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Impact and acceptability of HIV self-testing for trans men and trans women: A mixed-methods subgroup analysis of the SELPHI randomised controlled trial and process evaluation in England and Wales.

作者信息

Witzel T Charles, Wright Talen, McCabe Leanne, Gabriel Michelle M, Wolton Aedan, Gafos Mitzy, Ward Denise, Lampe Fiona C, Phillips Andrew N, Trevelion Roy, Collaco-Moraes Yolanda, Harbottle Justin, Speakman Andrew, Bonell Chris, Dunn David D, McCormack Sheena, Burns Fiona M, Weatherburn Peter, Rodger Alison J

机构信息

Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom.

Medical Research Council Clinical Trials Unit at University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom.

出版信息

EClinicalMedicine. 2021 Feb 11;32:100700. doi: 10.1016/j.eclinm.2020.100700. eCollection 2021 Feb.


DOI:10.1016/j.eclinm.2020.100700
PMID:33681732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7910695/
Abstract

BACKGROUND: Globally, trans people are disproportionately affected by HIV, but research on strategies to increase testing are limited. SELPHI is a randomised-controlled-trial (RCT) of 10,135 men, trans men, and trans women reporting lifetime anal intercourse with male partners ( or trans), evaluating whether the offer of free HIV self-testing (HIVST) increases diagnosis. This subgroup analysis from the SELPHI RCT aims to describe key HIVST outcomes and HIVST acceptability for trans people. METHODS: SELPHI recruited using social networking and trans focused social media. Participants were randomised 60/40 to baseline HIVST (Biosure™) (BT) vs no baseline HIVST (nBT); and at 3-months (if completed the survey and reported recent CAI) 50/50 to 3-monthly HIVST (RT) vs no repeat HIVST (nRT). Outcomes were self-reported through online surveys. We conducted a qualitative study of semi-structured peer-led participant interviews ( = 20) exploring HIVST motivations and experiences. These were analysed using a framework approach. FINDINGS: SELPHI recruited and randomised 118 trans men and trans women (94 trans men, 24 trans women), of whom 20 (16 trans men, 4 trans women) underwent the second randomisation. Median age at baseline was 29 (IQR: 22, 37), 79% were white, 79% were UK born, 37% had degree level education, and 31% had never tested for HIV. 62% ( = 59) of trans men completed the 3-month survey, but survey completion by trans women in nBT was too low (1/11) for randomised comparison. In trans men HIV testing uptake by 3 months was significantly higher in BT (95% 36/38) vs nBT (29%, 6/21) (RR=3.32 (1.68, 6.55) <0.001). Trans people randomised to RT reported 3 times higher rate of HIV testing compared to nRT during the two-year follow-up (IRR 3.66 (1.86, 8.01) <0.0001). STI testing frequency (mean number of tests during each 13 week period/ 2-year follow-up) was not significantly different across interventions: RT (0.03) and nRT (0.01) (IRR=1.86 95%CI; 0.77, 5.15;  = 0.15). Social harms were rare. Acceptability was very high in BT: 97% (38/39) found instructions easy to understand, 97% (37/38) found the HIVST simple to use and 100% (39/39) reported good overall experience. In interviews, reported HIVST benefits included increased autonomy, privacy, convenience and avoidance of health care providers perceived to be discriminatory and services that increased dysphoria. Minor lancet and test processing issues were reported. INTERPRETATION: HIVST significantly increased testing uptake and frequency in trans men and trans people overall, although recruitment and retention of trans women was low. HIVST acceptability was high and indicates easy access to this novel technology may increase HIV testing access for this key population.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4a1/7910695/2e73c9b15d4c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4a1/7910695/c38da58aabc7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4a1/7910695/2e73c9b15d4c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4a1/7910695/c38da58aabc7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4a1/7910695/2e73c9b15d4c/gr2.jpg

相似文献

[1]
Impact and acceptability of HIV self-testing for trans men and trans women: A mixed-methods subgroup analysis of the SELPHI randomised controlled trial and process evaluation in England and Wales.

EClinicalMedicine. 2021-2-11

[2]
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Sex Transm Infect. 2023-12

[3]
HIV self-testing intervention experiences and kit usability: results from a qualitative study among men who have sex with men in the SELPHI (Self-Testing Public Health Intervention) randomized controlled trial in England and Wales.

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[4]
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[5]
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[6]
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[7]
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引用本文的文献

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Evaluating HIV testing preferences and uptake of oral fluid-based HIV self-testing among men who have sex with men and transgender women in the Greater Manila Area of the Philippines: an explanatory sequential mixed-methods research protocol.

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[2]
Comparison of HIV self-test distribution modalities to reduce HIV transmission and burden in western Kenya: a mathematical modelling study.

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[3]
Global Human Immunodeficiency Virus Prevalence and Risk Behaviors in Transmasculine Individuals: A Scoping Review.

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[4]
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Front Health Serv. 2025-3-28

[5]
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BMC Public Health. 2025-2-20

[6]
HIV Testing and PrEP Use Among Trans and/or Non-binary Participants in the TASG Study, a Participatory Study in Germany.

AIDS Behav. 2025-5

[7]
Assessing Whether Providing Regular, Free HIV Self-Testing Kits Reduces the Time to HIV Diagnosis: An Internet-Based, Randomized Controlled Trial in Men Who Have Sex With Men.

J Acquir Immune Defic Syndr. 2025-3-1

[8]
Effects of HIV Self-Testing on Testing Promotion and Risk Behavior Reduction Among Transgender Women in China: Randomized Controlled Trial.

J Med Internet Res. 2024-10-29

[9]
How can HIV self-testing facilitate increased access to HIV testing among multiply marginalised populations? Perspectives from GBMSM and trans women in England and Wales.

PLoS One. 2024

[10]
Needs & networks: understanding the role and impact of social networks on HIV (self-)testing among GBMSM and trans people in England and Wales.

BMC Public Health. 2024-7-25

本文引用的文献

[1]
Comparing the effects of HIV self-testing to standard HIV testing for key populations: a systematic review and meta-analysis.

BMC Med. 2020-12-3

[2]
Sexual risk and HIV testing disconnect in men who have sex with men (MSM) recruited to an online HIV self-testing trial.

HIV Med. 2020-10

[3]
Exploring Mechanisms of Action: Using a Testing Typology to Understand Intervention Performance in an HIV Self-Testing RCT in England and Wales.

Int J Environ Res Public Health. 2020-1-10

[4]
Use of HIV Self-Testing Kits to Screen Clients Among Transgender Female Sex Workers in New York and Puerto Rico.

AIDS Behav. 2020-2

[5]
HIV self-testing intervention experiences and kit usability: results from a qualitative study among men who have sex with men in the SELPHI (Self-Testing Public Health Intervention) randomized controlled trial in England and Wales.

HIV Med. 2020-3

[6]
Psychosocial and sexual factors associated with recent sexual health clinic attendance and HIV testing among trans people in the UK.

BMJ Sex Reprod Health. 2019-10-30

[7]
Pilot phase of an internet-based RCT of HIVST targeting MSM and transgender people in England and Wales: advertising strategies and acceptability of the intervention.

BMC Infect Dis. 2019-8-8

[8]
Human Immunodeficiency Virus and Trans Women: A Literature Review.

Transgend Health. 2018-12-28

[9]
Protocol, rationale and design of SELPHI: a randomised controlled trial assessing whether offering free HIV self-testing kits via the internet increases the rate of HIV diagnosis.

BMC Infect Dis. 2018-10-23

[10]
A Pilot, Randomized Controlled Trial of HIV Self-Testing and Real-Time Post-Test Counseling/Referral on Screening and Preventative Care Among Men Who Have Sex with Men.

AIDS Patient Care STDS. 2018-9

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