Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.
Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
AIDS Res Ther. 2024 Nov 13;21(1):82. doi: 10.1186/s12981-024-00672-x.
BACKGROUND: Oral HIV self-testing (HIVST) among men is relatively low and still inadequate in Sub-Saharan Africa. Delivering HIVST kits by pregnant women attending antenatal care to their partners is a promising strategy for increasing HIV testing among men. However, even amidst the HIV testing interventions, most men do not know their HIV status. This study, aimed to determine the proportion of partners who received and used oral HIVST kits delivered by pregnant women, associated factors, barriers, and facilitators for uptake. METHODS: We conducted an exploratory sequential mixed methods study among 380 sampled partners. Lists of partners from HIVST logbooks whose women picked an HIVST kit were obtained and systematic sampling was done to recruit participants. Fourteen (14) male partners were purposively selected for in-depth interviews to identify barriers and facilitators. We used modified poison regression to determine factors associated with oral HIVST. We used an inductive thematic analysis for qualitative analysis. RESULTS: Out of 380 participants, 260(68.4%) received an oral HIVST kit from their pregnant women, and 215(82.7%) used it for HIVST. Oral HIVST was associated with; Information Education and Communication like availability of HIVST guiding materials (aPR = 1.64, 95%CI: 1.48-1.82), being reached at home (aPR = 1.04, 95%CI 1.01-1.08), and being aware of the woman's HIV status (aPR = 1.04, 95%CI 0.99-1.09). In-depth results identified barriers to uptake as, lack of trust in the HIVST kit results, fear of test outcome in the presence of their partner and inclination that the HIV status of their women is the same as theirs; Facilitators included convenience, ease of use, prior awareness of their HIV status, and fear of relationship consequences and breakup. CONCLUSION: Delivery of oral HIVST kits to men through pregnant women reached a high number of men and achieved high uptake. Accessing information, education, communication and the kit's convenience were major reasons for uptake among men who received the kit as; trust issues affected its use among partners. Scaling up the delivery of oral HIVST kits at all departments of hospitals through women seeking health services is paramount to support HIV screening among men to reach the UNAIDS 95 strategy.
背景：在撒哈拉以南非洲，男性进行口腔 HIV 自我检测（HIVST）的比例相对较低，且仍不充分。向接受产前护理的孕妇的伴侣提供 HIVST 检测包是增加男性 HIV 检测的一项有前途的策略。然而，即使在 HIV 检测干预措施中，大多数男性也不知道自己的 HIV 状况。本研究旨在确定接受并使用孕妇提供的口腔 HIVST 检测包的伴侣比例，以及相关因素、障碍和促进因素。
方法：我们对 380 名抽样伴侣进行了探索性顺序混合方法研究。从 HIVST 日志中获取了其女性选择 HIVST 检测包的伴侣名单，并进行系统抽样以招募参与者。为了确定障碍和促进因素，我们特意选择了 14 名男性伴侣进行深入访谈。我们使用改良的毒剂回归来确定与口腔 HIVST 相关的因素。我们使用归纳主题分析进行定性分析。
结果：在 380 名参与者中，有 260 名（68.4%）从其孕妇那里收到了口腔 HIVST 检测包，有 215 名（82.7%）使用该检测包进行了 HIVST。口腔 HIVST 与以下因素相关：信息、教育和宣传，如 HIVST 指导材料的可用性（调整后的比值比[aPR] = 1.64，95%置信区间[CI]：1.48-1.82）、在伴侣家接受检测（aPR = 1.04，95%CI：1.01-1.08）和知晓伴侣的 HIV 状况（aPR = 1.04，95%CI：0.99-1.09）。深入的结果表明，采用该检测包的障碍包括对检测包结果的不信任、担心伴侣在场时的检测结果以及倾向于认为伴侣的 HIV 状况与他们自己的相同；促进因素包括便利性、易用性、对自身 HIV 状况的事先了解、以及担心关系后果和分手。
结论：通过孕妇向男性提供口腔 HIVST 检测包的方式，接触到了大量男性并实现了高使用率。获取信息、教育、宣传和检测包的便利性是男性接受检测包的主要原因，因为他们信任该检测包；而信任问题影响了伴侣对该检测包的使用。通过在医院的所有科室向寻求医疗服务的女性提供口腔 HIVST 检测包，对支持男性的 HIV 筛查以实现联合国艾滋病规划署 95 战略至关重要。
BMC Public Health. 2021-5-27
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