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撒哈拉以南非洲地区男性对 HIV 自我检测的看法:系统评价和元综合。

Men's perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis.

机构信息

Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

CIHR Canadian HIV Trials Network, Vancouver, BC, Canada.

出版信息

BMC Public Health. 2020 Jan 15;20(1):66. doi: 10.1186/s12889-020-8184-0.


DOI:10.1186/s12889-020-8184-0
PMID:31941479
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6964071/
Abstract

BACKGROUND: Despite the many HIV testing models implemented in Africa, the level of HIV testing uptake remains relatively poor, especially among men. The HIV self-testing (HIVST) model offers an additional approach for encouraging men to get tested. This study aimed to synthesise evidence on men's perspectives regarding HIVST in sub-Saharan Africa (SSA). METHODS: The databases searched included PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations; SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; ERIC; CINAH; PsychInfo; Embase, Sociological Abstract, Scopus; and Google Scholar. The World Health Organization (WHO) and The Joint United Nations' Programme on HIV and AIDS (UNAIDS) websites were further searched. We only extracted qualitative information from the included studies, despite the research method used (qualitative or mixed methods). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), as well as the Mixed Method Appraisal Tool (MMAT) version 2018, were used to determine the methodological quality of the included studies. NVivo version 11 was used for thematic analysis. RESULTS: A total of 21,184 articles were identified by the initial search criteria, but only 16 articles were included in the data extraction and quality assessment stage. The following key themes emerged: knowledge of HIVST; acceptability of HIVST; need for HIVST counselling; confidentiality of HIVST; convenience of HIVST; and accuracy of HIVST. The study shows that while HIVST provides men with an alternative, confidential and convenient testing model, the potential for psychological and physical harm remains a challenge. CONCLUSION: The introduction of the HIVST strategy has the potential of improving men's uptake in HIV testing services, thereby contributing towards addressing the first cascade of the 90-90-90 strategy. While HIVST has a potential for addressing men's barriers to attending clinic settings, such as confidentiality and convenience, it barely addresses the HIVST counselling and accuracy concerns.

摘要

背景:尽管非洲实施了许多艾滋病毒检测模式,但艾滋病毒检测的采用率仍然相对较低,尤其是在男性中。艾滋病毒自我检测(HIVST)模式为鼓励男性接受检测提供了另一种方法。本研究旨在综合评估撒哈拉以南非洲(SSA)地区男性对 HIVST 的看法。

方法:检索的数据库包括 PubMed/MEDLINE、EBSCO 主机上的美国博士论文;联合论文和论文目录;SA ePublications 通过 SABINET Online;WorldCat Dissertations;通过 OCLC 的论文和论文;ERIC;CINAH;PsychInfo;Embase、社会学摘要、Scopus;和谷歌学术。还进一步搜索了世界卫生组织(WHO)和联合国艾滋病规划署(UNAIDS)的网站。尽管使用了研究方法(定性或混合方法),但我们仅从纳入的研究中提取定性信息。使用系统评价和荟萃分析的首选报告项目(PRISMA)以及混合方法评估工具(MMAT)版本 2018 来确定纳入研究的方法学质量。使用 NVivo 版本 11 进行主题分析。

结果:通过初始搜索标准共确定了 21,184 篇文章,但只有 16 篇文章被纳入数据提取和质量评估阶段。出现了以下关键主题:HIVST 的知识;HIVST 的可接受性;对 HIVST 咨询的需求;HIVST 的保密性;HIVST 的便利性;和 HIVST 的准确性。研究表明,虽然 HIVST 为男性提供了一种替代、保密和方便的检测模式,但潜在的心理和身体伤害仍然是一个挑战。

结论:引入 HIVST 策略有可能提高男性对艾滋病毒检测服务的采用率,从而有助于实现 90-90-90 战略的第一级目标。虽然 HIVST 具有解决男性在参加诊所环境方面的障碍的潜力,例如保密性和便利性,但它几乎没有解决 HIVST 咨询和准确性问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/497d/6964071/04a8c90dada2/12889_2020_8184_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/497d/6964071/04a8c90dada2/12889_2020_8184_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/497d/6964071/04a8c90dada2/12889_2020_8184_Fig1_HTML.jpg

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本文引用的文献

[1]
Men's perspectives on HIV self-testing in sub-Saharan Africa: a qualitative systematic review protocol.

JBI Evid Synth. 2020-3

[2]
Mapping evidence of intervention strategies to improving men's uptake to HIV testing services in sub-Saharan Africa: A systematic scoping review.

BMC Infect Dis. 2019-6-6

[3]
HIV self-testing: South African young adults' recommendations for ease of use, test kit contents, accessibility, and supportive resources.

BMC Public Health. 2019-1-29

[4]
Mate Yako Afya Yako: Formative research to develop the Tanzania HIV self-testing education and promotion (Tanzania STEP) project for men.

PLoS One. 2018-8-27

[5]
'If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV': HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda.

Glob Health Action. 2018

[6]
Acceptability of HIV self-testing among men and women in KwaZulu-Natal, South Africa.

AIDS Care. 2019-2

[7]
Barriers to HIV testing among male clients of female sex workers in Indonesia.

Int J Equity Health. 2018-5-30

[8]
Female Sex Workers Often Incorrectly Interpret HIV Self-Test Results in Uganda.

J Acquir Immune Defic Syndr. 2018-9-1

[9]
"He Told Me to Check My Health": A Qualitative Exploration of Social Network Influence on Men's HIV Testing Behavior and HIV Self-Testing Willingness in Tanzania.

Am J Mens Health. 2018-9

[10]
Understanding linkage to care with HIV self-test approach in Lusaka, Zambia - A mixed method approach.

PLoS One. 2017-11-17

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