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村卫生团队提供的口腔艾滋病毒自我检测增加了乌干达男性的治疗关联和抗逆转录病毒治疗的启动率。

Village health team-delivered oral HIV self-testing increases linkage-to-care and antiretroviral-therapy initiation among men in Uganda.

机构信息

Clinical Epidemiology Unit, College of Health Sciences, Makerere University, Kampala, Uganda.

Infectious Diseases Research Collaboration, Kampala, Uganda.

出版信息

AIDS Care. 2024 Apr;36(4):482-490. doi: 10.1080/09540121.2023.2223901. Epub 2023 Jun 18.


DOI:10.1080/09540121.2023.2223901
PMID:37331019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10859534/
Abstract

Targeted strategies are central to increasing HIV-status awareness and progress on the care cascade among men. We implemented Village-Health-Team (VHT)-delivered HIV self-testing (HIVST) among men in a peri-urban Ugandan district and assessed linkage to confirmatory-testing, antiretroviral-therapy (ART) initiation and HIV-status disclosure following HIVST. We conducted a prospective cohort study from November 2018 to June 2019 and enrolled 1628 men from 30-villages of Mpigi district. VHTs offered each participant one HIVST-kit and a linkage-to-care information leaflet. At baseline, we collected data on demographics, testing history and risk behavior. At one-month, we measured linkage to confirmatory-testing and HIV-status disclosure, and at three months ART-initiation if tested HIV-positive. We used Poisson regression generalized estimating equations to evaluate predictors of confirmatory-testing. We found that 19.8% had never tested for HIV and 43% had not tested in the last 12-months. After receiving HIVST-kits, 98.5% self-reported HIVST-uptake in 10-days, 78.8% obtained facility-based confirmation in 30-days of HIVST with 3.9% tested HIV-positive. Of the positives, 78.8% were newly diagnosed, 88% initiated ART and 57% disclosed their HIV-status to significant others. Confirmatory testing was associated with having a higher level of education and knowing a partner's HIV-status. VHT-delivered HIVST may be effective for boosting testing, ART-initiation and HIV-status disclosure among men.

摘要

目标策略是提高 HIV 感染者知晓率和艾滋病护理服务衔接率的核心。我们在乌干达郊区实施了乡村卫生工作队(VHT)提供的 HIV 自我检测(HIVST),并评估了 HIVST 后与确认检测、抗逆转录病毒治疗(ART)启动和 HIV 状态披露的衔接情况。我们开展了一项前瞻性队列研究,时间为 2018 年 11 月至 2019 年 6 月,纳入了 Mpigi 区 30 个村庄的 1628 名男性。VHT 为每位参与者提供了一份 HIVST 试剂盒和一份衔接至护理的信息传单。在基线时,我们收集了人口统计学、检测史和风险行为的数据。在一个月时,我们测量了与确认检测和 HIV 状态披露的衔接情况,如果检测 HIV 阳性,则在三个月时测量 ART 启动情况。我们使用泊松回归广义估计方程来评估确认检测的预测因素。我们发现,19.8%的人从未接受过 HIV 检测,43%的人在过去 12 个月内未接受过检测。在收到 HIVST 试剂盒后,98.5%的人在 10 天内报告了 HIVST 检测,78.8%的人在 30 天内获得了基于机构的确认检测,其中 3.9%的人 HIV 检测呈阳性。在阳性者中,78.8%为新诊断病例,88%开始接受 ART 治疗,57%向重要他人披露了 HIV 状态。确认检测与受教育程度较高和知晓伴侣 HIV 状态有关。VHT 提供的 HIVST 可能对提高男性的检测率、ART 启动率和 HIV 状态披露率有效。

相似文献

[1]
Village health team-delivered oral HIV self-testing increases linkage-to-care and antiretroviral-therapy initiation among men in Uganda.

AIDS Care. 2024-4

[2]
Uptake and perceptions of oral HIV self-testing delivered by village health teams among men in Central Uganda: A concurrent parallel mixed methods analysis.

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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Feasibility, acceptability and preliminary effect of a community-led HIV self-testing model among adolescent girls and young women in Rural Northern Uganda: a quasi-experimental study protocol.

Implement Sci Commun. 2024-5-21

[2]
Uptake and perceptions of oral HIV self-testing delivered by village health teams among men in Central Uganda: A concurrent parallel mixed methods analysis.

PLOS Glob Public Health. 2023-6-14

本文引用的文献

[1]
Prevalence, associated factors and perspectives of HIV testing among men in Uganda.

PLoS One. 2020-8-7

[2]
An implementation study of oral and blood-based HIV self-testing and linkage to care among men in rural and peri-urban KwaZulu-Natal, South Africa.

J Int AIDS Soc. 2020-6

[3]
Measuring linkage to HIV treatment services following HIV self-testing in low-income settings.

J Int AIDS Soc. 2020-6

[4]
Promoting HIV Testing by Men: A Discrete Choice Experiment to Elicit Preferences and Predict Uptake of Community-based Testing in Uganda.

Appl Health Econ Health Policy. 2020-6

[5]
Men's perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis.

BMC Public Health. 2020-1-15

[6]
Factors associated with HIV in younger and older adult men in South Africa: findings from a cross-sectional survey.

BMJ Open. 2019-12-23

[7]
Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review.

HIV AIDS (Auckl). 2019-12-2

[8]
Who are the missing men? Characterising men who never tested for HIV from population-based surveys in six sub-Saharan African countries.

J Int AIDS Soc. 2019-10

[9]
Reaching the second 90: the strategies for linkage to care and antiretroviral therapy initiation.

Curr Opin HIV AIDS. 2019-11

[10]
Mapping evidence of intervention strategies to improving men's uptake to HIV testing services in sub-Saharan Africa: A systematic scoping review.

BMC Infect Dis. 2019-6-6

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