Drake Alison L, Quinn Caitlin, Kidula Nancy, Sibanda Euphemia, Steyn Petrus, Barr-DiChiara Magdalena, Jamil Muhammad S, Rodolph Michelle, Gaffield Mary E, Kiarie James, Baggaley Rachel, Johnson Cheryl
Department of Global Health, University of Washington, Seattle, WA, United States.
Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland.
Front Reprod Health. 2021 May 26;3:657728. doi: 10.3389/frph.2021.657728. eCollection 2021.
Offering HIV testing services (HTS) within sexual and reproductive health (SRH) services is a priority, especially for women who have a substantial risk. To reach women with HIV who do not know their status and prevent mother-to-child HIV transmission, the World Health Organization (WHO) recommends routinely offering HTS as part of family planning (FP) service delivery in high HIV burden settings. We conducted a landscape analysis to assess HTS uptake and HIV positivity in the context of FP/SRH services. We searched records from PubMed, four gray literature databases, and 13 organization websites, and emailed 24 organizations for data on HTS in FP/SRH services. We also obtained data from International Planned Parenthood Federation (IPPF) affiliates in Eswatini, Kenya, Lesotho, Malawi, Namibia, Uganda, Zambia, and Zimbabwe. Unique programs/studies from records were included if they provided data on, or barriers/facilitators to, offering HTS in FP/SRH. Overall, 2,197 records were screened and 12 unique programs/studies were eligible, including 10 from sub-Saharan Africa. Four reported on co-delivery of SRH services (including FP), with reported HTS uptake between 17 and 94%. Six reported data on HTS in FP services: four among general FP clients; one among couples; and one among female sex workers, adolescent girls, and young women. Two of the six reported HTS uptake >50% (51%, 419/814 Kenya; 63%, 5,930/9,439 Uganda), with positivity rates of 2% and 4.1%, respectively. Uptake was low (8%, 74/969 Kenya) in the one FP program offering pre-exposure prophylaxis. In the IPPF program, seven countries reported HTS uptake in FP services and ranged from 4% in Eswatini to 90% in Lesotho; between 0.6% (Uganda) and 8% (Eswatini) of those tested were HIV positive. Data on providing HTS in FP/SRH service delivery were sparse and HTS uptake varied widely across programs. As countries expand HTS in FP/SRH appropriate to epidemiology, they should ensure data are reported and monitored for progress and impact.
在性与生殖健康（SRH）服务中提供HIV检测服务（HTS）是一项优先事项，对于面临重大风险的女性而言尤为如此。为了接触到那些不知道自己感染状况的HIV感染女性，并预防母婴HIV传播，世界卫生组织（WHO）建议在HIV高负担地区，将常规提供HTS作为计划生育（FP）服务的一部分。我们进行了一项现状分析，以评估在FP/SRH服务背景下的HTS接受情况和HIV阳性率。我们检索了PubMed、四个灰色文献数据库以及13个组织网站的记录，并向24个组织发送电子邮件，索要关于FP/SRH服务中HTS的数据。我们还从国际计划生育联合会（IPPF）在斯威士兰、肯尼亚、莱索托、马拉维、纳米比亚、乌干达、赞比亚和津巴布韦的分支机构获取了数据。如果记录中的独特项目/研究提供了关于在FP/SRH中提供HTS的数据或障碍/促进因素，就将其纳入。总体而言，共筛选了2197条记录，12个独特项目/研究符合条件，其中10个来自撒哈拉以南非洲。四项报告了SRH服务（包括FP）的联合提供情况，报告的HTS接受率在17%至94%之间。六项报告了FP服务中HTS的数据：四项针对一般FP客户；一项针对夫妇；一项针对女性性工作者、少女和年轻女性。六项中有两项报告的HTS接受率>50%（肯尼亚为51%，419/814；乌干达为63%，5930/9439），阳性率分别为2%和4.1%。在提供暴露前预防的一个FP项目中，接受率较低（肯尼亚为8%，74/969）。在IPPF项目中，七个国家报告了FP服务中的HTS接受情况，范围从斯威士兰的4%到莱索托的90%；接受检测者中HIV阳性率在0.6%（乌干达）至8%（斯威士兰）之间。关于在FP/SRH服务提供中提供HTS的数据稀少，且不同项目的HTS接受情况差异很大。随着各国根据流行病学情况在FP/SRH中扩大HTS，它们应确保报告数据并监测进展和影响。
