Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
Family Health International, Port-au-Prince, Haiti.
PLoS One. 2020 May 22;15(5):e0233606. doi: 10.1371/journal.pone.0233606. eCollection 2020.
HIV self-testing (HIVST), which allows people to test in private, is an innovative testing strategy that has been shown to increase HIV testing among men. Delivering HIVST kits to men via women is one promising assisted partner service strategy. Little research has been conducted on HIVST secondary distribution to men by women living with HIV (WLWH) in the Caribbean and other settings. The purpose of this study was to assess the perspectives of WLWH, their male partners, and healthcare professionals on the perceived advantages and disadvantages of HIVST, and recommendations for implementing HIVST in Haiti, with a focus on secondary distribution of HIVST to men by WLWH. Sixteen key informant interviews and nine focus groups with 44 healthcare workers, 31 Option B+ clients, and 13 men were carried out in Haiti. Key informants were representatives of the Ministry of Health and of a non-governmental agency involved in HIV partner services. Focus group members included program leads and staff members from the HIV care and treatment program, the Option B+ program, the community health service program, and the HIV counseling and testing services from 2 hospitals. Perceived HIVST advantage included an increase in the number of people who would learn their HIV status and start treatment. The perceived disadvantages were lack of support to ensure self-testers initiate treatment, uncertainty about male partner's reaction, risk of violence towards women delivering HIVST kits after receiving an HIVST kit from a woman, and the inability of women to counsel a man in case his self-test result is positive. Recommendations for integrating HIVST and secondary distribution of HIVST by WLWH included coupling HIVST distribution with public information, education, and communication through media and social marketing, relying on community health workers to mediate use of HIVST and ensure linkage to care, piloting HIVST programs on a small scale. HIVST is an appropriate and feasible strategy HIV prevention for men and women; however, more research is needed on how best to implement different strategies for this approach in the Caribbean.
HIV 自我检测（HIVST）允许人们私下检测，是一种创新的检测策略，已被证明可以增加男性的 HIV 检测率。通过女性向男性提供 HIVST 试剂盒是一种有前途的辅助伴侣服务策略。在加勒比地区和其他地方，很少有研究关注感染艾滋病毒的女性（WLWH）向男性二次分发 HIVST。本研究旨在评估 WLWH、其男性伴侣和医疗保健专业人员对 HIVST 的优势和劣势的看法，以及在海地实施 HIVST 的建议，重点是 WLWH 向男性二次分发 HIVST。在海地进行了 16 次关键知情人访谈和 9 次焦点小组讨论，共有 44 名医疗保健工作者、31 名 Option B+ 客户和 13 名男性参加。关键知情人是卫生部和参与 HIV 伴侣服务的非政府机构的代表。焦点小组的成员包括来自 HIV 护理和治疗项目、Option B+ 项目、社区卫生服务项目和来自 2 家医院的 HIV 咨询和检测服务的项目负责人和工作人员。感知到的 HIVST 优势包括增加了了解自己 HIV 状况并开始治疗的人数。感知到的劣势包括缺乏支持以确保自测试者开始治疗，对男性伴侣反应的不确定性，在从女性那里收到 HIVST 试剂盒后，女性向男性提供 HIVST 试剂盒可能会遭受暴力，以及女性无法在男性自测结果阳性的情况下为其提供咨询。整合 HIVST 和 WLWH 二次分发 HIVST 的建议包括将 HIVST 分发与通过媒体和社会营销进行的公共信息、教育和宣传相结合，依靠社区卫生工作者调解 HIVST 的使用并确保与护理的联系，小规模试点 HIVST 计划。HIVST 是一种适合和可行的男性和女性 HIV 预防策略；然而，在加勒比地区，需要更多的研究来了解如何最好地实施这种方法的不同策略。
