Dermatology Department, Clemenceau Medical Center Affiliated With Johns Hopkins, Beirut, Lebanon.
National AIDS Program, Beirut, Lebanon.
Health Res Policy Syst. 2021 Apr 21;19(Suppl 1):50. doi: 10.1186/s12961-021-00709-x.
BACKGROUND: In Lebanon, HIV is concentrated in both native and refugee communities of men who have sex with men (MSM). For over 10 years, the National AIDS Program (NAP) has offered HIV voluntary counselling and testing through a partnership with nongovernmental organizations (NGOs). In 2018, implementation of HIV self-tests (HIVST) was introduced, and this self-care intervention has been further scaled up during the coronavirus disease 2019 (COVID-19) pandemic. This paper (1) describes the effectiveness of implementing HIVST in Lebanon, and (2) discusses how the success of HIVST implementation has been reflected during the COVID-19 pandemic. METHODS: The NAP conducted a series of workshops (July-November 2018) to introduce HIVST services for healthcare workers working at different NGOs. The workshops highlighted that HIVST would be distributed for free, that it would be confidential and voluntary, and that participants were encouraged to notify the NGOs of their results, which would be kept strictly confidential. NGOs collected data anonymously and confidentially from beneficiaries (age, consistency of condom use and HIV testing history), who were asked to call back with the results of their HIVST. At the NAP, data were combined, aggregated and analysed. RESULTS: In 2019, the NGOs distributed 1103/1380 (79.9%) HIVST kits to their beneficiaries. The NGOs collected feedback on 111 kit results, of which two were HIV-positive. Feedback about HIVST results from beneficiaries was low (111/1103) due to noncompliance of beneficiaries and the lack of human and financial resources in the NGOs. From January through May 2020, a total of 625/780 HIVST kits (80.1%) were distributed. This period was divided into pre-COVID-19 and during COVID-19. The follow-up with the beneficiaries during COVID-19 was much improved because of the absence of on-site activities, shifting more efforts towards HIVST (449/625). There have been no reports of social harm related to HIVST. CONCLUSION: HIVST implementation in Lebanon serves as an example of introducing a self-care intervention as part of a community-led effort. In order to maintain HIVST services at the same improved level, reorganization of care is needed within each NGO following the adaptation process due to COVID-19, along with continuous monitoring and evaluation of HIVST reported data.
背景:在黎巴嫩,艾滋病毒主要集中在男男性行为者(MSM)的本地和难民社区。10 多年来,国家艾滋病规划署(NAP)通过与非政府组织(NGO)合作,提供艾滋病毒自愿咨询和检测。2018 年,引入了艾滋病毒自我检测(HIVST),并在 2019 年冠状病毒病(COVID-19)大流行期间进一步扩大了这种自我保健干预措施。本文(1)描述了在黎巴嫩实施 HIVST 的效果,(2)讨论了 HIVST 实施的成功如何在 COVID-19 大流行期间得到体现。
方法:NAP 举办了一系列研讨会(2018 年 7 月至 11 月),向在不同 NGO 工作的医护人员介绍 HIVST 服务。研讨会强调,HIVST 将免费分发,检测将是保密和自愿的,并鼓励参与者将检测结果通知 NGO,这些结果将严格保密。NGO 从受益人那里匿名和保密地收集数据(年龄、 condom 使用一致性和艾滋病毒检测史),并要求受益人回电告知 HIVST 检测结果。在 NAP,数据被合并、汇总和分析。
结果:2019 年,NGO 向其受益人分发了 1103/1380(79.9%)HIVST 试剂盒。NGO 收集了 111 个试剂盒结果的反馈,其中 2 个结果呈阳性。由于受益人的不遵守和 NGO 缺乏人力和财力资源,受益人对 HIVST 结果的反馈很低(111/1103)。2020 年 1 月至 5 月,共分发了 625/780(80.1%)HIVST 试剂盒。这段时间分为 COVID-19 前和 COVID-19 期间。由于现场活动的缺失,将更多的精力转移到 HIVST 上,因此 COVID-19 期间与受益人的随访得到了很大改善(449/625)。没有报告与 HIVST 相关的社会危害。
结论:在黎巴嫩实施 HIVST 为引入自我保健干预措施作为社区主导努力的一部分树立了榜样。为了保持 HIVST 服务的同一改进水平,需要在每个 NGO 中进行组织重组,以适应 COVID-19 后的适应过程,同时对报告的数据进行持续监测和评估。
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