School of Social Work, San Diego State University, San Diego, CA, USA.
School of Medicine, University of California San Diego, La Jolla, CA, USA.
Harm Reduct J. 2024 Jun 17;21(1):116. doi: 10.1186/s12954-024-01031-9.
People who use drugs (PWUD) are at increased risk for HIV infection. HIV self-testing (HIVST) is a promising method for identifying new infections, but optimal distribution strategies remain understudied.
To characterize PWUD by HIVST distribution strategy (peers vs. mail), we examined data from July 2022 to June 2023 collected from a real-world HIVST program led by the non-profit, Florida Harm Reduction Collective. We used descriptive statistics and Poisson regressions with robust error variance to compare those who received HIVST through peers or via mail by socio-demographics, Ending the HIV Epidemic (EHE) county designation, and HIV testing experience.
Among 728 participants, 78% received HIVST from peers, 47% identified as cisgender female, 48% as heterosexual, and 45% as non-White; 66% resided in an EHE county, and 55% had no HIV testing experience. Compared to those who received an HIV self-test from peers, those who received tests via mail were less likely to be cisgender male (vs. cisgender female; prevalence ratio [PR] = 0.59, 95% confidence interval [CI]: 0.43, 0.81), non-Hispanic Black (vs. non-Hispanic White; PR = 0.57, 95% CI: 0.36, 0.89) or from EHE counties (vs. non-EHE counties; PR = 0.33, 95% CI: 0.25, 0.44). Those who received tests via mail were also more likely to identify their sexual orientation as "Other/Undisclosed" (vs. straight/heterosexual; PR = 2.00, 95% CI: 1.51, 2.66).
Our findings support the role of community-based HIVST distribution strategies in increasing HIV testing coverage among PWUD. Additional research could help inform the equitable reach of HIVST.
使用毒品的人（PWUD）感染 HIV 的风险增加。HIV 自我检测（HIVST）是识别新感染的一种很有前途的方法，但最佳的分发策略仍在研究中。
为了通过 HIVST 分发策略（同伴与邮件）来描述 PWUD，我们检查了 2022 年 7 月至 2023 年 6 月期间由非营利组织佛罗里达减少伤害集体领导的真实世界 HIVST 计划中收集的数据。我们使用描述性统计和具有稳健误差方差的泊松回归来比较通过同伴或通过邮件接受 HIVST 的人在社会人口统计学、终结艾滋病毒流行（EHE）县指定和 HIV 检测经验方面的差异。
在 728 名参与者中，78%通过同伴获得 HIVST，47%自我认同为顺性别女性，48%为异性恋，45%为非白人；66%居住在 EHE 县，55%没有 HIV 检测经验。与通过同伴接受 HIV 自检的人相比，通过邮件接受检测的人更不可能是顺性别男性（与顺性别女性相比；流行率比 [PR] = 0.59，95%置信区间 [CI]：0.43，0.81），非西班牙裔黑人（与非西班牙裔白人相比；PR = 0.57，95% CI：0.36，0.89）或来自 EHE 县（与非 EHE 县相比；PR = 0.33，95% CI：0.25，0.44）。通过邮件接受检测的人也更有可能将其性取向认定为“其他/未披露”（与直/异性恋相比；PR = 2.00，95% CI：1.51，2.66）。
我们的研究结果支持社区为基础的 HIVST 分发策略在增加 PWUD 中 HIV 检测覆盖率方面的作用。进一步的研究可以帮助了解 HIVST 的公平普及情况。
