Shaw Souradet Y, Leung Stella, Isac Shajy, Musyoki Helgar, Mugambi Mary, Kioko Japheth, Musimbi Janet, Olango Kennedy, Kuria Samuel, Ongaro Martin K, Walimbwa Jeffrey, Melon Memory, Emmanuel Faran, Moses Stephen, Blanchard James F, Pickles Michael, Lazarus Lisa, Lorway Robert R, Becker Marissa L, Mishra Sharmistha, Bhattacharjee Parinita
Institute for Global Public Health, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
India Health Action Trust, Delhi, India.
PLOS Glob Public Health. 2023 Aug 18;3(8):e0001547. doi: 10.1371/journal.pgph.0001547. eCollection 2023.
Men who have sex with men (MSM) bear a disproportionate burden of new HIV infections in Kenya, while experiencing discrimination, leading to suboptimal levels of HIV care. HIV self-testing (HIVST) is a tool to increase HIV screening and earlier diagnosis; however, questions remain regarding how best to scale-up HIVST to MSM in Kenya. The main objective of this study was to examine changes in knowledge and use of HIVST after implementation of a community-led HIVST project. Participants were MSM recruited from Kisumu, Mombasa, and Kiambu counties. Data were collected from two rounds (Round 1: 2019; Round 2: 2020) of serial cross-sectional integrated biological and behavioural assessments (IBBA), pre-, and post-project implementation. Two main outcomes were measured: 1) whether the respondent had ever heard of HIVST; and 2) whether they had ever used HIVST kits. Changes in outcomes between IBBA rounds were examined using modified multivariable Poisson regression models; adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI) are reported. A total of 2,328 respondents were included in main analyses. The proportion of respondents who had heard of HIVST increased from 75% in Round 1 to 94% in Round 2 (aPR: 1.2, 95% CI: 1.2-1.3), while those reporting using an HIVST kit increased from 20% to 53% (aPR: 2.3, 95% CI: 2.0-2.6). Higher levels of education and HIV programme awareness were associated with both outcomes. Awareness and use of HIVST kits increased after implementation of a community-led HIVST implementation project, demonstrating the importance of integration with existing community groups.
在肯尼亚,男男性行为者(MSM)承受着不成比例的新增艾滋病毒感染负担,同时还遭受歧视,导致艾滋病毒护理水平欠佳。艾滋病毒自我检测(HIVST)是一种增加艾滋病毒筛查和早期诊断的工具;然而,对于如何在肯尼亚以最佳方式向男男性行为者推广HIVST,仍存在问题。本研究的主要目的是检查在实施一项由社区主导的HIVST项目后,HIVST知识和使用情况的变化。参与者是从基苏木、蒙巴萨和基安布县招募的男男性行为者。数据收集自两轮(第1轮:2019年;第2轮:2020年)连续横断面综合生物学和行为评估(IBBA),分别在项目实施前和实施后。测量了两个主要结果:1)受访者是否听说过HIVST;2)他们是否使用过HIVST检测试剂盒。使用改良的多变量泊松回归模型检查了IBBA各轮之间结果的变化;报告了调整后的患病率比(aPR)和95%置信区间(95%CI)。主要分析共纳入2328名受访者。听说过HIVST的受访者比例从第1轮的75%增加到第2轮的94%(aPR:1.2,95%CI:1.2 - 1.3),而报告使用过HIVST检测试剂盒的比例从20%增加到53%(aPR:2.3,95%CI:2.0 - 2.6)。较高的教育水平和对艾滋病毒项目的知晓度与这两个结果均相关。在实施由社区主导的HIVST实施项目后,对HIVST检测试剂盒的知晓度和使用率有所提高,这表明与现有社区团体整合的重要性。
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