Phatsoane Gaven Mothepane, Quaife Matthew, Majam Mohammed, Singh Leanne, Rhagnath Naleni, Wonderlik Theodore, Gumede Siphamandla Bonga
Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Front Reprod Health. 2023 Feb 27;5:1073492. doi: 10.3389/frph.2023.1073492. eCollection 2023.
The main impediment to operational scale-up of HIV self-testing (HIVST) and counselling, is a dearth of information on utilisation, reporting, and linkage to care for HIV-positive individuals. To inform solutions to this issue, this study investigated the utility of self-testers reporting their results using a mobile-health (mHealth) platform, and whether seropositive users linked into care.
Candidates who met the recruitment criteria across multiple sites within inner-city Johannesburg each received an HIVST kit. Using short message service (SMS) reminders (50% standard and 50% behavioural science), participants were prompted to self-report results on provided platforms. On the seventh day, users who did not make contact, were called, and surveyed an interactive voice response system (IVRS). Multivariable regression was used in reporting by age and sex.
Of the 9,505 participants, 2,467 (25.9%) participants answered any survey question, and of those, 1,933 (78.4%) were willing to self-report their HIV status. Men were more likely than women to make an inbound call (10.2% vs. 9.1%, = 0.06) however, women were significantly more likely to self-report their test result (AOR = 1.12, 95%CI = 1.01-1.24, = 0.025). Overall, self-reporting a test result was predicted by being younger and female. In addition, reporting HIV results was associated with age, 25-35 (AOR = 1.58, 95% CI = 1.24-2.02) and above 35 years (AOR = 2.12, 95% CI = 1.61-2.80). Out of 1,933 participants willing to report their HIV status, 314 reported a positive test, indicating a HIV prevalence of 16.2% (95% CI: 14.6%-18.0%) and of those 204 (65.0%) reported inclination to link to care.
While self-reporting HIVST results an IVRS system yielded a higher response rate, behavioural SMSs were ineffective in increasing self-reporting.
扩大艾滋病毒自我检测（HIVST）及咨询服务的业务规模的主要障碍是，缺乏关于艾滋病毒呈阳性者的检测利用情况、报告情况以及与护理服务衔接情况的信息。为了找到解决该问题的办法，本研究调查了自我检测者通过移动健康（mHealth）平台报告检测结果的效用，以及血清反应呈阳性的使用者是否与护理服务建立了联系。
符合招募标准的候选人在约翰内斯堡市中心的多个地点均收到了一套HIVST检测试剂盒。通过短信提醒（50%为标准短信，50%为行为科学短信），促使参与者在提供的平台上自行报告检测结果。在第7天，未取得联系的使用者会接到电话，并通过交互式语音应答系统（IVRS）接受调查。在按年龄和性别进行报告时采用了多变量回归分析。
在9505名参与者中，有2467名（25.9%）参与者回答了任何一项调查问题，其中1933名（78.4%）愿意自行报告其艾滋病毒感染状况。男性打进电话的可能性高于女性（10.2%对9.1%，P = 0.06），然而，女性自行报告检测结果的可能性显著更高（调整后比值比[AOR]=1.12，95%置信区间[CI]=1.01 - 1.24，P = 0.025）。总体而言，年龄较小和为女性更容易自行报告检测结果。此外，报告艾滋病毒检测结果与年龄有关，年龄在25 - 35岁之间（AOR = 1.58，95% CI = 1.24 - 2.02）以及35岁以上（AOR = 2.12，95% CI = 1.61 - 2.80）。在1933名愿意报告其艾滋病毒感染状况的参与者中，有314人报告检测结果呈阳性，表明艾滋病毒感染率为16.2%（95% CI：14.6% - 18.0%），其中204人（65.0%）表示倾向于与护理服务建立联系。
虽然通过IVRS系统自行报告HIVST检测结果的应答率较高，但行为科学短信在提高自行报告率方面无效。
