Department of Public and Global Health, University of Nairobi, Nairobi, Kenya.
Department of Global Health, University of Washington, Seattle, WA, 98105, USA.
Curr HIV/AIDS Rep. 2022 Oct;19(5):394-408. doi: 10.1007/s11904-022-00617-x. Epub 2022 Jul 29.
PURPOSE OF REVIEW: HIV self-testing (HIVST) has the potential to expand access to and uptake of HIV pre-exposure prophylaxis (PrEP) delivery. We conducted a systematic literature review to understand the evidence on HIVST use for PrEP delivery. RECENT FINDINGS: After screening 1055 records, we included eight: three randomized trials and five values and preferences studies. None measured PrEP initiation. Most studies occurred in Sub-Saharan Africa (7/8) and included different populations. One trial found that HIVST use between quarterly clinic visits as part of an adherence package with biofeedback slightly increased adherence; the other two trials found that HIVST use between or in lieu of quarterly clinic visits had no significant or non-inferior effects on adherence. HIVST to support PrEP delivery was acceptable, feasible, and preferred. HIVST use for PrEP continuation largely resulted in similar outcomes to standard-of-care delivery and was perceived acceptable and feasible. Further research is needed to optimize HIVST use within PrEP programming.
目的综述:HIV 自我检测(HIVST)有可能扩大获得和接受 HIV 暴露前预防(PrEP)的机会。我们进行了系统的文献综述,以了解 HIVST 在 PrEP 提供方面的使用证据。
最近的发现:在筛选了 1055 条记录后,我们纳入了八项研究:三项随机试验和五项价值和偏好研究。没有一项研究测量 PrEP 的起始率。大多数研究发生在撒哈拉以南非洲(8/8),并包括不同的人群。一项试验发现,作为带有生物反馈的依从性方案的一部分,每季度在诊所就诊之间使用 HIVST 稍微增加了依从性;另外两项试验发现,在每季度诊所就诊之间或代替每季度诊所就诊使用 HIVST 对依从性没有显著或非劣效影响。HIVST 支持 PrEP 的提供是可以接受、可行和首选的。HIVST 用于 PrEP 的持续治疗在很大程度上产生了与标准护理提供相似的结果,并且被认为是可以接受和可行的。需要进一步研究以优化 PrEP 方案中 HIVST 的使用。
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