Faculty of Medicine, Department of Pediatrics, 26683Chulalongkorn University, Bangkok, Thailand.
Center of Excellence in Transgender Health, 26683Chulalongkorn University, Bangkok, Thailand.
Int J STD AIDS. 2021 Sep;32(10):927-932. doi: 10.1177/09564624211003742. Epub 2021 Apr 23.
Young men who have sex with men (YMSM) and young transgender women (YTGW) in Thailand are at high HIV risk. HIV self-tests (HIVSTs) are rapidly administrable and prompt linkage to HIV treatment or prevention services. This study assesses the acceptability and feasibility of blood-based HIVST use in adolescents.
A cross-sectional study was conducted among YMSM and YTGW aged 15-19 years with HIV acquisition risk. Participants completed questionnaires on the HIVST and then administered INSTI® independently, an HIVST immunoassay detecting gp41 and gp36 antibodies from finger-stick blood. Confirmatory HIV antibody tests were performed.
Between July and September 2020, 90 adolescents were enrolled. Mean (SD) age was 17.6 (1.1) years. Half ( = 45) were YMSM. Forty-six (51%) were first-time HIV testers, and 32 (36%) had "ever used" HIV pre-exposure prophylaxis (PrEP). Two (2.2%, 95% CI: 0.0-5.3) tested positive, 21 (23.4%) invalid, and 67 (74.4%) negative. Invalidity causes included 17 (81%) insufficient blood, 3 (14%) buffer spillage, and 1 (5%) procedural missteps; all had negative HIV antibody tests. HIV self-test acceptability was 87.8% (95% CI: 81.0-94.5). Most (79%) preferred HIVST performance in hospital rather than at home.
HIVSTs are acceptable in HIV at-risk adolescents. Blood-based HIVSTs should be positioned as rapid point-of-care tests with real-time linkage to HIV services.
泰国的男男性行为者青年（YMSM）和跨性别青年女性（YTGW）感染 HIV 的风险很高。HIV 自我检测（HIVST）可快速进行，并能及时将 HIV 感染者与 HIV 治疗或预防服务联系起来。本研究评估了基于血液的 HIVST 在青少年中的可接受性和可行性。
在有 HIV 感染风险的 15-19 岁 YMSM 和 YTGW 中进行了一项横断面研究。参与者完成了 HIVST 问卷，然后自行进行 INSTI®检测，这是一种通过手指采血检测 gp41 和 gp36 抗体的 HIVST 免疫测定法。进行了确认 HIV 抗体检测。
在 2020 年 7 月至 9 月期间，共招募了 90 名青少年。平均（SD）年龄为 17.6（1.1）岁。其中一半（=45）为 YMSM。46 名（51%）为首次进行 HIV 检测者，32 名（36%）曾“使用过”HIV 暴露前预防（PrEP）。有 2 名（2.2%，95%CI：0.0-5.3）检测结果阳性，21 名（23.4%）无效，67 名（74.4%）阴性。无效的原因包括 17 名（81%）血液不足、3 名（14%）缓冲液溢出和 1 名（5%）操作失误；所有这些都有阴性 HIV 抗体检测结果。HIV 自我检测的可接受性为 87.8%（95%CI：81.0-94.5）。大多数（79%）更喜欢在医院而不是在家中进行 HIVST。
HIVST 在 HIV 高危青少年中是可以接受的。基于血液的 HIVST 应该被定位为快速的即时护理检测方法，并与 HIV 服务实时联系。
