School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia; Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC, Australia.
Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.
Lancet HIV. 2024 Nov;11(11):e774-e782. doi: 10.1016/S2352-3018(24)00187-5. Epub 2024 Sep 24.
HIV self-testing, which has been increasingly available since 2016, can substantially enhance the uptake of HIV testing, especially for key populations. Clinical trials have explored the application of self-testing in various HIV prevention strategies, including post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), and voluntary medical male circumcision. Research indicates that self-testing can facilitate PrEP initiation and improve adherence and continuation. However, evidence on the effectiveness of linkage to PrEP post HIV self-testing is mixed, underscoring the need to further understand contextual factors and optimal implementation strategies. Studies on linking voluntary medical male circumcision post HIV self-testing show no statistically significant difference compared with standard voluntary medical male circumcision demand creation strategies. There is a shortage of trials examining the role of self-testing in PrEP reinitiation, PEP initiation, or PEP follow-up. Evidence for the use of HIV prevention models that support self-testing is accumulating, but there is a need for further research in different contexts and among different populations to assess its value when scaled up to contribute to reducing HIV infections globally.
自 2016 年以来，艾滋病毒自检越来越普及，这大大提高了艾滋病毒检测的普及率，特别是对重点人群而言。临床试验已经探索了自检在各种艾滋病毒预防策略中的应用，包括暴露后预防 (PEP)、暴露前预防 (PrEP) 和自愿医疗男性包皮环切术。研究表明，自检可以促进 PrEP 的启动，并提高其依从性和持续性。然而，关于艾滋病毒自检后与 PrEP 联系的有效性的证据参差不齐，这突显了需要进一步了解背景因素和最佳实施策略的必要性。关于艾滋病毒自检后与自愿医疗男性包皮环切术联系的研究结果与标准自愿医疗男性包皮环切术需求创造策略相比，没有统计学上的显著差异。目前还缺乏关于自检在 PrEP 重新启动、PEP 启动或 PEP 随访中的作用的试验。支持自检的艾滋病毒预防模式的使用证据正在不断增加，但需要在不同背景和不同人群中进行进一步的研究，以评估其在扩大规模以帮助减少全球艾滋病毒感染方面的价值。
