Faculty of Health Sciences, Department of Public Health, University of Lomé, Center for Training and Research in Public Health, Lomé, Togo.
African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo.
PLoS One. 2024 Oct 24;19(10):e0312693. doi: 10.1371/journal.pone.0312693. eCollection 2024.
HIV self-testing is a complementary screening strategy that could facilitate access to HIV care services for street adolescents. The objectives of this study were to assess the acceptability and feasibility of HIV self-testing and their associated factors, to estimate HIV prevalence among street adolescents in Togo, and to describe the sexual behavior of this population.
A cross-sectional study was conducted between July 2021 and May 2022 in Lomé and Kara (Togolese cities with the highest number of street adolescents). Street adolescents aged 13-19 years were included. An oral HIV self-test (OraQuick®) was used. Acceptability was defined as the proportion of adolescents who completed the test, and feasibility was defined as the proportion of adolescents who reported a test with a valid result. An HIV serological test was performed for all participants. A weighted logistic regression model was used to identify the factors associated with the acceptability and feasibility of HIV self-testing.
A total of 432 street adolescents (12.3% female) with a median age of 15 years, interquartile range (IQR) [14-17], were included in this study. Of the 231 sexually active adolescents, only 30.3% (n = 70) reported having used a condom during their last sexual intercourse. HIV self-test was offered to a sub-sample of 294 street adolescents. Acceptability was 96.6% (284/294), (95%CI = [93.8-98.3]) and feasibility 98.9% (281/284), (95%CI = [97.0-100.0]). Being 16 years of age or older (aOR = 28.84; p<0.001) was associated with HIV self-test acceptability. Reporting drug abuse (aOR = 0.47; p = 0.020) was negatively associated to acceptability. Having an educational level at least equivalent to secondary school was associated to HIV self-testing feasibility (aOR = 3.92; p = 0.040). Self-test results were correctly interpreted by 98.6% of street adolescents. HIV prevalence was estimated at 0.9% (95%CI [0.4-2.4]).
HIV self-testing is acceptable and feasible among street adolescents, a population at high risk of HIV infection in Togo. The provision of HIV self-testing kits, coupled with condom distribution, represents an opportunity to improve access to HIV care services.
HIV 自我检测是一种补充性的筛查策略，可以促进街头青少年获得 HIV 护理服务。本研究的目的是评估 HIV 自我检测的可接受性和可行性及其相关因素，估计多哥街头青少年的 HIV 流行率，并描述该人群的性行为。
本研究于 2021 年 7 月至 2022 年 5 月在洛美和卡拉（多哥街头青少年人数最多的两个城市）进行了一项横断面研究。纳入年龄在 13-19 岁的街头青少年。使用口腔 HIV 自我检测（OraQuick®）。可接受性定义为完成检测的青少年比例，可行性定义为报告检测结果有效的青少年比例。所有参与者均进行 HIV 血清学检测。使用加权逻辑回归模型确定与 HIV 自我检测的可接受性和可行性相关的因素。
本研究共纳入 432 名街头青少年（12.3%为女性），中位年龄为 15 岁，四分位距（IQR）[14-17]。在 231 名有性行为的青少年中，只有 30.3%（n=70）报告在最近一次性交中使用了避孕套。HIV 自我检测仅提供给 294 名街头青少年的一个亚样本。可接受性为 96.6%（284/294），（95%CI=[93.8-98.3]），可行性为 98.9%（281/284），（95%CI=[97.0-100.0]）。16 岁及以上（OR=28.84；p<0.001）与 HIV 自我检测的可接受性相关。报告药物滥用（OR=0.47；p=0.020）与可接受性呈负相关。具有至少相当于中学水平的教育程度与 HIV 自我检测的可行性相关（OR=3.92；p=0.040）。98.6%的街头青少年正确解读了自我检测结果。HIV 流行率估计为 0.9%（95%CI[0.4-2.4]）。
HIV 自我检测在多哥街头青少年中是可以接受和可行的，这是一个 HIV 感染风险很高的人群。提供 HIV 自我检测试剂盒并结合避孕套的发放，为改善获得 HIV 护理服务的机会提供了机会。
