Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, Washington, DC, USA.
School of Nursing, Rochester University, Rochester, NY, USA.
BMC Health Serv Res. 2024 Oct 2;24(1):1166. doi: 10.1186/s12913-024-11586-9.
BACKGROUND: According to the 2016-2017 Tanzania HIV Impact Survey, only 45% of men living with HIV (MLWH) were aware of their HIV status. In an effort to increase HIV testing in Tanzania, including among men, the Government of Tanzania passed a law in December 2019 allowing HIV self-testing (HIVST) to be included in the national testing strategies. The objective of this paper is to describe the development and pilot feasibility assessment of the Self-Testing Education and Promotion (STEP) intervention, which includes male peer education and demand creation for HIVST, and nurse-led distribution of HIVST kits in a community setting. METHODS: The development and piloting processes were guided by the ADAPT-ITT model and informed by a national PEPFAR/USAID-funded HIV implementation science project called Sauti. The adapted STEP intervention included the following two components: 1) peer-based HIVST promotion; and 2) nurse-led HIVST distribution. For the feasibility assessment, 25 men were selected and trained as peer educators in 2019 to promote HIVST among their peers before recruiting 253 men who received instructions and an HIVST kit from a nurse at a community-based study tent site. RESULTS: Of the 236 participants who completed the 1-month follow-up survey, 98.3% reported using the kit. The majority (92.4%) of participants reported a negative HIVST result while 4.2% (n = 10) received a positive result. Most (70%, n = 7) of the participants with a positive result sought follow-up services at a healthcare facility while 40.3% (n = 95) of the participants with a negative self-test result visited the community-based project site. Most of the men (53%, n = 129) did not visit a healthcare facility or the study site. CONCLUSION: The findings demonstrate that the combined peer-based promotion and nurse-led distribution of HIVST intervention was acceptable and feasible, though seeking follow-up services at healthcare facilities remained low. Future research should evaluate the effectiveness of offering nurse-led community-based clinical follow-up services in addition to HIVST rather than referral to facilities.
背景：根据 2016-2017 年坦桑尼亚艾滋病毒影响调查，只有 45%的艾滋病毒感染者（MLWH）知晓其艾滋病毒状况。为了提高包括男性在内的坦桑尼亚艾滋病毒检测率，坦桑尼亚政府于 2019 年 12 月通过了一项法律，允许将艾滋病毒自我检测（HIVST）纳入国家检测战略。本文旨在描述自我检测教育和推广（STEP）干预措施的制定和试点可行性评估，该干预措施包括男性同伴教育和对 HIVST 的需求创造，以及在社区环境中由护士主导的 HIVST 试剂盒分发。
方法：开发和试点过程遵循 ADAPT-ITT 模型，并以国家 PEPFAR/USAID 资助的艾滋病毒实施科学项目“ Sauti ”为指导。经过调整的 STEP 干预措施包括以下两个组成部分：1）基于同伴的 HIVST 推广；2）护士主导的 HIVST 分发。为了进行可行性评估，2019 年选择了 25 名男性作为同伴教育者，在招募 253 名男性在社区研究帐篷现场从护士那里接受指导和 HIVST 试剂盒之前，向他们的同伴推广 HIVST。
结果：在完成 1 个月随访调查的 236 名参与者中，98.3%的人报告使用了试剂盒。大多数参与者（92.4%）报告 HIVST 结果为阴性，而 4.2%（n=10）的参与者结果为阳性。大多数参与者（70%，n=7）阳性结果的参与者在医疗机构寻求后续服务，而 40.3%（n=95）的阴性自我检测结果参与者访问了社区项目现场。大多数男性（53%，n=129）没有去医疗机构或研究点。
结论：研究结果表明，基于同伴的推广和护士主导的 HIVST 干预措施的组合是可以接受和可行的，尽管在医疗机构寻求后续服务的比例仍然较低。未来的研究应评估在提供 HIVST 之外，还提供护士主导的社区临床后续服务而不是转介到医疗机构的效果。
World J Methodol. 2023-6-20
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