Gerencia Regional de Salud de Castilla y León, Valladolid, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
J Med Internet Res. 2020 Nov 30;22(11):e21268. doi: 10.2196/21268.
BACKGROUND: Late HIV diagnosis remains frequent among the gay, bisexual, and other men who have sex with men (GBMSM) population across Europe. HIV self-sampling could help remove barriers and facilitate access to testing for this high-risk population. OBJECTIVE: We assessed the capacity of HIV self-sampling to increase the testing frequency among GBMSM living in Denmark, Germany, Greece, Portugal, Romania, and Spain, and evaluated the role of new technologies in the result communication phase. METHODS: We analyzed a convenience sample of 5019 GBMSM with prior HIV testing experience who were recruited during 2016 through gay dating websites. We estimated the proportion of GBMSM who reported that the availability of self-sampling would result in an increase of their current testing frequency. We constructed a Poisson regression model for each country to calculate prevalence ratios and 95% CIs of factors associated with an increase of testing frequency as a result of self-sampling availability. RESULTS: Overall, 59% (between country range 54.2%-77.2%) of the participants considered that they would test more frequently for HIV if self-sampling was available in their country. In the multivariate analysis, the increase of testing frequency as a result of self-sampling availability was independently associated with reporting a higher number of unprotected anal intercourse events in all countries except for Greece. Independent associations were also observed among GBMSM who were not open about their sex life in Germany, Greece, Portugal, and Spain; those with a lower number of previous HIV tests in Denmark, Greece, Portugal, and Spain; and for those that took their last test more than 3 months previously in Germany, Portugal, Romania, and Spain. In addition, 58.4% (range 40.5%-73.6%) of the participants indicated a preference for learning their result through one-way interaction methods, mainly via email (25.6%, range 16.8%-35.2%) and through a secure website (20.3%, range 7.3%-23.7%). Almost two thirds (65%) of GBMSM indicated preferring one of these methods even if the result was reactive. CONCLUSIONS: Availability of HIV self-sampling kits as an additional testing methodology would lead to a much-needed increase of testing frequency, especially for the hidden, high-risk, and undertested GBMSM population. Online-based technologies without any personal interaction were preferred for the communication of the results, even for reactive results.
背景:在整个欧洲,男同性恋、双性恋和其他与男性发生性关系的男性(GBMSM)人群中,艾滋病病毒(HIV)的晚期诊断仍然很常见。HIV 自我采样可以帮助消除障碍,为这一高危人群提供检测。 目的:我们评估了 HIV 自我采样在丹麦、德国、希腊、葡萄牙、罗马尼亚和西班牙的 GBMSM 中增加检测频率的能力,并评估了新技术在结果传播阶段的作用。 方法:我们分析了 2016 年通过同性恋约会网站招募的 5019 名有 HIV 检测经验的 GBMSM 的便利样本。我们估计了报告称自我采样的可用性将增加他们当前检测频率的 GBMSM 的比例。我们为每个国家构建了一个泊松回归模型,以计算与自我采样可用性导致检测频率增加相关的因素的患病率比和 95%置信区间。 结果:总体而言,59%(国家间范围为 54.2%-77.2%)的参与者认为,如果他们所在的国家有自我采样,他们会更频繁地检测 HIV。在多变量分析中,除了希腊之外,在所有国家中,自我采样可用性导致检测频率增加与报告更高数量的无保护肛交事件独立相关。在德国、希腊、葡萄牙和西班牙,对性生活保密的 GBMSM;在丹麦、希腊、葡萄牙和西班牙,检测次数较少的 GBMSM;以及在德国、葡萄牙、罗马尼亚和西班牙,最后一次检测超过 3 个月的 GBMSM,也观察到了独立的关联。此外,58.4%(范围 40.5%-73.6%)的参与者表示更喜欢通过单向交互方法了解结果,主要是通过电子邮件(25.6%,范围 16.8%-35.2%)和通过安全网站(20.3%,范围 7.3%-23.7%)。几乎三分之二(65%)的 GBMSM 表示即使结果呈阳性,他们也更倾向于选择其中一种方法。 结论:HIV 自我采样试剂盒作为一种额外的检测方法,如果提供,将导致非常需要的检测频率增加,特别是对于隐藏的、高风险的和未检测的 GBMSM 人群。在线的、无需任何人际互动的技术更受欢迎用于结果的交流,即使是对于阳性结果。
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