Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
Harm Reduct J. 2024 Jan 3;21(1):4. doi: 10.1186/s12954-023-00922-7.
BACKGROUND: HIV self-testing (HIVST) could increase HIV testing access among people who inject drugs (PWID), and secondary distribution (i.e., peer-delivery) of HIVST kits in PWID social networks could further expand coverage. We assessed willingness to use and distribute HIVST kits among PWID in the San Diego-Tijuana border region. METHODS: From 2020 to 2021, HIV-negative PWID in San Diego, USA, and Tijuana, Mexico, completed surveys and provided data on individual (N = 539) and social network (N = 366) characteristics. We used modified Poisson regression to examine the effects of individual and social network characteristics on willingness to use and distribute HIVST kits. RESULTS: Most participants were willing to use (81%) and distribute (81%) HIVST kits. At the individual level, prior HIV testing was positively associated with willingness to use (adjusted prevalence ratio [aPR] = 1.24, 95% confidence interval [CI] 1.10-1.40) and distribute (aPR = 1.27, 95% CI 1.12-1.43) HIVST kits, while perceiving oneself to be at higher HIV risk than others was negatively associated with willingness to use HIVST kits (aPR = 0.83, 95% CI 0.74-0.93). At the network level, willingness to distribute HIVST kits was positively associated with network size (aPR = 1.04 per member, 95% CI 1.01-1.08) and greater proportions of one's network encouraging them to use drugs (aPR = 1.29, 95% CI 1.16-1.44) and having a history of homelessness (aPR = 1.51, 95% CI 1.31-1.74) or detention/arrest (aPR = 1.57, 95% CI 1.36-1.82), and negatively associated with a greater proportion of one's network including "very close" persons (aPR = 0.80, 95% CI 0.69-0.94). CONCLUSIONS: We found high potential for HIVST kits and their secondary distribution to increase HIV testing among PWID who face the greatest barriers to facility-based testing.
背景:艾滋病毒自我检测(HIVST)可以增加注射毒品者(PWID)进行艾滋病毒检测的机会,而在 PWID 社交网络中二级分发(即同伴交付)HIVST 检测包可以进一步扩大覆盖范围。我们评估了圣地亚哥-蒂华纳边境地区 PWID 使用和分发 HIVST 检测包的意愿。
方法:2020 年至 2021 年,在美国圣地亚哥和墨西哥蒂华纳的 HIV 阴性 PWID 完成了调查,并提供了个人(N=539)和社交网络(N=366)特征的数据。我们使用修正后的泊松回归来检验个人和社交网络特征对使用和分发 HIVST 检测包的意愿的影响。
结果:大多数参与者愿意使用(81%)和分发(81%)HIVST 检测包。在个人层面上,之前的艾滋病毒检测与使用(调整后的患病率比 [aPR]=1.24,95%置信区间 [CI] 1.10-1.40)和分发(aPR=1.27,95%CI 1.12-1.43)HIVST 检测包的意愿呈正相关,而认为自己的艾滋病毒感染风险高于他人与使用 HIVST 检测包的意愿呈负相关(aPR=0.83,95%CI 0.74-0.93)。在网络层面上,分发 HIVST 检测包的意愿与网络规模呈正相关(每个成员增加 aPR=1.04,95%CI 1.01-1.08),网络中更大比例的人鼓励他们使用毒品(aPR=1.29,95%CI 1.16-1.44),有过无家可归史(aPR=1.51,95%CI 1.31-1.74)或被拘留/逮捕(aPR=1.57,95%CI 1.36-1.82),与网络中包括“非常亲密”的人的比例更大呈负相关(aPR=0.80,95%CI 0.69-0.94)。
结论:我们发现,HIVST 检测包及其二级分发在面临最大设施检测障碍的 PWID 中,有很大潜力增加艾滋病毒检测。
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