National Centre for Infectious Diseases, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Sex Transm Infect. 2021 Nov;97(7):514-520. doi: 10.1136/sextrans-2020-054773. Epub 2021 Jan 15.
Voluntary HIV testing rates are still low in several Asian countries including Singapore. HIV self-testing (HIVST) has the potential to increase testing, leading to earlier diagnosis and better prognosis. However, the views of at-risk individuals, especially heterosexual men (HSM), who are not coming forward for testing are still poorly understood. In this study, we examined the barriers and facilitators to and delivery preferences for HIVST in order to implement an effective intervention in Singapore.
From May 2017 to June 2018, 48 in-depth interviews were conducted with HSM aged 21-66 years and at risk of HIV infection. Participants were purposively sampled based on ethnicity, age and testing behaviour. Recruitment was done mainly at brothels and entertainment establishments in Singapore. Participants gave their views on HIV testing, factors affecting HIVST use and their preferred HIVST service delivery model.
Most participants preferred HIVST over conventional testing for its convenience, privacy, anonymity and autonomy, but older men still preferred conventional testing. Low self-perceived risk, low awareness and self-efficacy for HIVST, and non-comprehensive test for other STIs were reported as barriers to HIVST. There were mixed opinions on kit preference. A blood-based kit was favoured for higher accuracy, while the oral-fluid-based kit was favoured for ease of use. Participants wanted a human touch for post-test counselling and linkage to care only if they self-tested positive. Traditional media, internet and social media, and venue-based outreach were potential advertising platforms mentioned.
A locally acceptable and feasible HIVST intervention must address the barriers and facilitators of using HIVST in order to improve HIV testing rates among this at-risk population who might otherwise delay or fail to present for testing.
包括新加坡在内的一些亚洲国家的自愿艾滋病毒检测率仍然很低。艾滋病毒自检（HIVST）有可能增加检测，从而更早地诊断和改善预后。然而，对于高危人群，特别是异性恋男性（HSM），他们不愿意进行检测，人们对他们的看法仍然知之甚少。在这项研究中，我们研究了 HIVST 的障碍、促进因素和交付偏好，以便在新加坡实施有效的干预措施。
2017 年 5 月至 2018 年 6 月，对年龄在 21-66 岁、有感染艾滋病毒风险的 HSM 进行了 48 次深入访谈。参与者根据种族、年龄和检测行为进行了有针对性的抽样。招募主要在新加坡的妓院和娱乐场所进行。参与者就艾滋病毒检测、影响 HIVST 使用的因素以及他们首选的 HIVST 服务交付模式发表了看法。
大多数参与者更喜欢 HIVST 而不是传统检测，因为它方便、私密、匿名和自主，但年长的男性仍然更喜欢传统检测。报告的 HIVST 障碍包括自我感知风险低、对 HIVST 的认识和自我效能感低、以及对其他性传播感染的检测不全面。对试剂盒的偏好存在分歧意见。基于血液的试剂盒因准确性更高而受到青睐，而基于口腔液的试剂盒则因使用方便而受到青睐。参与者希望在自我检测呈阳性时仅提供人工咨询和联系护理服务。传统媒体、互联网和社交媒体以及基于场所的外展活动被提到是潜在的广告平台。
为了提高高危人群的艾滋病毒检测率，必须解决使用 HIVST 的障碍和促进因素，否则这些人可能会延迟或未能进行检测。
