在南非广泛流行的 HIV 疫情中,对两种社交网络干预版本进行试点测试,以增加男性的 HIV 检测和病例发现。
Pilot Testing Two Versions of a Social Network Intervention to Increase HIV Testing and Case-finding among Men in South Africa's Generalized HIV Epidemic.
机构信息
Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL 60612, USA.
Sweetwaters Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg 3201, South Africa.
出版信息
Int J Environ Res Public Health. 2023 Dec 30;21(1):54. doi: 10.3390/ijerph21010054.
Locating undiagnosed HIV infections is important for limiting transmission. However, there is limited evidence about how best to do so. In South Africa, men have been particularly challenging to reach for HIV testing due, in part, to stigma. We pilot-tested two versions of a network-based case-finding and care-linkage intervention. The first, TRIP, asked "seeds" (original participants) to recruit their sexual and/or injection partners. The second, TRIPLE, aimed to circumvent some stigma-related issues by asking seeds to recruit anyone they know who might be at risk of being HIV-positive-unaware. We recruited 11 (18% male) newly diagnosed HIV-positive (NDP) seeds from two clinics in KwaZulu-Natal, South Africa and randomly assigned them to either TRIP or TRIPLE. Network members were recruited two steps from each seed. The TRIP arm recruited 12 network members; the TRIPLE arm recruited 62. Both arms recruited NDPs at higher rates than local clinic testing, with TRIP (50.0%) outperforming ( = 0.012) TRIPLE (14.5%). However, TRIPLE (53.2%) was far superior to clinics (27.8%) and to TRIP (25.0%) at recruiting men. Given challenges around testing and treating men for HIV in this context, these findings suggest that the TRIPLE expanded network-tracing approach should be tested formally among larger samples in multiple settings.
发现未诊断的 HIV 感染对于限制传播非常重要。然而,关于如何最好地做到这一点,证据有限。在南非,由于部分原因是耻辱感,男性特别难以接受 HIV 检测。我们对两种基于网络的病例发现和护理联系干预措施进行了试点测试。第一种方法是 TRIP,要求“种子”(原始参与者)招募他们的性伴侣和/或注射伙伴。第二种方法是 TRIPLE,旨在通过要求种子招募任何他们认为可能处于 HIV 阳性但不知情风险的人,来规避一些与耻辱感相关的问题。我们从南非夸祖鲁-纳塔尔省的两家诊所招募了 11 名(18%为男性)新诊断为 HIV 阳性(NDP)的种子,并将他们随机分配到 TRIP 或 TRIPLE 组。网络成员从每个种子招募两步。TRIP 组招募了 12 名网络成员;TRIPLE 组招募了 62 名。两个小组招募 NDP 的比例都高于当地诊所的检测比例,TRIP(50.0%)的表现优于 TRIPLE(14.5%)(=0.012)。然而,TRIPLE(53.2%)远远优于诊所(27.8%)和 TRIP(25.0%)招募男性。考虑到在这种情况下对男性进行 HIV 检测和治疗的挑战,这些发现表明,应在多个环境中使用更大的样本正式测试 TRIPLE 扩展网络追踪方法。