CUNY School of Public Health, New York, New York, USA
CUNY Institute for Implementation Science in Population Health, New York, New York, USA.
J Epidemiol Community Health. 2020 Sep;74(9):741-753. doi: 10.1136/jech-2019-213493. Epub 2020 May 20.
Among those at high risk for HIV, it is important to examine the ways in which someone who has recently tested for HIV might differ from someone who has not.
In 2017-2018, a total of 5001 men, trans women and trans men who have sex with men from across the United States completed an online survey about their recent testing behaviour as well as self-collected oral samples for HIV testing.
In total, 3.8% tested HIV-positive and-among those with positive results-35% were recent HIV infections (ie, self-reported an HIV-negative test result within the 12 months prior to enrollment). Those with HIV-positive results-regardless of how recent their HIV test was prior to enrollment-differed from those with negative results in ways that are known to be associated with HIV risk: racial and income disparities, housing instability, recent transactional sex and recent methamphetamine use. Among those with HIV-positive results at enrollment, only having a primary care physician distinguished those who recently tested negative prior to enrollment versus not. Among those with HIV-negative results, there were numerous differences between those who had recently tested for HIV prior to enrollment, versus not, such that those who had not recently tested were significantly more likely to report being at higher risk for HIV.
Strategies aimed at improving more frequent HIV testing among HIV-negative persons at high risk for HIV should address other needs including stable housing, transactional sex, access to a primary care provider and methamphetamine use.
在 HIV 高危人群中,重要的是要研究最近接受过 HIV 检测的人与未接受过检测的人之间的差异。
2017-2018 年,来自美国各地的 5001 名男性、跨性别女性和跨性别男性,他们通过在线调查报告了最近的检测行为以及自我采集的口腔样本进行 HIV 检测。
共有 3.8%的人 HIV 检测呈阳性,在阳性结果中,有 35%的人是最近的 HIV 感染(即在入组前 12 个月内报告 HIV 阴性检测结果)。无论他们在入组前多久进行的 HIV 检测呈阳性,这些结果与已知与 HIV 风险相关的因素不同:种族和收入差距、住房不稳定、最近的商业性行为和最近的甲基苯丙胺使用。在入组时 HIV 检测呈阳性的人中,只有有初级保健医生才能区分那些在入组前最近一次检测结果为阴性的人与没有的人。在 HIV 检测结果为阴性的人中,那些在入组前最近进行过 HIV 检测的人与没有进行过的人之间存在许多差异,以至于那些最近没有进行过 HIV 检测的人报告自己感染 HIV 的风险更高。
旨在提高 HIV 高危人群中 HIV 阴性者更频繁进行 HIV 检测的策略,应该解决其他需求,包括稳定的住房、商业性行为、获得初级保健提供者和甲基苯丙胺的使用。