Peiper Nicholas C, Shamblen Steve, Gilbertson Adam, Guest Greg, Kopp Michael, Guy Laura, Rose Michelle R
Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA.
Pacific Institute for Research and Evaluation, Calverton, MD, USA.
Int J Drug Policy. 2022 May;103:103613. doi: 10.1016/j.drugpo.2022.103613. Epub 2022 Mar 4.
People who use illicit drugs (PWUD) remain at significantly elevated risk for HIV infection and continue to have very low testing rates. HIV self-testing (HIVST) has been shown to be acceptable among many high-risk populations, but less is known about PWUD.
From May-June 2021, a HIVST program was implemented at a syringe services program (SSP) in Louisville, Kentucky. PWUD were given the option to privately self-test at the SSP or take the test home and follow-up with study staff. Primary outcomes were acceptability, ease of use, usability, reasons for self-testing, testing location, frequency of future testing, and preference for future testing location.
Among 230 study participants, 77% reported high acceptability (i.e., the HIVST kits made them feel much more able to keep track of their HIV status compared to standard testing methods). Virtually all (97.4%) reported the test kits were very easy to use. Problems while using the HIVST kits were rare (range 1.3-3.0%). The most common reasons for testing were a desire to know their status (85.2%), the test was free (37%), and the short duration for results (30.9%). Testing primarily occurred onsite (87.8%). The majority (83%) reported they would use the HIVST kits at least every six months if made available through the health department and would prefer to test at home (71.7%). Multivariate analyses found that awareness of and intention to use pre-exposure prophylaxis (PrEP) were significantly associated with high acceptability and testing onsite.
Study participants found HIVST to be acceptable and very easy to use. The multivariate findings suggest HIVST interventions should be packaged with PrEP interventions and harm reduction programs.
使用非法药物的人（PWUD）感染艾滋病毒的风险仍然显著升高，且检测率一直很低。艾滋病毒自我检测（HIVST）在许多高危人群中已被证明是可接受的，但对于使用非法药物的人了解较少。
2021年5月至6月，在肯塔基州路易斯维尔的一个注射器服务项目（SSP）中实施了一项HIVST项目。使用非法药物的人可以选择在SSP私下自行检测，或者将检测带回家并与研究人员进行后续跟进。主要结果包括可接受性、易用性、可用性、自我检测的原因、检测地点、未来检测频率以及对未来检测地点的偏好。
在230名研究参与者中，77%报告了高可接受性（即与标准检测方法相比，HIVST试剂盒让他们更能跟踪自己的艾滋病毒感染状况）。几乎所有（97.4%）的人报告检测试剂盒非常易于使用。使用HIVST试剂盒时出现问题的情况很少见（范围为1.3 - 3.0%）。检测的最常见原因是想知道自己的感染状况（85.2%）、检测免费（37%）以及结果等待时间短（30.9%）。检测主要在现场进行（87.8%）。大多数（83%）报告称，如果通过卫生部门提供，他们至少每六个月会使用一次HIVST试剂盒，并且更愿意在家中检测（71.7%）。多变量分析发现，对暴露前预防（PrEP）的知晓和使用意愿与高可接受性和现场检测显著相关。
研究参与者发现HIVST是可接受的且非常易于使用。多变量研究结果表明，HIVST干预措施应与PrEP干预措施及减少伤害项目相结合。
