Op de Coul Eline, den Daas Chantal, Spijker Ralph, Heijman Titia, de Vos Marvin, Götz Hannelore, Vermey Koenraad, Zuilhof Wim, Van den Boogaard Jossy, Davidovich Udi, Zuure Freke
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands.
JMIR Res Protoc. 2020 Feb 9;9(2):e14743. doi: 10.2196/14743.
Of newly diagnosed HIV positive men who have sex with men (MSM) in the Netherlands, 29% have a non-Western migration background (MSM-NW). Among MSM-NW, HIV positivity rates are high (0.8%-2.0%), as is the proportion of late stage infections (39%). Factors such as HIV and sexual orientation-related stigma may form barriers for timely testing. Innovative approaches for HIV testing are needed to better reach MSM-NW. Social network testing (SNT) for HIV is an evidence-supported approach where peer recruiters identify persons (network associates) who could benefit from testing in their social or sexual networks. Web-supported SNT might be particularly promising for reaching people who may not be reached by regular care.
The purpose of this paper is to describe the design of our pilot PREVENT (Peer-Empowered Voluntary Extended Network Testing). In this pilot, we will explore whether SNT using HIV self-tests is feasible and acceptable among MSM-NW in the Netherlands and whether it reaches those who were never or not recently tested for HIV (>1 year ago).
The project aims to include 50 to 60 MSM and MSM-NW peers who will distribute 4 to 5 oral HIV self-tests each aiming to reach 200 network associates (NAs). Enrollment of peers includes 4 steps: (1) fostering interest in becoming a peer by health care professionals at sexual health clinics, HIV treatment clinics, and community settings; (2) sending peer contact information to the peer coordinator; (3) registering peers and giving program instructions by the peer coordinator and referring to the Web-based training at time2test; and (4) receiving precoded HIV self-tests for distribution in the peers' networks. NAs who receive the self-test will log in with their test package code in the time2test application for step-by-step test instructions. After testing is complete, NAs receive tailored follow-up information depending on their test result.
Between January and May 2019, 10 STI clinics and 7 HIV treatment clinics started recruiting peers. Results of the PREVENT pilot are expected in December 2020.
This is the first Web-supported peer-driven SNT pilot using HIV self-tests in the Netherlands and one of the first in Europe. Implementation is considered successful if it reaches MSM-NW who were never or not recently tested for HIV. Additionally, it may encourage conversations within the networks about risk behavior and barriers to HIV testing, potentially contributing to the Joint United Nations Programme on HIV/AIDS goal of zero HIV infections.
Netherlands Trial Registry NL7424; https://www.trialregister.nl/trial/7424.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14743.
在荷兰新诊断出的男男性行为者（MSM）艾滋病毒阳性患者中，29% 有非西方移民背景（MSM-NW）。在MSM-NW中，艾滋病毒阳性率很高（0.8%-2.0%），晚期感染比例也很高（39%）。诸如艾滋病毒和性取向相关的污名等因素可能成为及时检测的障碍。需要创新的艾滋病毒检测方法，以便更好地覆盖MSM-NW。艾滋病毒社交网络检测（SNT）是一种有证据支持的方法，由同伴招募者在其社交或性网络中识别可能从检测中受益的人（网络联系人）。网络支持的SNT对于接触那些常规护理可能无法覆盖的人群可能特别有前景。
本文旨在描述我们的PREVENT（同伴赋能自愿扩展网络检测）试点项目的设计。在这个试点项目中，我们将探索在荷兰的MSM-NW中使用艾滋病毒自我检测进行SNT是否可行且可接受，以及它能否覆盖那些从未或近期（>1年前）未进行艾滋病毒检测的人群。
该项目旨在纳入50至60名MSM和MSM-NW同伴，并由他们每人分发4至5份口服艾滋病毒自我检测试剂，目标是覆盖200名网络联系人（NA）。同伴的招募包括4个步骤：（1）性健康诊所、艾滋病毒治疗诊所和社区环境中的医护人员激发人们成为同伴的兴趣；（2）将同伴联系信息发送给同伴协调员；（3）同伴协调员登记同伴并给予项目指导，并引导其参加time2test网站的培训；（4）为同伴提供预编码的艾滋病毒自我检测试剂，以便在他们的网络中分发。收到自我检测试剂的NA将使用其检测试剂盒代码登录time2test应用程序，获取逐步检测说明。检测完成后，NA会根据检测结果收到量身定制的后续信息。
2019年1月至5月期间，10家性传播感染诊所和7家艾滋病毒治疗诊所开始招募同伴。预计PREVENT试点项目的结果将于2020年12月公布。
这是荷兰首个网络支持的、由同伴驱动的使用艾滋病毒自我检测的SNT试点项目，也是欧洲首批此类项目之一。如果能够覆盖那些从未或近期未进行艾滋病毒检测的MSM-NW，则认为实施是成功的。此外，它可能会鼓励网络内关于风险行为和艾滋病毒检测障碍的对话，有可能有助于实现联合国艾滋病规划署的零艾滋病毒感染目标。
荷兰试验注册中心NL742；https://www.trialregister.nl/trial/7424。
国际注册报告识别号（IRRID）：DERR1-10.2196/14743。
