Costa Angelo Brandelli, Viscardi Lucas Henriques, Feijo Marina, Fontanari Anna Martha Vaitses
Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil.
Medicine Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil.
EClinicalMedicine. 2022 Aug 12;52:101612. doi: 10.1016/j.eclinm.2022.101612. eCollection 2022 Oct.
HIV disproportionately affects people who inject drugs, transgender people, sex workers, men who have sex with men, and incarcerated people. Recognized as key populations (KP), these groups face increased impact of HIV infection and reduced access to health assistance. In 1990, the Center for Disease Control and Prevention organized technical guidance on HIV Voluntary Counseling and Testing (VCT-HIV), with subsequent trials comparing intervention methodologies, no longer recommending this strategy. However, KP needs have not been explicitly considered.
We assessed VCT-HIV effectiveness for sexual risk-reduction among KP (PROSPERO 2020 CRD42020088816). We searched Pubmed, EMBASE, Global Health, Scopus, PsycINFO, and Web of Science for peer-reviewed, controlled trials from February, 2020, to April, 2022. We screened the references list and contacted the main authors, extracted data through Covidence, applied the Cochrane Risk-of-Bias tool, and performed the meta-analysis using Review Manager.
We identified 17 eligible trials, including 10,916 participants and evaluated HIV risk behaviors. When compared to baseline, VCT-HIV reduced unsafe sex frequency (=5.40; <0.00001, I²=0%).
While our meta-analysis identified VCT-HIV as protective for sexual risk behaviors for among KP, the results are limited to MSM and PWID, demonstrating the paucity of data on the other KP. Also, it highlights the importance of applying a clear VCT-HIV guideline as well as properly training the counselors.
Research funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ/MS-DIAHV N° 24/2019), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
艾滋病毒对注射毒品者、跨性别者、性工作者、男男性行为者和被监禁者的影响尤为严重。这些群体被视为关键人群，面临着艾滋病毒感染影响加剧和获得医疗援助机会减少的问题。1990年，疾病控制与预防中心组织了关于艾滋病毒自愿咨询检测（VCT-HIV）的技术指导，随后进行了比较干预方法的试验，不再推荐这一策略。然而，关键人群的需求尚未得到明确考虑。
我们评估了VCT-HIV在降低关键人群性风险方面的有效性（PROSPERO 2020 CRD42020088816）。我们在Pubmed、EMBASE、Global Health、Scopus、PsycINFO和Web of Science上搜索了2020年2月至2022年4月期间经过同行评审的对照试验。我们筛选了参考文献列表并联系了主要作者，通过Covidence提取数据，应用Cochrane偏倚风险工具，并使用Review Manager进行荟萃分析。
我们确定了17项符合条件的试验，包括10916名参与者，并评估了艾滋病毒风险行为。与基线相比，VCT-HIV降低了不安全性行为的频率（=5.40；<0.00001，I²=0%）。
虽然我们的荟萃分析确定VCT-HIV对关键人群的性风险行为具有保护作用，但结果仅限于男男性行为者和注射毒品者，表明其他关键人群的数据匮乏。此外，它强调了应用明确的VCT-HIV指南以及对咨询员进行适当培训的重要性。
由巴西国家科学技术发展委员会（CNPQ/MS-DIAHV N° 24/2019）和高等教育人员素质提升协调办公室资助的研究。
