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基于社区的干预措施作为提高男男性行为者 HIV 自检和护理衔接的机会——来自西非加纳的经验教训。

Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men - Lessons From Ghana, West Africa.

机构信息

Center for Interdisciplinary Research on AIDS, School of Medicine, Yale University, New Haven, CT, United States.

School of Medicine, Yale University, New Haven, CT, United States.

出版信息

Front Public Health. 2021 Jun 11;9:660256. doi: 10.3389/fpubh.2021.660256. eCollection 2021.


DOI:10.3389/fpubh.2021.660256
PMID:34178919
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8226123/
Abstract

MSM in Ghana encounter challenges in accessing HIV services and may experience barriers to HIV self-testing due to multiple forms of stigma present in health care settings. We worked with community-based organization partners to implement three interventions that successfully engaged and retained MSM which provides an opportunity for linkage to self-testing and medical care. These interventions were (1) Many Men Many Voices (3MV) a locally-led culturally grounded group-level HIV prevention program, (2) Auntie's Corner: a mobile-app based connecting MSM to health monitoring by a registered nurse and (3) HIV Education, Empathy, & Empowerment (HIVE3): a mobile-app based peer support intervention for MSM living with HIV. The 3MV intervention may be effective in improving HIV self-testing due to its effectiveness in engaging MSM, increasing HIV testing, and improving MSM understanding of the need for HIV testing. The utilization of apps like Auntie's Corner could positively impact HIV self-testing among MSM because it increases contact with nurses and reporting of symptoms. In HIVE3, participants expressed appreciation of the security and privacy that protects their identities as MSM and the peer mentors' abilities to make referrals to the nurses in Auntie's Corners. The confidentiality component has proven key among MSM and connecting MSM to self-testing through apps to report their process and receive care could increase utilization. Together, we show the efficacy of using the community-engaged process in reaching and engaging highly stigmatized populations like Ghana and sub-Saharan Africa, and its potential in increasing HIV self-testing and linkage to HIV care.

摘要

在加纳,男男性行为者(MSM)在获取艾滋病毒服务方面面临挑战,并且由于医疗环境中存在多种形式的污名化,他们可能难以进行艾滋病毒自我检测。我们与社区组织合作伙伴合作,实施了三项干预措施,成功地接触和留住了 MSM,为他们进行自我检测和获得医疗保健提供了机会。这些干预措施包括:(1)“Many Men Many Voices”(3MV),这是一个由当地主导、具有文化基础的团体层面艾滋病毒预防项目;(2)Auntie's Corner:一个基于移动应用程序的应用程序,通过注册护士将 MSM 与健康监测联系起来;(3)HIV Education, Empathy, & Empowerment(HIVE3):一个基于移动应用程序的针对 HIV 感染者的同伴支持干预措施。3MV 干预措施可能通过其吸引 MSM、增加 HIV 检测以及提高 MSM 对 HIV 检测必要性的认识,从而有效提高 HIV 自我检测率。Auntie's Corner 等应用程序的使用可能会对 MSM 的 HIV 自我检测产生积极影响,因为它增加了与护士的接触和症状报告。在 HIVE3 中,参与者对保护他们作为 MSM 身份的安全性和隐私性以及同伴导师向 Auntie's Corners 中的护士转介的能力表示赞赏。保密性是 MSM 关注的关键,通过应用程序将 MSM 与自我检测联系起来,报告他们的检测过程并获得护理,可以提高利用率。总之,我们展示了通过社区参与的过程来接触和吸引像加纳和撒哈拉以南非洲这样高度污名化的人群的效果,以及通过这种方式增加 HIV 自我检测和与 HIV 护理联系的潜力。

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[3]
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[4]
Self-reported life experiences of members of the LGBTQ+ community in Accra, Ghana.

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[5]
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[6]
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[9]
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[10]
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本文引用的文献

[1]
Acceptability of HIV Oral Self-Test Among Men Having Sex With Men and Transgender Population: A Qualitative Investigation From Pune, India.

Infect Dis (Auckl). 2020-10-13

[2]
Implementation and evaluation of a culturally grounded group-based HIV prevention programme for men who have sex with men in Ghana.

Glob Public Health. 2021-7

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An implementation study of oral and blood-based HIV self-testing and linkage to care among men in rural and peri-urban KwaZulu-Natal, South Africa.

J Int AIDS Soc. 2020-6

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Stigma, discrimination, violence, and HIV testing among men who have sex with men in four major cities in Ghana.

AIDS Care. 2020-8

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Lancet HIV. 2019-10-7

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An Internet-Based HIV Self-Testing Program to Increase HIV Testing Uptake Among Men Who Have Sex With Men in Brazil: Descriptive Cross-Sectional Analysis.

J Med Internet Res. 2019-8-1

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Community-led HIV testing services including HIV self-testing and assisted partner notification services in Vietnam: lessons from a pilot study in a concentrated epidemic setting.

J Int AIDS Soc. 2019-7

[8]
Acceptability, perceived reliability and challenges associated with distributing HIV self-test kits to young MSM in Uganda: a qualitative study.

J Int AIDS Soc. 2019-3

[9]
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J Int AIDS Soc. 2019-3

[10]
The Self-Testing AfRica (STAR) Initiative: accelerating global access and scale-up of HIV self-testing.

J Int AIDS Soc. 2019-3

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