Fistonich George M, Troutman Kenya M, Visconti Adam J
District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA), Washington, District of Columbia.
District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA), Washington, District of Columbia.
Am J Prev Med. 2021 Nov;61(5 Suppl 1):S16-S25. doi: 10.1016/j.amepre.2021.06.009.
In 2019, the District of Columbia recorded a 20-year low rate in new HIV infections but also had near-record numbers of gonorrhea and chlamydia infections. District of Columbia Department of Health has supported numerous forms of community-based in-person screening but not direct at-home testing.
In summer 2020, the District of Columbia Department of Health launched GetCheckedDC.org for District of Columbia residents to order home-based oral HIV antibody test and urogenital, pharyngeal, and rectal chlamydia and gonorrhea tests. Initial and follow-up surveys were completed by individuals for both test modalities.
A retrospective analysis was conducted for the first 5 months of the program. During that period, 1,089 HIV and 1,262 gonorrhea and chlamydia tests (535 urogenital, 520 pharyngeal, 207 rectal) were ordered by 1,245 District of Columbia residents. The average age was 33.1 (median=31, range=14-78) years; 51.6% of requestors identified as Black; 39.3% identified as men who have sex with men; 16.2% reported no form of insurance; and 8.1% and 10.4% reported never being testing for HIV and sexually transmitted infections, respectively. More than half of people requesting tests reported convenience and COVID-19 as the reasons. In total, 39.5% of sexually transmitted infection tests were returned; 7.22% of people testing for sexually transmitted infections received a positive result, and 10.35% of rectal tests were positive. No individuals reported a positive HIV self-test that was confirmed; 98.5% of respondents said that they would recommend the HIV self-test kit.
Mail-out HIV and sexually transmitted infection testing was readily taken up among high-priority demographics within a diverse, urban, high-morbidity jurisdiction during the COVID-19 pandemic. Extragenital testing for gonorrhea and chlamydia should be included in all at-home screening tests given the high positivity rate.
2019年，哥伦比亚特区的新增艾滋病毒感染率创下20年来的新低，但淋病和衣原体感染病例数却接近历史最高纪录。哥伦比亚特区卫生部支持多种形式的社区现场筛查，但不支持直接在家检测。
2020年夏天，哥伦比亚特区卫生部推出了GetCheckedDC.org网站，供哥伦比亚特区居民订购家用口服艾滋病毒抗体检测以及泌尿生殖系统、咽部和直肠的衣原体和淋病检测。个人针对这两种检测方式完成了初始调查和后续调查。
对该项目的前5个月进行了回顾性分析。在此期间，1245名哥伦比亚特区居民订购了1089次艾滋病毒检测以及1262次淋病和衣原体检测（535次泌尿生殖系统检测、520次咽部检测、207次直肠检测）。平均年龄为33.1岁（中位数=31岁，范围=14 - 78岁）；51.6%的申请者为黑人；39.3%为男同性恋者；16.2%的人表示没有任何形式的保险；8.1%和10.4%的人分别表示从未接受过艾滋病毒和性传播感染检测。超过一半的检测申请者表示便利性和新冠疫情是他们申请检测的原因。性传播感染检测的总体送检率为39.5%；接受性传播感染检测的人中，7.22%结果呈阳性，直肠检测的阳性率为10.35%。没有个人报告艾滋病毒自我检测呈阳性且得到确认的情况；98.5%的受访者表示他们会推荐艾滋病毒自我检测试剂盒。
在新冠疫情期间，可以方便地向不同的城市高发病率辖区内的高优先级人群提供邮寄式艾滋病毒和性传播感染检测。鉴于高阳性率，所有家用筛查检测都应包括淋病和衣原体的生殖器外检测。
