NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.
Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.
J Med Internet Res. 2021 Oct 26;23(10):e28508. doi: 10.2196/28508.
BACKGROUND: HIV self-testing (HIVST) kits are common in key sexually active populations. Direct secondary distribution of HIVST kits (DSDHK) is effective in improving the uptake of HIVST. However, there are concerns about the various limitations of DSDHK, including limited geographic reach, payment problems, and need for face-to-face interactions. OBJECTIVE: In this study, we aim to evaluate the feasibility and characteristics of indirect secondary distribution of HIVST kits (ISDHK) via WeChat (distributing HIVST application links and follow-up HIVST kits to partners) among men who have sex with men (MSM). METHODS: From October 2017 to September 2019, an HIVST recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for the HIVST kits (referred to as index participants [IPs]). All MSM participants were encouraged to distribute the HIVST application link to their friends and sexual partners (referred to as alters) through their social networks. All the alters were further encouraged to continue distributing the HIVST application link. All participants paid a deposit (US $7), which was refundable upon completion of the questionnaire, and uploaded the test results via a web-based survey system. RESULTS: A total of 2263 MSM met the criteria and successfully applied for HIVST. Of these, 1816 participants returned their HIVST results, including 1422 (88.3%) IPs and 394 (21.7%) alters. More alters had condomless anal intercourse, a higher proportion of them had never previously tested for HIV, and they showed a greater willingness to distribute HIVST kits to their sexual partners (P=.002) than the IPs. After controlling for age, education, and income, the alters had a greater proportion of MSM who had never tested for HIV before (adjusted odds ratio [aOR] 1.29, 95% CI 1.00-1.68), were more willing to distribute the HIVST application link (aOR 1.71, 95% CI 1.21-2.40), had a lower number of sexual partners (aOR 0.71, 95% CI 0.57-0.90), and were less likely to search for sexual partners on the web (aOR 0.78, 95% CI 0.60-1.02) than IPs. In comparison, the rates of reactive HIVST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy were similar for IPs and alters. CONCLUSIONS: The ISDHK model of distributing HIVST application links among the MSM population via social media is feasible. The ISDHK model should be used to supplement the DSDHK model to enable a greater proportion of the MSM population to know their HIV infection status.
背景:艾滋病毒自我检测(HIVST)试剂盒在主要活跃人群中很常见。直接二级分发 HIVST 试剂盒(DSDHK)可有效提高 HIVST 的采用率。然而,人们对 DSDHK 的各种局限性表示担忧,包括地理覆盖范围有限、支付问题以及需要面对面的互动。
目的:本研究旨在评估通过微信(向伴侣分发 HIVST 应用链接和后续 HIVST 试剂盒)间接二级分发 HIVST 试剂盒(ISDHK)在男男性行为者(MSM)中的可行性和特征。
方法:2017 年 10 月至 2019 年 9 月,我们在微信社交媒体平台上发布了 HIVST 招募广告,邀请 MSM 申请 HIVST 试剂盒(称为索引参与者[IPs])。我们鼓励所有 MSM 参与者通过他们的社交网络将 HIVST 应用链接分发给他们的朋友和性伴侣(称为改变者)。所有改变者都被进一步鼓励继续分发 HIVST 应用链接。所有参与者支付了 7 美元的押金(可在完成问卷后退还),并通过基于网络的调查系统上传了测试结果。
结果:共有 2263 名 MSM 符合条件并成功申请了 HIVST。其中,1816 名参与者返回了他们的 HIVST 结果,包括 1422 名(88.3%)IPs 和 394 名(21.7%)改变者。与 IPs 相比,改变者的无保护肛交比例更高,从未接受过 HIV 检测的比例更高,他们更愿意将 HIVST 试剂盒分发给他们的性伴侣(P=.002)。在控制年龄、教育程度和收入后,改变者中以前从未接受过 HIV 检测的 MSM 比例更高(调整后的优势比[aOR] 1.29,95%CI 1.00-1.68),更愿意分发 HIVST 应用链接(aOR 1.71,95%CI 1.21-2.40),性伴侣数量较少(aOR 0.71,95%CI 0.57-0.90),并且不太可能在网上寻找性伴侣(aOR 0.78,95%CI 0.60-1.02)与 IPs 相比。相比之下,IPs 和改变者的 HIVST 结果阳性率、进行 HIV 确证检测、HIV 血清阳性率和开始 HIV 抗逆转录病毒治疗率相似。
结论:通过社交媒体在 MSM 人群中分发 HIVST 应用链接的 ISDHK 模式是可行的。应使用 ISDHK 模型补充 DSDHK 模型,以使更多的 MSM 人群了解他们的 HIV 感染状况。
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