Centre for Global Public Health, University of Manitoba, Winnipeg, Canada.
Partners for Health and Development in Africa, University of Manitoba, Geomaps Building, Upper Hill, Nairobi, Kenya.
BMC Public Health. 2019 Jul 23;19(1):986. doi: 10.1186/s12889-019-7291-2.
HIV prevalence among men having sex with men (MSM) in Kenya is 18.2%. Despite scale-up of HIV testing services, many MSM remain unaware of their HIV status and thus do not benefit from accessing HIV treatment or prevention services. HIV self-testing (HIVST) may help address this gap. However, evidence is limited on how, when, and in what contexts the delivery of HIVST to MSM could increase awareness of HIV status and lead to early linkage to HIV treatment and prevention.
The study will be embedded within existing MSM-focused community-based HIV prevention and treatment programmes in 3 counties in Kenya (Kisumu, Mombasa, Kiambu). The study is designed to assess three HIV testing outcomes among MSM, namely a) coverage b) frequency of testing and c) early uptake of testing. The study will adopt a mixed methods programme science approach to the implementation and evaluation of HIVST strategies via: (i) a baseline and endline bio-behavioural survey with 1400 MSM; (ii) a socio-sexual network study with 351 MSM; (iii) a longitudinal qualitative cohort study with 72 MSM; (iv) routine programme monitoring in three sites; (v) a programme-specific costing exercise; and (vi) mathematical modelling. This protocol evaluates the impact of community-based implementation of HIV self-testing delivery strategies among MSM in Kenya on reducing the undiagnosed MSM population, and time for linkage to prevention, treatment and care following HIV self-testing. Baseline data collection started in April 2019 and the endline data collection will start in July 2020.
This study is one of the first programme science studies in Sub-Saharan Africa exploring the effectiveness of integrating HIVST interventions within already existing HIV prevention and treatment programmes for MSM in Kenya at scale. Findings from this study will inform national best approaches to scale up HIVST among MSM in Kenya.
肯尼亚男男性行为者（MSM）中的艾滋病毒流行率为 18.2%。尽管艾滋病毒检测服务有所扩大，但许多 MSM 仍然不知道自己的艾滋病毒状况，因此无法受益于获得艾滋病毒治疗或预防服务。艾滋病毒自我检测（HIVST）可能有助于解决这一差距。然而，关于如何、何时以及在何种情况下向 MSM 提供 HIVST 可以提高对艾滋病毒状况的认识，并导致及早与艾滋病毒治疗和预防相联系，证据有限。
该研究将嵌入肯尼亚三个县（基苏木、蒙巴萨、基安布）现有的 MSM 为重点的社区为基础的艾滋病毒预防和治疗方案中。该研究旨在评估 MSM 中的三种艾滋病毒检测结果，即 a）覆盖范围 b）检测频率和 c）及早接受检测。该研究将采用混合方法方案科学方法，通过以下方式实施和评估 HIVST 策略：（i）对 1400 名 MSM 进行基线和期末生物行为调查；（ii）对 351 名 MSM 进行社会性行为网络研究；（iii）对 72 名 MSM 进行纵向定性队列研究；（iv）在三个地点进行常规方案监测；（v）进行特定方案的成本效益分析；以及（vi）数学建模。本方案评估在肯尼亚 MSM 中实施基于社区的 HIV 自我检测交付策略对减少未确诊 MSM 人群的影响，以及从 HIV 自我检测到预防、治疗和护理的联系时间。基线数据收集始于 2019 年 4 月，期末数据收集将于 2020 年 7 月开始。
这是撒哈拉以南非洲首例方案科学研究之一，探索在肯尼亚大规模实施将 HIVST 干预措施纳入已经存在的艾滋病毒预防和治疗方案中对 MSM 的有效性。本研究的结果将为肯尼亚扩大 MSM 中 HIVST 的最佳方法提供信息。
