Partners for Health and Development in Africa, Nairobi, Kenya.
Institute for Global Public Health, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada.
Gates Open Res. 2024 Mar 25;7:127. doi: 10.12688/gatesopenres.14819.2. eCollection 2023.
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.
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。
Health Res Policy Syst. 2021-4-21