在乌干达农村一个艾滋病高度流行的渔村开展以同伴为主导的 HIV 自我检测试点干预措施的可行性和可接受性。
Feasibility and acceptability of a pilot, peer-led HIV self-testing intervention in a hyperendemic fishing community in rural Uganda.
机构信息
Makerere University School of Public Health, Kampala, Uganda.
Busitema University Faculty of Health Sciences, Mbale, Uganda.
出版信息
PLoS One. 2020 Aug 7;15(8):e0236141. doi: 10.1371/journal.pone.0236141. eCollection 2020.
BACKGROUND
Novel interventions are needed to reach young people and adult men with HIV services given the low HIV testing rates in these population sub-groups. We assessed the feasibility and acceptability of a peer-led oral HIV self-testing (HIVST) intervention in Kasensero, a hyperendemic fishing community (HIV prevalence: 37-41%) in Rakai, Uganda.
METHODS
This study was conducted among young people (15-24 years) and adult men (25+ years) between May and August 2019. The study entailed distribution of HIVST kits by trained "peer-leaders," who were selected from existing social networks and trained in HIVST distribution processes. Peer-leaders received up to 10 kits to distribute to eligible social network members (i.e. aged 15-24 years if young people or 25+ years if adult man, not tested in the past 3 months, and HIV-negative or of unknown HIV status at enrolment). The intervention was evaluated against the feasibility benchmark of 70% of peer-leaders distributing up to 70% of the kits that they received; and the acceptability benchmark of >80% of the respondents self-testing for HIV.
RESULTS
Of 298 enrolled into the study at baseline, 56.4% (n = 168) were young people (15-24 years) and 43.6% (n = 130) were adult males (25+ years). Peer-leaders received 298 kits and distributed 296 (99.3%) kits to their social network members. Of the 282 interviewed at follow-up, 98.2% (n = 277) reported that they used the HIVST kits. HIV prevalence was 7.4% (n = 21). Of the 57.1% (n = 12) first-time HIV-positives, 100% sought confirmatory HIV testing and nine of the ten (90%) respondents who were confirmed as HIV-positive were linked to HIV care within 1 week of HIV diagnosis.
CONCLUSION
Our findings show that a social network-based, peer-led HIVST intervention in a hyperendemic fishing community is highly feasible and acceptable, and achieves high linkage to HIV care among newly diagnosed HIV-positive individuals.
背景
鉴于青年人和成年男性的 HIV 检测率较低，需要新的干预措施来为这些人群亚组提供 HIV 服务。我们评估了在乌干达拉凯的卡森塞罗（HIV 流行率：37-41%）一个高度流行的渔业社区中，由同伴主导的口腔 HIV 自我检测（HIVST）干预措施的可行性和可接受性。
方法
这项研究于 2019 年 5 月至 8 月在青年人和成年男性（25 岁及以上）中进行。研究涉及由从现有社交网络中挑选出来的受过 HIVST 分发培训的“同伴领袖”分发 HIVST 试剂盒。同伴领袖收到了多达 10 个试剂盒，用于分发给符合条件的社交网络成员（如果是年轻人，则年龄在 15-24 岁；如果是成年男性，则年龄在 25 岁及以上；过去 3 个月未接受过检测；并且在入组时 HIV 检测结果为阴性或 HIV 状态未知）。该干预措施的评估标准是 70%的同伴领袖分发了他们收到的多达 70%的试剂盒，以及>80%的受访者接受 HIV 自我检测的可接受性基准。
结果
在基线时有 298 人入组研究，其中 56.4%（n=168）为年轻人（15-24 岁），43.6%（n=130）为成年男性（25 岁及以上）。同伴领袖收到了 298 个试剂盒，并将 296 个（99.3%）试剂盒分发给了他们的社交网络成员。在随访时接受采访的 282 人中，98.2%（n=277）报告他们使用了 HIVST 试剂盒。HIV 感染率为 7.4%（n=21）。在首次检测 HIV 阳性的 57.1%（n=12）中，100%的人寻求了确认性 HIV 检测，在十名 HIV 阳性确诊者中，有九名（90%）在 HIV 诊断后一周内被联系到 HIV 护理。
结论
我们的研究结果表明，在一个高度流行的渔业社区中，基于社交网络的同伴主导的 HIVST 干预措施是高度可行和可接受的，并在新诊断为 HIV 阳性的个体中实现了与 HIV 护理的高关联。
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