Partners in Hope, Box, 302, Lilongwe, Malawi.
Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
BMC Public Health. 2021 Dec 2;21(1):2200. doi: 10.1186/s12889-021-12213-6.
Facility HIV self-testing (HIVST) within outpatient departments can increase HIV testing coverage by facilitating HIVST use in outpatient waiting spaces while clients wait for routine care. Facility HIVST allows for the majority of outpatients to test with minimal health care worker time requirements. However, barriers and facilitators to outpatients' use of facility HIVST are still unknown.
As part of a cluster randomized trial on facility HIVST in Malawi, we conducted in-depth interviews with 57 adult outpatients (> 15 years) who were exposed to the HIVST intervention and collected observational journals that documented study staff observations from facility waiting spaces where HIVST was implemented. Translated and transcribed data were analyzed using constant comparison analysis in Atlas.ti.
Facility HIVST was convenient, fast, and provided autonomy to outpatients. The strategy also had novel facilitators for testing, such as increased motivation to test due to seeing others test, immediate support for HIVST use, and easy access to additional HIV services in the health facility. Barriers to facility HIVST included fear of judgment from others and unwanted status disclosure due to lack of privacy. Desired changes to the intervention included private, separate spaces for kit use and interpretation and increased opportunity for disclosure and post-test counseling.
Facility HIVST was largely acceptable to outpatients in Malawi with novel facilitators that are unique to facility HIVST in OPD waiting spaces.
The parent trial is registered with ClinicalTrials.gov , NCT03271307 , and Pan African Clinical Trials, PACTR201711002697316.
在门诊部开展的机构 HIV 自检（HIVST）可以通过在门诊等候区为 HIVST 提供便利，使患者在等待常规护理的同时进行 HIVST，从而提高 HIV 检测覆盖率。机构 HIVST 允许大多数门诊患者在最少的卫生保健工作者时间要求下进行检测。然而，门诊患者使用机构 HIVST 的障碍和促进因素仍不清楚。
作为马拉维一项关于机构 HIVST 的整群随机试验的一部分，我们对 57 名接触过 HIVST 干预措施的成年门诊患者（>15 岁）进行了深入访谈，并收集了观察日记，记录了在实施 HIVST 的医疗机构等候区中研究人员的观察情况。经过翻译和转录的数据使用 Atlas.ti 中的恒比分析进行了分析。
机构 HIVST 既方便又快捷，为门诊患者提供了自主权。该策略还为检测提供了新的促进因素，例如由于看到其他人检测而增加了检测的动机、对 HIVST 使用的即时支持以及在医疗机构中更容易获得额外的 HIV 服务。机构 HIVST 的障碍包括担心受到他人的评判以及由于缺乏隐私而导致的不希望的身份披露。干预措施的改进需求包括用于试剂盒使用和解释的私人、单独的空间以及更多的披露和检测后咨询机会。
在马拉维，机构 HIVST 得到了门诊患者的广泛认可，其在门诊等候区开展的机构 HIVST 具有独特的新促进因素。
该试验的母试验在美国临床试验数据库注册，注册号为 NCT03271307，在泛非临床试验注册中心注册，注册号为 PACTR201711002697316。
