Sexual Health Unit, Santé publique France, Saint Maurice, France
iPLESP UMRS1136, INSERM, Paris, France.
Sex Transm Infect. 2021 Mar;97(2):134-140. doi: 10.1136/sextrans-2020-054790. Epub 2021 Jan 4.
In 2017, to reduce the proportion of men who have sex with men (MSM) in the undiagnosed HIV population in France (38%), HIV screening is advised each 3 months and STI screening is advised each year in multipartner MSM. Despite the range of testing solutions, over 40% of MSM were not tested for HIV and over 50% for STIs in the past year. Based on international experiments that offer screening solutions via online advertising, the French National Health Agency launched a programme (MemoDepistages) to provide a free self-sampling kit (SSK) for HIV and STIs. This article analyses the sociodemographic and behavioural characteristics of MSM in terms of kit acceptance and sample return.
Participants were registered for the programme online after ordering an SSK. The study included men aged over 18 years, living in one of the four selected French regions, and willing to disclose their postal and email address; they had health insurance, acknowledged more than one male partner in the past year, indicated a seronegative or unknown HIV status and were not taking medically prescribed pre-exposure prophylaxis drugs. Samples were collected by users and posted directly to the laboratory. Characteristics associated with kit acceptance and sample return were analysed using logistic regression.
Overall, 7158 eligible MSM were offered to participate in the programme, with 3428 ordering the kit (47.9%) and 1948 returning their sample, leading to a return rate of 56.8% and an overall participation rate of 27.2%. Acceptance and return rates were strongly associated with sociodemographic characteristics, mainly education level but not with behavioural characteristics. Non-college graduates had lower acceptance (44.2%) and return rates (47.7%).
The programme rapidly recruited a large number of MSM. It removed geographical inequalities related to screening access.
2017 年，为降低法国未确诊 HIV 人群中男男性行为者（MSM）的比例（38%），建议每 3 个月对 MSM 进行一次 HIV 筛查，每年对多性伴 MSM 进行一次性传播感染（STI）筛查。尽管有多种检测解决方案，但在过去一年中，超过 40%的 MSM 未接受 HIV 检测，超过 50%的 MSM 未接受 STI 检测。基于提供在线广告筛查解决方案的国际实验，法国国家卫生署启动了一项计划（MemoDepistages），为 MSM 提供免费的 HIV 和 STI 自我采样包（SSK）。本文分析了 MSM 对套件接受度和样本返回的社会人口统计学和行为特征。
参与者在订购 SSK 后在线注册该计划。研究包括年龄在 18 岁以上、居住在四个选定的法国地区之一、愿意透露其邮政和电子邮件地址的男性；他们有健康保险，承认过去一年中有多个男性伴侣，HIV 血清学检测结果为阴性或未知，且未服用医学上规定的暴露前预防药物。用户自行采集样本并直接寄往实验室。使用逻辑回归分析与套件接受度和样本返回相关的特征。
共有 7158 名符合条件的 MSM 被邀请参加该计划，其中 3428 人订购了套件（47.9%），1948 人返回了样本，因此返回率为 56.8%，总参与率为 27.2%。接受度和返回率与社会人口学特征密切相关，主要与教育水平有关，但与行为特征无关。未完成大学学业的人接受度（44.2%）和返回率（47.7%）较低。
该计划迅速招募了大量 MSM。它消除了与筛查机会相关的地理不平等。
