Rodriguez Natalia M, Balian Lara, Kataki Ishita, Tolliver Cealia, Rivera-De Jesus Julio, Linnes Jacqueline C
Purdue University.
Res Sq. 2024 Apr 19:rs.3.rs-4243639. doi: 10.21203/rs.3.rs-4243639/v1.
BACKGROUND/OBJECTIVE: The utilization of rapid HIV tests has been effective at reducing transmission rates in high-risk populations by allowing individuals to receive diagnosis in as little as one minute and begin treatment. However, no current rapid tests can detect HIV immediately after infection in the acute HIV infection (AHI) phase, when the virus is at its most infectious, and instead require a waiting period of up to 90 days after exposure. Rapid HIV tests to detect AHI are currently under development. Investigation of stakeholder perspectives and context-specific needs are critical to ensure successful translation of novel AHI tests. The objectives of this study were to 1) understand context-specific factors such as barriers to HIV testing in Indiana, a state with one of 48 prioritized counties for HIV elimination; 2) assess the acceptability of a novel rapid AHI test, and 3) identify key implementation considerations for such a device, including ideal end-users.
Semi-structured in-depth interviews were conducted with staff (n = 14) and clients (n = 5) of Indiana-based organizations that conduct HIV testing, including syringe service programs. Utilizing human-centered design frameworks, interview guides were developed and tailored to each participant group to understand their experiences with HIV testing, perspectives on a novel rapid AHI test in development, and preferences for self-testing versus testing by a community health worker (CHW) or a peer recovery coach. Thematic analysis was conducted to identify major themes, including barriers to HIV testing and perceived benefits and concerns of the proposed AHI test.
Overall acceptability for a novel AHI rapid test was high with a greater preference for CHW/Peerled testing. While self-testing was not a preferred modality, it was still seen as a potential tool to reach and address key barriers among high-risk individuals. Key considerations for implementation emphasized accuracy, cost-effectiveness, ease of use, ensuring access to counseling, education, and navigation to care while maintaining a human element to self-testing.
Stakeholder engagement is meaningfully informing the design, development, and implementation of rapid AHI testing in order to facilitate adoption among populations at high-risk for HIV.
背景/目的：快速艾滋病毒检测的应用通过让个体在短短一分钟内获得诊断并开始治疗，在降低高危人群的传播率方面已见成效。然而，目前没有一种快速检测能够在急性艾滋病毒感染（AHI）阶段，即病毒传染性最强的时候，在感染后立即检测出艾滋病毒，而是需要在接触后长达90天的等待期。目前正在研发用于检测AHI的快速艾滋病毒检测方法。调查利益相关者的观点和特定背景下的需求对于确保新型AHI检测方法的成功转化至关重要。本研究的目的是：1）了解特定背景因素，如印第安纳州艾滋病毒检测的障碍，该州是48个优先消除艾滋病毒的县之一；2）评估一种新型快速AHI检测方法的可接受性；3）确定此类设备的关键实施考虑因素，包括理想的最终用户。
对印第安纳州开展艾滋病毒检测的组织（包括注射器服务项目）的工作人员（n = 14）和客户（n = 5）进行了半结构化深入访谈。利用以人为本的设计框架，针对每个参与群体制定并调整了访谈指南，以了解他们的艾滋病毒检测经历、对正在研发的新型快速AHI检测方法的看法，以及对自我检测与由社区卫生工作者（CHW）或同伴康复教练进行检测的偏好。进行了主题分析，以确定主要主题，包括艾滋病毒检测障碍以及对提议的AHI检测方法的感知益处和担忧。
新型AHI快速检测方法的总体可接受性较高，对由社区卫生工作者/同伴主导的检测更有偏好。虽然自我检测不是首选方式，但它仍被视为接触并解决高危个体关键障碍的潜在工具。实施的关键考虑因素强调准确性、成本效益、易用性、确保获得咨询、教育以及护理引导，同时在自我检测中保持人性化因素。
利益相关者的参与对快速AHI检测的设计、开发和实施具有重要指导意义，以便于在艾滋病毒高危人群中推广应用。
