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混合方法评估将家庭样本自我采集试剂盒纳入 HIV 暴露前预防的远程医疗项目中的实验室检测。

Mixed-Methods Evaluation of the Incorporation of Home Specimen Self-Collection Kits for Laboratory Testing in a Telehealth Program for HIV Pre-exposure Prophylaxis.

机构信息

Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA.

出版信息

AIDS Behav. 2021 Aug;25(8):2463-2482. doi: 10.1007/s10461-021-03209-9. Epub 2021 Mar 19.

DOI:10.1007/s10461-021-03209-9
PMID:33740212
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7975241/
Abstract

Home specimen self-collection kits with central laboratory testing may improve persistence with PrEP and enhance telehealth programs. We offered Iowa TelePrEP clients the choice of using a home kit or visiting a laboratory site for routine monitoring. Mixed-methods evaluation determined the proportion of clients who chose a kit, factors influencing choice, associations between kit use and completion of indicated laboratory monitoring, and user experience. About 46% (35/77) chose to use a kit. Compared to laboratory site use, kit use was associated with higher completion of extra-genital swabs (OR 6.33, 95% CI 1.20-33.51, for anorectal swabs), but lower completion of blood tests (OR 0.21, 95% CI 0.06-0.73 for creatinine). Factors influencing choice included self-efficacy to use kits, time/convenience, and privacy/confidentiality. Clients reported kit use was straight-forward but described challenges with finger prick blood collection. Telehealth PrEP programs should offer clients home kits and support clients with blood collection and kit completion.

摘要

家庭样本自检试剂盒与中心实验室检测相结合，可以提高 PrEP 的持续性，并增强远程医疗项目。我们为爱荷华州远程 PrEP 客户提供了使用家庭试剂盒或前往实验室进行常规监测的选择。混合方法评估确定了选择试剂盒的客户比例、影响选择的因素、试剂盒使用与完成规定实验室监测之间的关联以及用户体验。约 46%（35/77）选择使用试剂盒。与在实验室现场使用相比，试剂盒使用与更高的生殖器外拭子完成率相关（OR6.33，95%CI1.20-33.51，用于肛门直肠拭子），但血液检测完成率较低（OR0.21，95%CI0.06-0.73 用于肌酐）。影响选择的因素包括使用试剂盒的自我效能、时间/便利性和隐私/保密性。客户报告试剂盒使用简单，但描述了指尖采血的挑战。远程医疗 PrEP 项目应向客户提供家庭试剂盒，并为客户提供采血和试剂盒完成方面的支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/9c65b85b3d6d/10461_2021_3209_Fig4a_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/c37c46c0ab29/10461_2021_3209_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/7a5c79050ef0/10461_2021_3209_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/f397c32731df/10461_2021_3209_Fig3a_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/9c65b85b3d6d/10461_2021_3209_Fig4a_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/c37c46c0ab29/10461_2021_3209_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/7a5c79050ef0/10461_2021_3209_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/f397c32731df/10461_2021_3209_Fig3a_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ff/7975241/9c65b85b3d6d/10461_2021_3209_Fig4a_HTML.jpg

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