社交媒体关键意见领袖和社区组织联合实施的男男性行为人群 HIV 自我检测项目具有同等有效性和互补性：中国一项全国性实用研究。
HIV Self-Testing Programs to Men Who Have Sex With Men Delivered by Social Media Key Opinion Leaders and Community-Based Organizations are Both Effective and Complementary: A National Pragmatic Study in China.
机构信息
NHC Key Laboratory of AIDS Immunology (China Medical University), Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China.
National Clinical Research Center for Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China.
出版信息
J Acquir Immune Defic Syndr. 2020 Aug 15;84(5):453-462. doi: 10.1097/QAI.0000000000002375.
BACKGROUND
Social media key opinion leaders (SMKOLs) and community-based organizations (CBOs) are 2 leading delivery strategies for HIV self-testing (HIVST). This study compared respondent characteristics, linkage to care, antiretroviral treatment, and cost of HIVST among men who have sex with men (MSM) recruited via SMKOLs and CBOs in China.
METHODS
Between January and December 2018, SMKOLs distributed HIVST advertisements to MSM through WeChat public platforms; simultaneously, CBOs distributed HIVST program messages to local MSM. All participants were required to pay a deposit to apply for the HIVST kit and had their deposit refunded after completing an online survey and uploading HIVST results. Trained staff provided HIV referral services by telephone and WeChat.
RESULTS
One thousand seven hundred forty-three [63.0% (1743/2766)] and 1023 [37.0% (1023/2766)] individuals met criteria via SMKOLs and CBOs, respectively. MSM reached by SMKOLs had a lower HIV seropositive rate [2.1% (33/1561) vs. 12.5% (100/803)] and higher proportion received antiretroviral treatment [94.4% (31/33) vs. 29.0% (29/100)] compared with CBO-recruited MSM (all P < 0.05). The average number of HIVST respondents recruited by each investigator in SMKOL-strategy was higher than that of CBO-strategy (290 vs. 49). The SMKOLs had lower cost of per person tested (USD 13.18 vs. USD 101.21) and per newly identified HIV infection case (USD 632.66 vs. USD 812.70).
CONCLUSIONS
SMKOLs have lower cost of per person tested, whereas CBOs can reach MSM subpopulations with higher HIV seropositive rates. Both recruitment methods are efficient and should be used as complementary HIVST delivery strategies to address low HIV testing coverage among Chinese MSM.
背景
社交媒体关键意见领袖（SMKOLs）和社区组织（CBOs）是 HIV 自我检测（HIVST）的两种主要推广策略。本研究比较了通过中国的 SMKOLs 和 CBOs 招募的男男性行为者（MSM）的应答者特征、与护理的衔接、抗逆转录病毒治疗和 HIVST 的成本。
方法
2018 年 1 月至 12 月期间，SMKOLs 通过微信公众平台向 MSM 分发 HIVST 广告；同时，CBOs 向当地 MSM 发送 HIVST 项目信息。所有参与者都需要支付押金来申请 HIVST 试剂盒，在完成在线调查并上传 HIVST 结果后，押金将退还。经过培训的工作人员通过电话和微信提供 HIV 转介服务。
结果
通过 SMKOLs 和 CBOs 分别招募了 1743 名[63.0%（1743/2766）]和 1023 名[37.0%（1023/2766）]符合条件的参与者。通过 SMKOLs 招募的 MSM 的 HIV 阳性率较低[2.1%（33/1561）与 12.5%（100/803）]，接受抗逆转录病毒治疗的比例较高[94.4%（31/33）与 29.0%（29/100）]（均 P < 0.05）。SMKOL 策略中每位调查员招募的 HIVST 应答者数量高于 CBO 策略（290 与 49）。SMKOLs 的人均检测成本较低（13.18 美元与 101.21 美元），每发现一个新的 HIV 感染病例的成本也较低（632.66 美元与 812.70 美元）。
结论
SMKOLs 的人均检测成本较低，而 CBOs 可以覆盖 HIV 阳性率较高的 MSM 亚人群。两种招募方法都很有效，应该作为互补的 HIVST 推广策略，以解决中国 MSM 中 HIV 检测率低的问题。
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