进行。对购买性服务的男性进行了访谈,以探讨他们对 HIV 检测的看法。使用主题分析方法检查数据。共有 29 名男性参与了这项研究。在 HIV 检测障碍方面出现的主题包括:担心潜在的耻辱、尴尬和机密性泄露;担心如果检测结果呈阳性,会受到社会排斥;自我治疗和预防;到诊所的距离;时间限制;以及对侵入性检测方法的恐惧。被视为促进检测的因素包括:时间和地点的便利性;快速获得检测结果;以及隐私性。参与者对 HIV 自我检测表示有兴趣,并因其结果的隐私和保密性而更喜欢这种检测方式,而不是诊所检测。这些发现支持在这一群体中引入 HIV 自我检测策略,以改善 HIV 检测的获取。
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