Department of Global Health, University of Washington, Seattle, WA, United States of America.
Department of Epidemiology, University of Washington, Seattle, WA, United States of America.
PLoS One. 2024 Aug 13;19(8):e0302077. doi: 10.1371/journal.pone.0302077. eCollection 2024.
To compare preferences, uptake, and cofactors for unassisted home-based oral self-testing (HB-HIVST) versus clinic-based rapid diagnostic blood tests (CB-RDT) for maternal HIV retesting.
Prospective cohort.
Between November 2017 and June 2019, HIV-negative pregnant Kenyan women receiving antenatal care were enrolled and given a choice to retest with HB-HIVST or CB-RDT. Women were asked to retest between 36 weeks gestation and 1-week post-delivery if the last HIV test was <24 weeks gestation or at 6 weeks postpartum if ≥24 weeks gestation, and self-report on retesting at a 14-week postpartum.
Overall, 994 women enrolled and 33% (n = 330) selected HB-HIVST. HB-HIVST was selected because it was private (n = 224, 68%), convenient (n = 211, 63%), and offered flexibility in the timing of retesting (n = 207, 63%), whereas CB-RDT was selected due to the trust of providers to administer the test (n = 510, 77%) and convenience of clinic testing (n = 423, 64%). Among 905 women who reported retesting at follow-up, 135 (15%) used HB-HIVST. Most (n = 595, 94%) who selected CB-RDT retested with this strategy, compared to 39% (n = 120) who selected HB-HIVST retesting with HB-HIVST. HB-HIVST retesting was more common among women with higher household income and those who may have been unable to test during pregnancy (both retested postpartum and delivered <37 weeks gestation) and less common among women who were depressed. Most women said they would retest in the future using the test selected at enrollment (99% [n = 133] HB-HIVST; 93% [n = 715] CB-RDT-RDT).
While most women preferred CB-RDT for maternal retesting, HB-HIVST was acceptable and feasible and could be used to expand HIV retesting options.
比较经产妇居家自我检测（HB-HIVST）和诊所快速诊断血检（CB-RDT）用于艾滋病病毒（HIV）复查的偏好、接受度和影响因素。
前瞻性队列研究。
2017 年 11 月至 2019 年 6 月，招募了在肯尼亚接受产前保健且 HIV 检测结果为阴性的孕妇，为其提供 HB-HIVST 和 CB-RDT 两种复查选择。如果上次 HIV 检测时间在 24 周妊娠前，最后一次 HIV 检测时间在 24 周妊娠后且在 36 周妊娠内，孕妇需要在 36 周妊娠时进行复查；如果最后一次 HIV 检测时间在 24 周妊娠后 6 周内，孕妇需要在产后 6 周进行复查。同时，如果孕妇选择 HB-HIVST 进行复查，需要在产后 14 周时进行自我报告。
共有 994 名孕妇入组，其中 33%（n=330）选择 HB-HIVST。选择 HB-HIVST 的原因主要包括：隐私性（n=224，68%）、便利性（n=211，63%）以及检测时间灵活（n=207，63%）；选择 CB-RDT 的原因主要包括：医护人员可信度（n=510，77%）和诊所检测的便利性（n=423，64%）。在 905 名报告了随访时复查情况的女性中，有 135 名（15%）使用了 HB-HIVST。与选择 HB-HIVST 进行复查的 120 名女性相比，选择 CB-RDT 进行复查的 595 名女性（94%）更有可能进行 CB-RDT 复查。HB-HIVST 复查的情况在家庭收入较高的女性和可能在孕期无法进行检测的女性（均在产后进行了检测且分娩孕周＜37 周）中更为常见，在抑郁的女性中更为少见。大多数女性表示，未来将使用入组时选择的检测方法进行复查（HB-HIVST：99%[n=133]；CB-RDT：93%[n=715]）。
虽然大多数女性更倾向于选择 CB-RDT 进行复查，但 HB-HIVST 也是可以接受和可行的，且可以作为扩大 HIV 复查选择的方法。
