Médecins Sans Frontières, Khayelitsha Project, Cape Town, South Africa.
Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
PLoS One. 2019 May 2;14(5):e0215454. doi: 10.1371/journal.pone.0215454. eCollection 2019.
HIV self-testing (HIVST) offers a useful addition to HIV testing services and enables individuals to test privately. Despite recommendations to the contrary, repeat HIV testing is frequent among people already on anti-retroviral treatment (ART) and there are concerns that oral self-testing might lead to false negative results. A study was conducted in Khayelitsha, South Africa, to assess feasibility and uptake of HIVST and linkage-to-care following HIVST.
Participants were recruited at two health facilities from 1 March 2016 to 31 March 2017. People under 18 years, or with self-reported previously-diagnosed HIV infection, were excluded. Participants received an OraQuick Rapid HIV-1/2 Antibody kit, and reported their HIVST results by pre-paid text message (SMS) or by returning to the facility. Those not reporting within 7 days were contacted by phone. Electronic and paper-based clinical and laboratory records were retrospectively examined for all participants to identify known HIV outcomes, after matching for name, date of birth, and sex. These findings were compared with self-reported HIVST results where available.
Of 639 participants, 401 (62.8%) self-reported a negative HIVST result, 27 (4.2%) a positive result, and 211 (33.0%) did not report. The record search identified that of the 401 participants self-reporting a negative HIVST result, 19 (4.7%) were already known to be HIV positive; of the 27 self-reporting positive, 12 (44%) were known HIV positive. Overall, records showed 57/639 (8.9%) were HIV positive of whom 39/57 (68.4%) had previously-diagnosed infection and 18/57 (31.6%) newly-diagnosed infection. Of the 428 participants who self-reported a result, 366 (85.5%) reported by SMS.
HIVST can improve HIV testing uptake and linkage to care. SMS is acceptable for reporting HIVST results but negative self-reports by participants may be unreliable. Use of HIVST by individuals on ART is frequent despite recommendations to the contrary and its implications need further consideration.
HIV 自我检测（HIVST）为 HIV 检测服务提供了有用的补充，使个人能够进行私密检测。尽管有相反的建议，但已经接受抗逆转录病毒治疗（ART）的人经常会重复进行 HIV 检测，并且有人担心口腔自我检测可能会导致假阴性结果。在南非的开普敦，进行了一项研究，以评估 HIVST 的可行性和接受程度，以及 HIVST 后的护理联系。
参与者于 2016 年 3 月 1 日至 2017 年 3 月 31 日在两个卫生机构招募。排除年龄在 18 岁以下或自述以前诊断出 HIV 感染的人。参与者收到 OraQuick 快速 HIV-1/2 抗体试剂盒，并通过预付费短信（SMS）或返回机构报告他们的 HIVST 结果。在 7 天内未报告的人将通过电话联系。对所有参与者进行电子和纸质临床和实验室记录的回顾性检查，以确定已知的 HIV 结果，同时根据姓名、出生日期和性别进行匹配。将这些发现与可用的自我报告的 HIVST 结果进行比较。
在 639 名参与者中，401 名（62.8%）自我报告 HIVST 结果为阴性，27 名（4.2%）为阳性，211 名（33.0%）未报告。记录搜索确定，在 401 名自我报告 HIVST 结果为阴性的参与者中，有 19 名（4.7%）已知 HIV 阳性；在 27 名自我报告阳性的参与者中，有 12 名（44%）已知 HIV 阳性。总体而言，记录显示 57/639 名（8.9%）为 HIV 阳性，其中 39/57 名（68.4%）为先前诊断的感染，18/57 名（31.6%）为新诊断的感染。在 428 名自我报告结果的参与者中，有 366 名（85.5%）通过短信报告。
HIVST 可以提高 HIV 检测的参与率和护理联系。短信可用于报告 HIVST 结果，但参与者的阴性自我报告可能不可靠。尽管有相反的建议，但仍有许多接受 ART 的人经常使用 HIVST，其影响需要进一步考虑。
