Kozieł Aleksandra, Domański Igor, Szymczak Aleksandra, Dudzik Tomasz, Knysz Brygida, Szetela Bartosz
Department of Infectious Diseases, Liver Disease and Acquired Immune Deficiencies, Wroclaw Medical University, 50-367 Wroclaw, Poland.
All Saint's Clinic, Wrocławskie Centrum Zdrowia SP ZOZ, 50-136 Wroclaw, Poland.
Diagnostics (Basel). 2024 Nov 6;14(22):2475. doi: 10.3390/diagnostics14222475.
BACKGROUND/OBJECTIVES: A late HIV diagnosis represents a significant public health concern in Poland, with approximately 50% of patients being identified as late presenters (LPs), resulting in the delayed initiation of treatment. This study assesses the potential of HIV self-testing (HIVST) to enhance early detection, particularly among heterosexual individuals, and evaluates its advantages and limitations within the Polish context.
This study examines the advantages and disadvantages of HIVST by analyzing data from various studies. It focuses on the acceptability, sensitivity, and specificity of HIVST, comparing blood-based and oral fluid-based tests. Moreover, the economic impact and potential public health benefits of HIVST in Poland are evaluated.
HIVST is well-accepted, especially among key populations; it can reduce stigma and enhance privacy. The results of studies conducted in Poland indicate that heterosexuals are more inclined to use self-testing methods than traditional diagnostic procedures. On the other hand, HIVST has the potential for false-negative results due to the serological window and the possibility of missed diagnoses of other sexually transmitted infections (STIs). Moreover, the cost of HIVST remains a significant barrier, as it is not publicly funded in Poland.
Despite its limitations, HIVST offers a number of significant benefits, including increased rates of testing and earlier detection, which could prove vital in reducing the transmission of HIV in Poland. This study proposes that increased funding, the integration of HIVST into public health strategies, and further research to enhance its implementation, alongside education and support for its effective use, should be prioritized.
背景/目的:在波兰,艾滋病病毒(HIV)晚期诊断是一个重大的公共卫生问题,约50%的患者被认定为晚期就诊者(LP),这导致治疗开始延迟。本研究评估了HIV自我检测(HIVST)在加强早期检测方面的潜力,特别是在异性恋个体中,并在波兰背景下评估其优势和局限性。
本研究通过分析各项研究的数据来考察HIVST的优缺点。重点关注HIVST的可接受性、敏感性和特异性,比较基于血液和基于口腔液的检测。此外,还评估了HIVST在波兰的经济影响和潜在的公共卫生效益。
HIVST广受欢迎,尤其是在重点人群中;它可以减少耻辱感并增强隐私性。在波兰进行的研究结果表明,异性恋者比传统诊断程序更倾向于使用自我检测方法。另一方面,由于血清学窗口期以及漏诊其他性传播感染(STI)的可能性,HIVST有可能出现假阴性结果。此外,HIVST的成本仍然是一个重大障碍,因为在波兰它没有公共资金支持。
尽管存在局限性,但HIVST提供了许多显著益处,包括检测率提高和更早发现,这在减少波兰的HIV传播方面可能至关重要。本研究建议应优先增加资金投入,将HIVST纳入公共卫生战略,进一步开展研究以加强其实施,并提供教育和支持以促进其有效使用。