Nduhukyire Lawrence, Semitala Fred C, Mutanda Juliet Ntuulo, Muramuzi Dan, Ipola Patrick Albert, Kabagenyi Allen, Nangendo Joan, Namutundu Juliana
Makerere University.
Res Sq. 2024 May 15:rs.3.rs-4378165. doi: 10.21203/rs.3.rs-4378165/v1.
Oral HIV self-testing (HIVST) among men is relatively low and still inadequate in Sub-Saharan Africa. Delivering HIVST kits by pregnant women attending antenatal care to their partners is a promising strategy for increasing HIV testing among men. However, even amidst the interventions, most men do not know their HIV status. This study, aimed to determine the proportion of partners who received and used oral HIVST kits delivered by pregnant women, associated factors, barriers, and facilitators for uptake among partners.
We conducted an exploratory sequential mixed methods study among 380 sampled partners. Lists of partners in the HIVST log books whose women picked an HIVST kit were obtained and systematic random sampling was done to obtain participants. 14 male partners were purposively selected for in-depth interviews (IDIs) to identify barriers and facilitators. We used modified poison regression to determine the association between oral HIVST and independent variables. We used an inductive analysis for the qualitative analysis.
Out of 380 participants, 260(68.4%) received an oral HIVST kit from their pregnant women, and 215(82.7%) used the kit for HIVST. Oral HIVST was associated with; Information Education and Communication (CPR = 1.64, 95%CI 1.48-1.82), being reached at home (CPR = 1.04, 95%CI 1.01-1.08), and being aware of the woman's HIV status (CPR = 1.04, 95%CI 0.99-1.09). In-depth results identified barriers to uptake as, lack of trust in the HIVST kit results, fear of test outcome in the presence of the partner and inclination that the HIV status of their women is the same as theirs, and facilitators included convenience, ease to use, prior awareness of their HIV status, and fear of relationship consequences and breakup.
Delivery of oral HIVST kits to men through pregnant women reached a high number of men and achieved a high uptake. Accessing information, education, communication and convenience nature were the major reasons for uptake among men who received the Oral HIVST kit as trust issues of the kit affected use among partners. Scaling up the delivery of oral HIVST kits at all departments of the hospital through women seeking health services is paramount to support HIV screening among men to reach the UNAIDS 95 strategy.
在撒哈拉以南非洲地区，男性进行口服艾滋病毒自我检测（HIVST）的比例相对较低，且仍不充分。让参加产前护理的孕妇将HIVST检测试剂盒发放给其伴侣，是增加男性艾滋病毒检测的一项有前景的策略。然而，即便在采取了这些干预措施的情况下，大多数男性仍不清楚自己的艾滋病毒感染状况。本研究旨在确定接受并使用孕妇发放的口服HIVST检测试剂盒的伴侣比例、相关因素、伴侣接受检测的障碍及促进因素。
我们对380名抽样伴侣开展了一项探索性序列混合方法研究。从HIVST日志中获取其女性伴侣领取了HIVST检测试剂盒的伴侣名单，并通过系统随机抽样选取参与者。有目的地挑选了14名男性伴侣进行深入访谈（IDI），以确定障碍和促进因素。我们使用修正泊松回归来确定口服HIVST与自变量之间的关联。我们对定性分析采用归纳分析法。
在380名参与者中，260名（68.4%）从其孕妇伴侣处收到了口服HIVST检测试剂盒，215名（82.7%）使用该试剂盒进行了艾滋病毒检测。口服HIVST与以下因素相关：信息教育与宣传（CPR = 1.64，95%CI 1.48 - 1.82）、在家中收到试剂盒（CPR = 1.04，95%CI 1.01 - 1.08）以及知晓女性伴侣的艾滋病毒感染状况（CPR = 1.04，95%CI 0.99 - 1.09）。深入研究结果确定，接受检测的障碍包括对HIVST检测试剂盒结果缺乏信任、在伴侣在场时对检测结果的恐惧以及倾向于认为其女性伴侣的艾滋病毒感染状况与自己相同，促进因素包括方便、易于使用、事先知晓自己的艾滋病毒感染状况以及对关系后果和分手的恐惧。
通过孕妇向男性发放口服HIVST检测试剂盒，覆盖了大量男性且接受检测率很高。获取信息、教育宣传以及方便性是接受口服HIVST检测试剂盒的男性接受检测的主要原因，因为试剂盒的信任问题影响了伴侣间的使用。通过寻求医疗服务的女性在医院各科室扩大口服HIVST检测试剂盒的发放，对于支持男性艾滋病毒筛查以实现联合国艾滋病规划署95战略至关重要。
