Kim Rayne S, Wickersham Jeffrey A, Maviglia Francesca, Galka Jonathan M, Azwa Iskandar, Gautam Kamal, Shrestha Roman
Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
Department of the History of Science, Harvard University, Cambridge, MA, United States.
Front Med (Lausanne). 2023 Apr 6;10:1022746. doi: 10.3389/fmed.2023.1022746. eCollection 2023.
Although research on HIV self-testing (HIVST) has rapidly increased, few studies have explored HIVST uptake in female sex workers (FSW), and none in Malaysia. Therefore, we endeavored to assess the willingness to use HIVST in this at-risk, vulnerable population.
A cross-sectional survey study was conducted among 113 HIV-negative Malaysian FSW in 2017. Participants were recruited using advertisements on social media, flyers, and direct referrals from community-based organizations. Data were collected using self-administered surveys. Multivariable logistic regression was used to identify correlates of willingness to use HIVST.
Nearly a third of participants (30.1%) reported they would be willing to use HIVST. Multivariable analyses adjusting for Malay ethnicity, stable housing, living in Kuala Lumpur (KL), years in sex work, age of first sex work, childhood sexual assault, history of HIV testing, and previously in prison indicated that living in KL [adjusted odds ratio (aOR) = 5.214, = 0.0137] was associated with a greater willingness to use HIVST. In contrast, having stable housing (aOR = 0.100, = 0.0064) was negatively associated with willingness to use HIVST.
Our results indicate that HIVST may potentially enhance the uptake of HIV testing among FSWs living in an urban environment and experiencing unstable housing, but an overall willingness to use HIVST is low. These findings highlight the need for efforts to increase awareness of HIVST among FSWs and additional research on the effective implementation of HIVST for FSW.
尽管关于艾滋病毒自我检测（HIVST）的研究迅速增加，但很少有研究探讨女性性工作者（FSW）对HIVST的接受情况，而在马来西亚尚无此类研究。因此，我们致力于评估这一高危脆弱人群使用HIVST的意愿。
2017年对113名HIV阴性的马来西亚女性性工作者进行了一项横断面调查研究。通过社交媒体广告、传单以及社区组织的直接推荐招募参与者。使用自填式调查问卷收集数据。采用多变量逻辑回归来确定使用HIVST意愿的相关因素。
近三分之一的参与者（30.1%）表示愿意使用HIVST。在对马来族裔、稳定住房、居住在吉隆坡（KL）、从事性工作的年限、首次从事性工作的年龄、童年性侵犯、HIV检测史以及曾入狱等因素进行调整的多变量分析中，结果表明居住在KL [调整后的优势比（aOR）= 5.214， = 0.0137]与更愿意使用HIVST相关。相比之下，拥有稳定住房（aOR = 0.100， = 0.0064）与使用HIVST的意愿呈负相关。
我们的结果表明，HIVST可能会提高居住在城市环境且住房不稳定的女性性工作者的HIV检测率，但总体上使用HIVST的意愿较低。这些发现凸显了提高女性性工作者对HIVST的认识以及对女性性工作者有效实施HIVST进行更多研究的必要性。
