Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
BMC Infect Dis. 2019 Jun 6;19(1):496. doi: 10.1186/s12879-019-4124-y.
BACKGROUND: HIV testing serves as a critical gateway for linkage and retention to care services, particularly in sub-Saharan African countries with high burden of HIV infections. However, the current progress towards addressing the first cascade of the 90-90-90 programme is largely contributed by women. This study aimed to map evidence on the intervention strategies to improve HIV uptake among men in sub-Saharan Africa. METHODS: We conducted a scoping review guided by Arksey and O'Malley's (2005) framework and Levac et al. (2010) recommendation for methodological enhancement for scoping review studies. We searched for eligible articles from electronic databases such as PubMed/MEDLINE; American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations (UCTD); SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; and Google Scholar. We included studies from January 1990 to August 2018. We used the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. The Mixed Method Appraisal Tool version 2018 was used to determine the methodological quality of the included studies. We further used NVivo version 11 to aid with content thematic analysis. RESULTS: This study revealed that teaching men about HIV; Community-Based HIV testing; Home-Based HIV testing; Antenatal Care HIV testing; HIV testing incentives and HIV Self-testing are important strategies to improving HIV testing among men in sub-Saharan Africa. The need for improving programmes aimed at giving more information to men about HIV that are specifically tailored for men, especially given their poor uptake of HIV testing services was also found. This study further revealed the need for implementing Universal Test and Treat among HIV positive men found through community-based testing strategies, while suggesting the importance of restructuring home-based HIV testing visits to address the gap posed by mobile populations. CONCLUSION: The community HIV testing, as well as, HIV self-testing strategies showed great potential to increase HIV uptake among men in sub-Saharan Africa. However, to address poor linkage to care, ART should be initiated soon after HIV diagnosis is concluded during community testing services. We also recommend more research aimed at addressing the quality of HIV self-testing kits, as well as, improving the monitoring systems of the distributed HIV self-testing kits.
背景:艾滋病毒检测是连接和保留到护理服务的关键门户,特别是在艾滋病毒感染负担高的撒哈拉以南非洲国家。然而,目前在实现 90-90-90 方案第一级联方面取得的进展主要归功于妇女。本研究旨在绘制有关干预策略的证据,以提高撒哈拉以南非洲男性对艾滋病毒的接受程度。
方法:我们根据 Arksey 和 O'Malley(2005 年)的框架和 Levac 等人(2010 年)对范围综述研究方法改进的建议,进行了范围综述。我们从电子数据库(如 PubMed/MEDLINE;EBSCO 主机上的美国博士论文;UCTD 联合目录;SABINET Online 上的 SA ePublications;World Cat Dissertations;OCLC 上的论文)中搜索符合条件的文章。我们纳入了 1990 年 1 月至 2018 年 8 月的研究。我们使用 PRISMA-ScR(范围综述扩展)检查表和解释来确定纳入研究的方法质量。我们还使用 NVivo 版本 11 来帮助进行内容主题分析。
结果:这项研究表明,向男性传授艾滋病毒知识;社区艾滋病毒检测;家庭艾滋病毒检测;产前护理艾滋病毒检测;艾滋病毒检测激励措施和艾滋病毒自检是提高撒哈拉以南非洲男性艾滋病毒检测率的重要策略。还发现,需要改善旨在向男性提供更多关于艾滋病毒的信息的方案,这些方案专门针对男性制定,特别是因为他们对艾滋病毒检测服务的接受率很低。这项研究还表明,需要在通过社区检测策略发现的艾滋病毒阳性男性中实施普遍检测和治疗,同时建议调整家庭艾滋病毒检测访问,以解决流动人口带来的差距。
结论:社区艾滋病毒检测以及艾滋病毒自检策略显示出极大的潜力,可以提高撒哈拉以南非洲男性对艾滋病毒的接受程度。然而,为了解决联系护理服务的问题,应该在社区检测服务中得出艾滋病毒诊断后尽快开始启动抗逆转录病毒治疗。我们还建议进行更多的研究,以解决艾滋病毒自检试剂盒的质量问题,并改善分发的艾滋病毒自检试剂盒的监测系统。
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