Hawk Mary E, Chung Ashley, Creasy Stephanie L, Egan James E
Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Patient Prefer Adherence. 2020 Dec 2;14:2365-2375. doi: 10.2147/PPA.S251677. eCollection 2020.
Despite marked progress in the ability to test for, treat, and prevent HIV, the epidemic remains a significant public health concern, especially among key populations including prisoners; sex workers; transgender individuals; gay, bisexual, and other men who have sex with men (MSM); and Black and Latinx MSM. This scoping review was conducted to provide an overview of the current research describing patient preferences for HIVST in the United States to understand what key populations value about HIVST and why they are willing to use it. A targeted search for published literature on patient preferences for HIVST was conducted using Ovid Medline, PsychINFO, and an HIVST research database.
We reviewed 700 abstracts and 139 full texts. We found 19 articles published between January 2014 and April 2020 that included findings related to HIVST preferences. Overall, HIVST was preferred to more traditional testing. Six primary factors emerged as important HIVST values including: 1) convenience, 2) type of test; 3) cost, 4) stigma reduction, 5) risk reduction, and 6) self-control. Linkage to care was also identified as a key factor when considering HIVST as an option. Much of what makes HIVST attractive to individuals is their ability to self-determine how HIVST can be best integrated into their lives as a harm reduction tool for stigma and sexual risk mitigation.
While there is substantial evidence suggesting HIVST is feasible for use and there are aspects of HIVST that are beneficial and preferred over traditional testing approaches, there is a lack of rigorous implementation studies exploring how best to scale up HIVST in community settings. HIVST has the potential to be a powerful biobehavioral HIV prevention and harm reduction tool to empower individuals to engage with testing on their own terms while providing pathways to prevention and care support.
尽管在艾滋病毒检测、治疗和预防能力方面取得了显著进展，但该流行病仍是一个重大的公共卫生问题，尤其是在包括囚犯、性工作者、跨性别者、男同性恋者、双性恋者和其他与男性发生性关系的男性（男男性行为者）以及黑人和拉丁裔男男性行为者等关键人群中。开展这项范围综述是为了概述当前描述美国患者对自我检测艾滋病毒偏好的研究，以了解关键人群看重艾滋病毒自我检测的哪些方面以及他们愿意使用它的原因。我们使用Ovid Medline、PsychINFO和一个艾滋病毒自我检测研究数据库，针对性地搜索了关于患者对艾滋病毒自我检测偏好的已发表文献。
我们审查了700篇摘要和139篇全文。我们发现了2014年1月至2020年4月期间发表的19篇文章，其中包含与艾滋病毒自我检测偏好相关的研究结果。总体而言，与更传统的检测方法相比，艾滋病毒自我检测更受青睐。六个主要因素成为重要的艾滋病毒自我检测价值，包括：1）便利性；2）检测类型；3）成本；4）减少耻辱感；5）降低风险；6）自我控制。在将艾滋病毒自我检测作为一种选择时，与医疗服务的联系也被确定为一个关键因素。艾滋病毒自我检测对个人具有吸引力的很大一部分原因在于他们能够自行决定如何将艾滋病毒自我检测作为减少耻辱感和性风险的减少伤害工具，最好地融入他们的生活。
虽然有大量证据表明艾滋病毒自我检测在使用上是可行的，而且艾滋病毒自我检测的某些方面比传统检测方法更有益且更受青睐，但缺乏严格的实施研究来探索如何在社区环境中最好地扩大艾滋病毒自我检测的规模。艾滋病毒自我检测有可能成为一种强大的生物行为艾滋病毒预防和减少伤害工具，使个人能够按照自己的条件进行检测，同时提供预防和护理支持的途径。
