Phiri Mwelwa Muleba, Sigande Lucheka M, Mwansa Chisanga, Schaap Ab, Floyd Sian, Kalekanya Loyd, Banda Charles, Belemu Steve, Ayles Helen, Simwinga Musonda, Hensen Bernadette
Zambart, Lusaka, Zambia.
Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2025 Jul;30(7):712-720. doi: 10.1111/tmi.14128. Epub 2025 May 24.
We conducted a pilot time location sampling survey with young men aged 20-35 years in Lusaka, Zambia and aimed to describe knowledge of HIV status and determine factors associated with knowledge of HIV status.
Hotspots where men congregate were identified in a densely populated community in Lusaka. Hotspots were grouped into five strata (betting shops; car parks/washes; bus stations/taxi ranks; churches; and markets/shopping streets) and day/times when hotspots were frequented by men were listed. Within each stratum, three hotspots were randomly selected. Subsequently, 1 day/time was randomly selected for each hotspot. Men aged 20-35 were approached for participation and data was collected between July and October 2022. We describe participation in the survey, socio-demographics, and sexual behaviours. Using logistic regression, we explored factors associated with knowledge of HIV status.
339 men were approached, among whom 304 (90%) were eligible and 297 (98%) consenting to participate. Overall, 61% knew their HIV status. Adjusting for recruitment strata, knowledge of HIV status was similar by age (20-24: 56%; 25-29: 68%; and 30-35: 55%; p = 0.19). Among men reporting sex in the last month, men reporting no condomless sex were more likely to know their HIV status (78.2%) compared to men reporting one condomless sex partner in the past 1 month (55.5%; age-adjusted OR = 3.02; 95%CI 1.07, 8.55; p = 0.07). Knowledge of HIV status was lower among men who thought their friends were testing every 2-5 years (48%; n = 12/29) compared to those assuming that their friends tested more frequently (70.0%; adjOR = 0.28; 95%CI 0.08, 0.98; p < 0.001).
The time location sampling survey was acceptable among men, as evidenced by high participation. Overall, 40% of young men did not know their HIV status. A hotspot-driven approach to delivering HIV testing services may prove effective at reaching men. Furthermore, time location sampling surveys should be explored as a tool to evaluate interventions targeting men.
我们在赞比亚卢萨卡对20 - 35岁的年轻男性进行了一次试点时间地点抽样调查，旨在描述对艾滋病毒感染状况的知晓情况，并确定与艾滋病毒感染状况知晓情况相关的因素。
在卢萨卡一个人口密集的社区确定男性聚集的热点地区。热点地区被分为五个层次（博彩店；停车场/洗车场；公交车站/出租车候客点；教堂；以及市场/购物街），并列出男性经常光顾热点地区的日期/时间。在每个层次内，随机选择三个热点地区。随后，为每个热点地区随机选择1天/时间。邀请20 - 35岁的男性参与，于2022年7月至10月收集数据。我们描述了参与调查的情况、社会人口统计学特征和性行为。使用逻辑回归分析，我们探讨了与艾滋病毒感染状况知晓情况相关的因素。
共接触了339名男性，其中304名（90%）符合条件，297名（98%）同意参与。总体而言，61%的人知道自己的艾滋病毒感染状况。在调整招募层次后，按年龄划分的艾滋病毒感染状况知晓率相似（20 - 24岁：56%；25 - 29岁：68%；30 - 35岁：55%；p = 0.19）。在报告上个月有性行为的男性中，与报告在过去1个月有一个无保护性行为伴侣的男性（55.5%）相比，报告没有无保护性行为的男性更有可能知道自己的艾滋病毒感染状况（78.2%）（年龄调整后的比值比 = 3.02；95%置信区间1.07, 8.55；p = 0.07）。与那些认为他们的朋友检测频率更高的男性相比，认为他们的朋友每2 - 5年检测一次的男性中艾滋病毒感染状况知晓率较低（48%；n = 12/29）（调整后的比值比 = 0.28；95%置信区间0.08, 0.98；p < 0.001）。
时间地点抽样调查在男性中是可以接受的，高参与率证明了这一点。总体而言，40%的年轻男性不知道自己的艾滋病毒感染状况。一种以热点地区为驱动的提供艾滋病毒检测服务的方法可能在接触男性方面被证明是有效的。此外，应探索将时间地点抽样调查作为评估针对男性的干预措施的一种工具。
