School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada.
Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Biomed Res Int. 2021 Aug 21;2021:5599588. doi: 10.1155/2021/5599588. eCollection 2021.
BACKGROUND: Despite being sexually active and engaging in risky sexual behaviours similar to young adults, older adults (50 years or older) are less likely to receive HIV testing, and disaggregated data are still scarce about HIV prevention and treatment in this vulnerable population in sub-Saharan Africa (SSA). This systematic review is aimed at examining sex differences in HIV testing and counseling (HTC) among older adults in SSA. METHODS: A systematic search of four databases, namely, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and Global Health, was conducted from 2000 to January 2020. The primary outcome of interest for this study was gender differences in HTC among older adults in SSA. Observational studies including cross-sectional, retrospective, and prospective cohort studies were included. Eligible studies must have reported sex differences in HIV testing uptake in a standard HTC service among older adults in SSA. RESULTS: From the database search, 4143 articles were identified. Five studies were ultimately included in the final review. Of the 1189 participants, 606 (51.1%) and 580 (48.9%) were female and male, respectively. The review findings suggested that both men and women preferred HTC providers that are the same sex as them with women additionally preferring a provider who is also of a similar age. Men and women differed in their pathways to getting tested for HIV. The review documented mixed results with regard to the associations between sex of older adults and uptake of HTC. Older adult HTC uptake data are limited in scope and coverage in sub-Saharan Africa. CONCLUSION: This review revealed shortage of evidence to evaluate optimum HTC utilization among older adults. Few studies examined sex differences in HIV testing among older adults in the region. There is a need for stakeholders working in the area of HIV prevention and treatment to focus on older adult health utilization evidence organization, disaggregated by age and sex. Hence, high-quality research designs are needed on the topic in order to generate good quality evidence for targeted interventions to improve HTC among older adults in sub-Saharan Africa.
背景：尽管老年人（50 岁及以上）与年轻成年人一样具有性行为并参与危险的性行为，但他们接受 HIV 检测的可能性较小，关于撒哈拉以南非洲（SSA）这一弱势群体的 HIV 预防和治疗的分类数据仍然很少。本系统评价旨在研究 SSA 中老年人 HIV 检测和咨询（HTC）中的性别差异。
方法：从 2000 年到 2020 年 1 月，对四个数据库（即 Ovid 的 MEDLINE、Ovid 的 EMBASE、Web of Science 和全球健康）进行了系统搜索。本研究的主要结果是 SSA 中老年人 HTC 中的性别差异。包括横断面、回顾性和前瞻性队列研究在内的观察性研究被纳入。合格的研究必须报告 SSA 中老年人在标准 HTC 服务中接受 HIV 检测的性别差异。
结果：从数据库搜索中，共确定了 4143 篇文章。最终有 5 项研究纳入了最终审查。在 1189 名参与者中，分别有 606（51.1%）和 580（48.9%）人为女性和男性。审查结果表明，男性和女性都更喜欢与自己性别相同的 HTC 提供者，而女性更喜欢与自己年龄相仿的提供者。男性和女性在接受 HIV 检测的途径上存在差异。审查结果表明，关于成年人性别与 HTC 接受程度之间的关联，结果喜忧参半。撒哈拉以南非洲地区关于成年人大众 HTC 接受程度的数据范围和覆盖面有限。
结论：本综述揭示了评估老年人最佳 HTC 利用情况的证据不足。该地区很少有研究检查老年人 HIV 检测中的性别差异。需要在 HIV 预防和治疗领域工作的利益相关者关注老年保健利用证据的组织，按年龄和性别分类。因此，需要针对该主题进行高质量的研究设计，以便为针对撒哈拉以南非洲地区老年人的 HTC 改善干预措施提供高质量的证据。
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