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同伴提供的艾滋病毒和梅毒自检试剂盒以及协助性伴侣通知服务对男同性恋者、双性恋者和其他与男性发生性关系的男性的可行性和可接受性:乌干达的一项定性研究

Feasibility and acceptability of peer-delivered HIV and syphilis self-test kits and assisted partner notification services for gay, bisexual and other men who have sex with men: a qualitative study in Uganda.

作者信息

Okoboi Stephen, Mujugira Andrew, Ekusai-Sebatta Deborah, Twimukye Adeline, Tumuhimbise Peninah, Aliganyira Brian, Castelnuovo Barbara, King Rachel

机构信息

Infectious Diseases Institute, Makerere University, Kampala, Uganda.

Department of Global Health, University of Washington, Seattle, Washington, USA.

出版信息

J Int AIDS Soc. 2025 May;28(5):e26456. doi: 10.1002/jia2.26456.


DOI:10.1002/jia2.26456
PMID:40390332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12089651/
Abstract

INTRODUCTION: There is a need to combine different approaches to tackle the HIV epidemic, particularly in high-incidence populations. We explored the feasibility and acceptability of using peer-delivered HIV self-testing (HIVST), syphilis self-testing (SST) and assisted partner notification (APN) services among gay, bisexual and other men who have sex with men (GBMSM) in Uganda. METHODS: From November 2023 to March 2024, we conducted in-depth interviews with 20 purposively selected GBMSM peers and 10 healthcare workers (HCWs). The GBMSM and HCWs interviews explored their perspectives on (1) the feasibility, acceptability and preferences for peer-delivered interventions (HIVST, SST and APN) and (2) strategies and methods of reaching individuals who had not been tested or tested more than 6 months before the interview. We used a content analysis approach to define and organize codes deductively and inductively to identify themes. RESULTS: The median age of the 20 GBMSM peers was 27 years (interquartile range [IQR], 22-35 years), and 37 years (IQR, 25-52) for the 10 HCWs, of whom seven were female. We identified four emerging categories: (1) Trust: GBMSM peers and HCWs expressed trust in the peer delivery of self-test kits (HIVST and SST) to obtain same-day results effectively. HCWs were preferred over peers for APN services in reaching sexual contacts of index clients for testing; (2) Intimate partner violence (IPV): Although initial concerns about IPV were raised concerning both HIVST programmes and peer APN strategies, such incidents were rarely reported in practice; (3) Entry point: Similar to HIVST, SST was a self-administered activity that served as an entry point for HIV testing discussions among GBMSM who had either never undergone or had postponed testing. Self-test kits could also facilitate pre-sexual testing among GBMSM; (4) Social media: Campaigns on social media dedicated to promoting self-testing could expand testing coverage services to GBMSM vulnerable to HIV and syphilis acquisition. CONCLUSIONS: HCWs and GBMSM peers preferred delivery of self-test kits through peers over facility-based approaches; however, they favoured HCWs for providing APN services. Integrating peer-delivered self-testing programmes into differentiated testing models and leveraging social media influencers could expand testing coverage among GBMSM.

摘要

引言:需要结合不同方法来应对艾滋病毒疫情,特别是在高感染率人群中。我们探讨了在乌干达男同性恋者、双性恋者和其他与男性发生性关系的男性(GBMSM)中,由同伴提供艾滋病毒自我检测(HIVST)、梅毒自我检测(SST)和辅助性伴侣通知(APN)服务的可行性和可接受性。 方法:2023年11月至2024年3月,我们对20名经过有目的选择的GBMSM同伴和10名医护人员进行了深入访谈。对GBMSM和医护人员的访谈探讨了他们对以下方面的看法:(1)由同伴提供的干预措施(HIVST、SST和APN)的可行性、可接受性和偏好;(2)联系那些在访谈前未进行检测或超过6个月未检测的个体的策略和方法。我们采用内容分析方法,通过演绎和归纳来定义和组织编码,以识别主题。 结果:20名GBMSM同伴的中位年龄为27岁(四分位间距[IQR],22 - 35岁),10名医护人员的中位年龄为37岁(IQR,25 - 52岁),其中7名是女性。我们确定了四个新出现的类别:(1)信任:GBMSM同伴和医护人员表示信任由同伴提供自我检测试剂盒(HIVST和SST)以有效获得当日结果。在联系索引客户的性伴侣进行检测方面,医护人员在APN服务中比同伴更受青睐;(2)亲密伴侣暴力(IPV):尽管最初对HIVST计划和同伴APN策略都提出了对IPV的担忧,但在实际中此类事件很少被报告;(3)切入点:与HIVST类似,SST是一项自我管理的活动,对于从未接受过检测或推迟检测的GBMSM来说,它是进行艾滋病毒检测讨论的切入点。自我检测试剂盒还可以促进GBMSM在性行为前进行检测;(4)社交媒体:专门用于推广自我检测的社交媒体活动可以将检测覆盖服务扩展到易感染艾滋病毒和梅毒的GBMSM。 结论:医护人员和GBMSM同伴更喜欢通过同伴而非基于机构的方式提供自我检测试剂盒;然而,他们更倾向于由医护人员提供APN服务。将同伴提供的自我检测计划纳入差异化检测模式并利用社交媒体有影响力的人可以扩大GBMSM中的检测覆盖范围。

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本文引用的文献

[1]
Digital HIV self-testing as an exemplar: a perspective on benefits, challenges, and opportunities.

Expert Rev Mol Diagn. 2024-10

[2]
Sustaining HIV service delivery to key population clients using client-centered models during the debate and enactment of the Anti-Homosexuality Act in Uganda.

J Int AIDS Soc. 2024-5

[3]
Uganda's Anti-Homosexuality Act undermines public health.

J Int AIDS Soc. 2024-5

[4]
Determinants and acceptability of HIV self-testing among vulnerable groups in sub-Saharan Africa: A scoping review protocol.

BMJ Open. 2024-1-29

[5]
New HIV Infections Among Key Populations and Their Partners in 2010 and 2022, by World Region: A Multisources Estimation.

J Acquir Immune Defic Syndr. 2024-1-1

[6]
Implementation of unassisted and community-based HIV Self-Testing (HIVST) during the COVID-19 pandemic among Men-who-have-sex-with-Men (MSM) and Transgender Women (TGW): A demonstration study in Metro Manila, Philippines.

PLoS One. 2023

[7]
Participatory Design of a Web-Based HIV Oral Self-Testing Infographic Experiment (HOTIE) for Emerging Adult Sexual Minority Men of Color: A Mixed Methods Randomized Control Trial.

Int J Environ Res Public Health. 2021-11-12

[8]
Prevalence and risk factors associated with HIV and syphilis co-infection in the African Cohort Study: a cross-sectional study.

BMC Infect Dis. 2021-10-30

[9]
Assisted Partner Notification and Uptake of HIV Testing among Men Who Have Sex with Men: A Randomized Controlled Trial in China.

Lancet Reg Health West Pac. 2021-6-10

[10]
Peer Mobilization and Human Immunodeficiency Virus (HIV) Partner Notification Services Among Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in Coastal Kenya Identified a High Number of Undiagnosed HIV Infections.

Open Forum Infect Dis. 2021-4-29

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