Secondary distribution of HIV self-tests: an innovative strategy for promoting male partner testing and reducing risk

HIV自检的二次分发：促进男性伴侣检测和降低风险的创新策略

基本信息

批准号：
9762633
负责人：
HARSHA THIRUMURTHY
金额：
$ 65.36万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-15 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9762633
关键词：
AIDS prevention Affect Africa South of the Sahara Awareness Client Clinic Coercion Communities Counseling Country Couples Data Decision Making Development Disclosure Effectiveness Effectiveness of Interventions Ensure Environment Face General Population Goals HIV HIV Infections HIV risk Health system Human immunodeficiency virus test Incidence Individual International International AIDS Intervention Interview Investments Kenya Knowledge Liquid substance Measures Modality Oral Outcome Participant Persons Pilot Projects Policies Population Prevention Process Randomized Randomized Controlled Trials Reporting Research Research Methodology Resources Risk Safe Sex Safety Sensitivity and Specificity Services Sex Behavior Sexual Partners Sexual Transmission Social Network Structure Technology Test Result Testing Time Training Unsafe Sex Woman antiretroviral therapy base comparison group condoms cost cost effective cost effectiveness empowered experience falls female sex worker group intervention high risk high risk men high risk population high risk sexual behavior improved incremental cost-effectiveness innovation interest male meetings men novel prevent randomized trial scale up secondary outcome sex success symposium testing services treatment arm uptake voucher

项目摘要

Project Title Secondary distribution of HIV self-tests by female sex workers: an innovative strategy for promoting male partner testing and reducing HIV risk. Project Summary/Abstract Greater uptake of HIV testing among those likely to be HIV-infected is vital for meeting the first of the UNAIDS “90-90-90” targets. However, roughly 55% of HIV-infected individuals in sub-Saharan Africa remain unaware of their serostatus, with men having lower awareness than women. While community-based HIV testing strategies have had considerable success in promoting HIV testing in the general population, there is a need for innovative HIV testing strategies that can reach key populations and high-risk individuals such as male partners of female sex workers. Interventions are also needed to promote couples testing, which can result in improved sexual decision-making, including increased condom use and increased antiretroviral therapy use to prevent sexual transmission. HIV self-testing is a promising approach that has the potential to substantially increase access to testing in a manner that is confidential and empowering for users. Data from across the globe demonstrate high interest in and acceptability of self-testing among a wide range of populations. Although HIV self-testing can be a good alternative for those not engaged in regular repeat testing, little is known about the optimal distribution strategies for facilitating self-test use by the hardest-to-reach individuals. One innovative strategy is `secondary distribution' of HIV self-tests, whereby an individual who is given multiple self-tests can distribute them to sexual partners or to others in their social network. This project will evaluate whether secondary distribution of self-tests by female sex workers in Kenya can be used to fulfill multiple HIV prevention goals, including the promotion of HIV testing among high-risk men and the facilitation of mutual disclosure of serostatus, couples testing, and safer sexual decision making. By facilitating safer sexual decision-making, secondary distribution of self-tests has the potential to reduce HIV incidence among female sex workers, a population that faces an especially high risk of HIV infection. Building on preliminary data in demonstrating that female sex workers can safely distribute oral self-tests to their sexual partners and make safer sexual behavior decisions following self-testing, we will conduct a randomized controlled trial in which female sex workers are randomized to receive multiple self-tests or a voucher to refer partners to clinic-based HIV testing. In Aim 1, we will test whether secondary distribution of self-tests by female sex workers results in greater identification of HIV-infected men and safer sexual behaviors. In Aim 2, we will conduct in-depth interviews to assess study participants' experiences distributing self-tests to their sexual partners. In Aim 3, we will determine the cost-effectiveness of secondary distribution of self-tests by female sex workers. The project will help determine whether HIV self-testing can be useful in furthering multiple HIV prevention goals. It will also provide guidance on optimal distribution strategies for self-tests as countries in sub-Saharan Africa develop HIV self-testing policies and scale-up the availability of self-tests.

项目名称女性性工作者艾滋病毒自我检测的二次分发：促进男性性行为的创新策略伴侣检测和降低艾滋病毒风险。项目概要/摘要在可能感染艾滋病毒的人群中更多地接受艾滋病毒检测对于实现联合国艾滋病规划署的第一个目标至关重要然而，撒哈拉以南非洲地区大约 55% 的艾滋病毒感染者仍然不知道这一目标。男性的艾滋病毒检测意识低于女性。战略在促进普通人群中艾滋病毒检测方面取得了相当大的成功，因此有必要创新的艾滋病毒检测策略，可以覆盖关键人群和高危人群，例如男性还需要对女性性工作者的伴侣进行干预，以促进夫妻检测，这可能会导致改善性决策，包括增加安全套的使用和增加抗逆转录病毒治疗的使用预防性传播艾滋病毒自我检测是一种很有前景的方法，具有显着的潜力。以保密和授权的方式增加对来自整个用户的数据的测试访问。全球范围内的广大人群对自我测试表现出浓厚的兴趣和接受度。尽管对于那些不定期重复检测的人来说，艾滋病毒自我检测可能是一个很好的选择，但几乎没有什么作用。了解促进最难接触到的个人进行自测的最佳分配策略。一项创新策略是艾滋病毒自检的“二次分发”，即向一个人提供多次检测自我测试可以将它们分发给性伴侣或社交网络中的其他人，该项目将对其进行评估。肯尼亚女性性工作者二次分发自检是否可用于履行多重艾滋病毒检测预防目标，包括促进高危男性中的艾滋病毒检测以及促进相互通过促进更安全的性行为，披露血清状态、夫妻检测和更安全的性行为决策。决策、二次分发自检有可能降低女性艾滋病毒感染率根据初步数据，性工作者是艾滋病毒感染风险特别高的人群。证明女性性工作者可以安全地向其性伴侣分发口头自我测试，并做出为了在自我测试后做出更安全的性行为决定，我们将进行一项随机对照试验，其中女性性工作者被随机接受多项自我测试或一张凭证，以将伴侣转介至诊所在目标 1 中，我们将测试女性性工作者二次分发自我检测是否会导致艾滋病毒检测。更好地识别艾滋病毒感染者并实现更安全的性行为在目标 2 中，我们将进行深入的研究。在目标 3 中，我们通过访谈来评估研究参与者向其性伴侣分发自我测试的经历。将确定女性性工作者二次分发自我测试的成本效益。将有助于确定艾滋病毒自我检测是否有助于推进多项艾滋病毒预防目标。还为撒哈拉以南非洲国家的自测最佳分配策略提供指导制定艾滋病毒自检政策并扩大自检范围。