使用自我检测来增加男男性行为者和跨性别女性中的艾滋病毒检测——系统评价概述

Use of self-test to increase HIV testing among men who have sex with men and transgender women-overview of systematic reviews.

作者信息

Azevêdo Ana Regina Tavares Cairo, Faria Joyce Costa Melgaço, Rocha Gustavo Machado, Menezes de Pádua Cristiane Aparecida

机构信息

Department of Clinical and Toxicological Analysis, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.

出版信息

AIDS Care. 2025 Jun;37(6):873-883. doi: 10.1080/09540121.2025.2484331. Epub 2025 Apr 2.

Abstract

Human Immunodeficiency Virus (HIV) infection is stigmatizing, especially for key populations, who are disproportionately affected by Sexually Transmitted Infections (STIs). The stigma and discrimination suffered by these groups are among the main obstacles to HIV prevention, treatment and care, which is why the World Health Organization recommends the use of self-tests to increase HIV testing and achieve the 95-95-95 target by 2030 proposed by the United Nations. We conducted an overview of systematic reviews and meta-analyses, searching for free and indexed terms in nine databases, and using the acronym PICO as an inclusion criterion. Two independent reviewers performed the selection in two stages, and disagreements were resolved by consensus with a third reviewer. Quality analysis was performed using the Assessing the Methodological Quality of Systematic Reviews, version 2 (AMSTAR 2) tool. Four studies were included, one evaluating men who have sex with men (MSM), one evaluating MSM and another key population, and two evaluating MSM and transgender women (TGW). HIVST was effective in increasing testing frequency and uptake and was considered as good as or better in detecting new HIV infections. However, the presence of more than one critical weakness and multiple non-critical flaws reduced the overall confidence.

摘要

人类免疫缺陷病毒(HIV)感染具有污名化现象,尤其是对重点人群而言,他们受到性传播感染(STIs)的影响尤为严重。这些群体所遭受的污名和歧视是HIV预防、治疗和护理的主要障碍之一,这就是为什么世界卫生组织建议使用自我检测来增加HIV检测,并实现联合国提出的到2030年达到95-95-95的目标。我们对系统评价和荟萃分析进行了概述,在九个数据库中搜索自由词和索引词,并使用首字母缩写词PICO作为纳入标准。两名独立评审员分两个阶段进行筛选,分歧通过与第三名评审员达成共识来解决。使用《系统评价方法学质量评估》第2版(AMSTAR 2)工具进行质量分析。纳入了四项研究,一项评估男男性行为者(MSM),一项评估男男性行为者和另一重点人群,两项评估男男性行为者和跨性别女性(TGW)。HIV自我检测在提高检测频率和接受度方面是有效的,并且在检测新的HIV感染方面被认为与其他检测方法一样好或更好。然而,存在多个关键弱点和多个非关键缺陷降低了总体可信度。

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