中国男跨女同性恋者 HIV 自我检测对检测促进和降低风险行为的影响：随机对照试验。
Effects of HIV Self-Testing on Testing Promotion and Risk Behavior Reduction Among Transgender Women in China: Randomized Controlled Trial.
机构信息
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, NHC Key Laboratory of AIDS Prevention and Treatment, National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, China Medical University, Shenyang, China.
Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.
出版信息
J Med Internet Res. 2024 Oct 29;26:e58591. doi: 10.2196/58591.
BACKGROUND
To date, no randomized controlled trials have specifically addressed behavior changes after HIV self-testing (HIVST) among transgender women.
OBJECTIVE
This study aims to evaluate the effects of HIVST on changes in HIV testing behavior, frequency of condomless sex, and partner numbers among transgender women in China.
METHODS
Participants were recruited from 2 Chinese cities using both online and offline methods. Transgender women were randomly assigned to receive an HIVST intervention. Data from the previous 3 months were collected at baseline, 3 months, and 6 months. The primary outcome was the mean change in the number of HIV tests among transgender women during the 6-month follow-up. An intention-to-treat analysis was conducted. The statistical analysis used analysis of covariance and linear mixed-effects models.
RESULTS
From February to June 2021, and 255 transgender women were recruited, of which only 36.5% (93/255) had a steady job, and 27.1% (69/255) earned less than US $414.9 of income per month. They were randomly assigned to the intervention (n=127) and control (n=128) groups. At 6 months, the mean number of HIV tests was 2.14 (95% CI 1.80-2.48) in the intervention group and 1.19 (95% CI 0.99-1.40) in the control group (P<.001), with increases of 0.84 (95% CI 0.54-1.14) and 0.11 (95% CI -0.19-0.41) over 6 months, respectively. The net increase was 0.73 (95% CI 0.31-1.15; P<.001), with a similar adjusted result. No significant differences in the frequency of condomless sex or partner numbers were observed between the 2 groups.
CONCLUSIONS
HIVST is an effective strategy for enhancing regular HIV testing behavior among transgender women in China. This strategy should be combined with measures to address the financial vulnerability of the transgender women community to reduce subsequent risk behaviors, including condomless sex.
TRIAL REGISTRATION
Chinese Clinical Trial Registry ChiCTR2000039766; https://www.chictr.org.cn/showproj.html?proj=61402.
背景
迄今为止，尚无专门针对跨性别女性 HIV 自检（HIVST）后行为变化的随机对照试验。
目的
本研究旨在评估 HIVST 对中国跨性别女性 HIV 检测行为、无保护性行为频率和伴侣数量变化的影响。
方法
采用线上线下相结合的方式从中国两个城市招募参与者。跨性别女性被随机分配接受 HIVST 干预。在基线、3 个月和 6 个月时收集前 3 个月的数据。主要结局是 6 个月随访期间跨性别女性 HIV 检测次数的平均变化。采用意向治疗分析。统计分析采用协方差分析和线性混合效应模型。
结果
2021 年 2 月至 6 月，共招募了 255 名跨性别女性，其中只有 36.5%（93/255）有稳定工作，27.1%（69/255）每月收入低于 414.9 美元。他们被随机分配到干预组（n=127）和对照组（n=128）。6 个月时，干预组 HIV 检测次数的平均值为 2.14（95%CI 1.80-2.48），对照组为 1.19（95%CI 0.99-1.40）（P<.001），分别增加了 0.84（95%CI 0.54-1.14）和 0.11（95%CI -0.19-0.41）。6 个月的净增率为 0.73（95%CI 0.31-1.15；P<.001），调整后的结果相似。两组之间无保护性行为频率或伴侣数量无显著差异。
结论
HIVST 是增强中国跨性别女性定期 HIV 检测行为的有效策略。该策略应结合解决跨性别女性群体经济脆弱性的措施，以减少随后的风险行为，包括无保护性行为。
试验注册
中国临床试验注册中心 ChiCTR2000039766；https://www.chictr.org.cn/showproj.html?proj=61402。
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