Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD; and.
Baltimore City Health Department, Baltimore, MD.
J Acquir Immune Defic Syndr. 2022 Jul 1;90(S1):S84-S89. doi: 10.1097/QAI.0000000000002968.
Black men who have sex with men (MSM) carry the greatest burden of new HIV diagnoses in the United States. Ending the HIV epidemic requires strategic, culturally specific approaches to target factors contributing to persistent HIV disparities.
Safe Spaces 4 Sexual Health (SS4SH), a community-informed HIV/sexually transmitted infection (STI) testing strategy combining mobile van testing with online outreach, was implemented over a 14-month period from 2018 to 2019 in Baltimore, MD.
We evaluated the reach of MSM at high risk with high acquisition or transmission risk by SS4SH mobile van combined with online outreach as compared with the Baltimore City Health Department's venue-based mobile van (with no online outreach) operating during the same period based on the following HIV/STI testing outcome measures: (1) number of MSM HIV or STI tested, (2) new HIV diagnosis rate, (3) percent with new syphilis diagnosis, (4) percent at high risk for HIV acquisition, and (5) percent people living with HIV at high risk for transmission.
Over a 14-month period, SS4SH HIV/STI tested 151 MSM. Of these, 74% were Black and the mean age was 34 (SD = 10, range = 19-68). Seven percent (10/148) were new HIV diagnoses, and 10% (13/130) were diagnosed with syphilis. The Baltimore City Health Department's venue-based mobile van strategy yielded 53% (231) more MSM (71% Black, mean age 38, SD = 14, range = 15-74), but the HIV/syphilis positivity rate was significantly lower: 0.5% new HIV diagnosis rate (P < 0.001) and 0.5% with syphilis diagnosis (P < 0.001).
Our findings suggest SS4SH combing online outreach with mobile van testing may be more effective at reaching high-risk Black MSM than venue-based mobile testing.
在美国，与男性发生性关系的男男性行为者（MSM）新感染 HIV 的负担最大。要想终结 HIV 疫情，就需要采取有战略性且有针对性的方法，消除导致 HIV 持续存在差异的因素。
Safe Spaces 4 Sexual Health（SS4SH）是一种社区知情的 HIV/性传播感染（STI）检测策略，结合了移动车检测和在线外展，于 2018 年至 2019 年在马里兰州巴尔的摩市实施了 14 个月。
我们评估了 SS4SH 移动车与在线外展相结合的方式与同期运营的巴尔的摩市卫生局基于地点的移动车（无在线外展）相比，对高风险的 MSM 的覆盖面，这些 MSM 具有高感染或传播风险，评估指标如下：（1）接受 HIV/STI 检测的 MSM 数量；（2）新 HIV 诊断率；（3）新诊断梅毒的百分比；（4）HIV 感染高风险百分比；（5）HIV 传播高风险的 HIV 感染者百分比。
在 14 个月期间，SS4SH 对 151 名 MSM 进行了 HIV/STI 检测。其中，74%是黑人，平均年龄为 34 岁（SD = 10，范围 19-68）。7%（10/148）为新的 HIV 诊断，10%（13/130）诊断患有梅毒。巴尔的摩市卫生局基于地点的移动车策略增加了 53%（231 人）的 MSM（71%是黑人，平均年龄 38 岁，SD = 14，范围 15-74），但 HIV/梅毒阳性率显著降低：新 HIV 诊断率为 0.5%（P < 0.001），梅毒诊断率为 0.5%（P < 0.001）。
我们的研究结果表明，SS4SH 将在线外展与移动车检测相结合，可能比基于地点的移动车检测更有效地接触到高风险的黑人 MSM。
