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扩大艾滋病病毒检测选择:肯尼亚男男性行为者社区主导的艾滋病自我检测干预的过程评价。

Expanding options for HIV testing: A process evaluation of a community-led HIV self-testing intervention among men who have sex with men in Kenya.

机构信息

Partners for Health and Development in Africa, Nairobi, Kenya.

Institute for Global Public Health, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada.

出版信息

Gates Open Res. 2024 Mar 25;7:127. doi: 10.12688/gatesopenres.14819.2. eCollection 2023.


DOI:10.12688/gatesopenres.14819.2
PMID:39035469
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11259586/
Abstract

BACKGROUND: Men who have sex with men (MSM) in Kenya continue to face barriers to HIV testing, which leads to delays in HIV prevention and care. An HIV self-testing (HIVST) intervention was implemented in three Kenyan counties to increase coverage and frequency of HIV testing among MSM communities with high HIV prevalence. The evaluation study examined how HIVST can increase testing among MSM who are unaware of their status by increasing coverage, frequency, and early uptake of testing and support linkages to prevention and treatment. We share results from the process evaluation of the intervention implemented in partnership with MSM-led organizations. METHODS: For a 12-month period between August 2019 and July 2020, the project team conducted in-depth interviews with HIVST users, monthly meetings with programme implementation teams, and monthly monitoring data reviews. Polling booth surveys were also conducted with participants. The process evaluation explored the fidelity, feasibility, coverage, acceptability, quality, and effectiveness of the HIVST intervention. RESULTS: An average of 793 MSM received 1,041 HIVST kits on a monthly basis through different distribution channels. Of those who received HIVST kits, 67% were distributed to infrequent testers and non-testers. Testing frequency among users increased to 82% for those who had a recent test during the previous three months, compared to 58% of HIVST non-users. There was a high linkage to care and treatment services (84%) among those who tested reactive for HIV at endline. MSM shared preferring HIVST kits because of its convenience and privacy. During the COVID-19 pandemic, adaptations to the intervention were made to support ongoing HIV testing and linkages to services. CONCLUSION: The introduction of HIVST in MSM-led HIV prevention programmes was feasible with high acceptability. The involvement of the MSM community in the design, implementation and evaluation of the intervention was a key factor to intervention success.

摘要

背景:肯尼亚的男男性行为者(MSM)继续面临艾滋病毒检测的障碍,这导致艾滋病毒预防和护理的延迟。在三个肯尼亚县实施了艾滋病毒自我检测(HIVST)干预措施,以提高艾滋病毒流行率高的 MSM 社区的 HIV 检测覆盖率和频率。评估研究检查了 HIVST 如何通过增加检测的覆盖率、频率和早期采用率以及支持与预防和治疗的联系,来增加那些不知道自己状况的 MSM 进行检测。我们分享与 MSM 领导的组织合作实施的干预措施的过程评估结果。

方法:在 2019 年 8 月至 2020 年 7 月的 12 个月期间,项目团队对 HIVST 用户进行了深入访谈,每月与方案实施团队举行会议,并每月审查监测数据。还对参与者进行了投票站调查。该过程评估探讨了 HIVST 干预措施的保真度、可行性、覆盖率、可接受性、质量和有效性。

结果:平均每月有 793 名 MSM 通过不同的分发渠道收到 1041 份 HIVST 试剂盒。在收到 HIVST 试剂盒的人中,有 67%分发给不常检测和未检测的人。与 HIVST 非使用者相比,在过去三个月内最近进行过检测的使用者中,检测频率增加到 82%。在最后一次检测中 HIV 呈阳性反应的人中,有 84%与护理和治疗服务建立了联系。MSM 表示更喜欢 HIVST 试剂盒,因为它方便且隐私。在 COVID-19 大流行期间,对干预措施进行了调整,以支持持续的 HIV 检测和与服务的联系。

结论:在 MSM 领导的艾滋病毒预防方案中引入 HIVST 是可行的,且具有较高的可接受性。MSM 社区参与设计、实施和评估干预措施是干预成功的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/5d22a4a774de/gatesopenres-7-16889-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/d0cc95c3027c/gatesopenres-7-16889-g0000.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/46d2630e6406/gatesopenres-7-16889-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/5d22a4a774de/gatesopenres-7-16889-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/d0cc95c3027c/gatesopenres-7-16889-g0000.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/46d2630e6406/gatesopenres-7-16889-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7881/11259590/5d22a4a774de/gatesopenres-7-16889-g0002.jpg

相似文献

[1]
Expanding options for HIV testing: A process evaluation of a community-led HIV self-testing intervention among men who have sex with men in Kenya.

Gates Open Res. 2023

[2]
Evaluation of community-based HIV self-testing delivery strategies on reducing undiagnosed HIV infection, and improving linkage to prevention and treatment services, among men who have sex with men in Kenya: a programme science study protocol.

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[3]
Evaluation of factors associated with HIV self-testing Acceptability and Uptake among the MSM community in Nairobi, Kenya: A cross sectional study.

PLoS One. 2023

[4]
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[5]
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Health Res Policy Syst. 2021-4-21

[6]
Implementation of unassisted and community-based HIV Self-Testing (HIVST) during the COVID-19 pandemic among Men-who-have-sex-with-Men (MSM) and Transgender Women (TGW): A demonstration study in Metro Manila, Philippines.

PLoS One. 2023

[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Assessing awareness and use of HIV self-testing kits after the introduction of a community-based HIV self-testing programme among men who have sex with men in Kenya.

PLOS Glob Public Health. 2023-8-18

[2]
Co-creation of HIVST delivery approaches for improving urban men's engagement with HIV services in eThekwini District, KwaZulu-Natal: nominal group technique in intervention development.

Pilot Feasibility Stud. 2022-6-9

[3]
Understanding socio-sexual networks: critical consideration for HIVST intervention planning among men who have sex with men in Kenya.

BMC Public Health. 2022-3-21

[4]
Remaking the Technosubject: Kenyan Men Contextualizing HIV Self-Testing Technologies.

Med Anthropol. 2022-4

[5]
Feasibility of Indirect Secondary Distribution of HIV Self-test Kits via WeChat Among Men Who Have Sex With Men: National Cross-sectional Study in China.

J Med Internet Res. 2021-10-26

[6]
Uptake of oral fluid-based HIV self-testing among men who have sex with men and transgender women in Thailand.

PLoS One. 2021

[7]
A decade and beyond: learnings from HIV programming with underserved and marginalized key populations in Kenya.

J Int AIDS Soc. 2021-7

[8]
Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya.

Gates Open Res. 2020-12-10

[9]
HIV testing amid COVID-19: community efforts to reach men who have sex with men in three Kenyan counties.

Gates Open Res. 2020-10-29

[10]
'I will welcome this one 101%, I will so embrace it': a qualitative exploration of the feasibility and acceptability of HIV self-testing among men who have sex with men (MSM) in Lagos, Nigeria.

Health Educ Res. 2020-12-23

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