Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
AIDS Behav. 2023 Feb;27(2):651-666. doi: 10.1007/s10461-022-03800-8. Epub 2022 Sep 12.
Gender disparities are pervasive throughout the HIV care continuum in sub-Saharan Africa, with men testing, receiving treatment, and achieving viral suppression at lower rates, and experiencing mortality at higher rates, compared with women. HIV self-testing (HIVST) has been shown to be highly acceptable among men in sub-Saharan Africa. However, evidence on linkage to HIV care following a reactive HIVST result is limited. In this systematic review, we aimed to synthesize the quantitative and qualitative literature from sub-Saharan Africa on men's rates of linkage to HIV care after receiving a reactive HIVST result. We systematically searched 14 bibliometric databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram was used to document the screening results. The Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of the included studies. Of 22,446 references screened, 15 articles were eligible for inclusion in this review. Linkage to HIV care following a reactive HIVST result was subject to several barriers: financial constraints due to travelling costs, potential long waiting hours at the clinics, stigma, discrimination, and privacy concerns. Men's rates of seeking confirmatory testing and linking to HIV care following a reactive HIVST result were inconsistent across studies. Combining financial incentives with HIVST was found to increase the likelihood of linking to HIV care following a reactive HIVST result. The variable rates of linkage to HIV care following a reactive HIVST result suggest a need for further research and development into strategies to increase linkage to HIV care.
在撒哈拉以南非洲,性别差异普遍存在于整个艾滋病护理连续体中,与女性相比,男性接受检测、接受治疗和实现病毒抑制的比例较低,死亡率较高。在撒哈拉以南非洲,艾滋病毒自检(HIVST)已被证明在男性中非常受欢迎。然而,关于接受阳性 HIVST 结果后与艾滋病毒护理联系的证据有限。在这项系统评价中,我们旨在综合撒哈拉以南非洲关于男性接受阳性 HIVST 结果后与艾滋病毒护理联系的定量和定性文献。我们系统地搜索了 14 个文献计量数据库。使用系统评价和荟萃分析的首选报告项目(PRISMA)流程图来记录筛选结果。混合方法评估工具(MMAT)用于评估纳入研究的方法学质量。在筛选出的 22446 篇参考文献中,有 15 篇文章符合纳入本综述的标准。接受阳性 HIVST 结果后与艾滋病毒护理联系受到多种障碍的影响:旅行费用导致的经济限制、诊所潜在的长时间等待、耻辱感、歧视和隐私问题。接受阳性 HIVST 结果后,男性寻求确认检测和与艾滋病毒护理联系的比例在不同研究中不一致。研究发现,将经济激励与 HIVST 相结合可以增加接受阳性 HIVST 结果后与艾滋病毒护理联系的可能性。接受阳性 HIVST 结果后与艾滋病毒护理联系的比率存在差异,这表明需要进一步研究和开发增加与艾滋病毒护理联系的策略。
JMIR Public Health Surveill. 2022-12-2
Cochrane Database Syst Rev. 2004
Cochrane Database Syst Rev. 2006-7-19
Health Technol Assess. 2001
Cochrane Database Syst Rev. 2001
PLOS Glob Public Health. 2025-6-20