Assessment of accuracy of immediate blood separation method: a novel blood analysis strategy

Objectives  

This study assesses the accuracy of the immediate blood separation method, a novel blood sampling strategy that enables blood analysis in any possible location.     

Quality assurance program for whole blood prothrombin time-international normalized ratio point-of-care monitors used for patient self-testing to control oral anticoagulation

Whole blood coagulation monitors are increasingly used for patient self-testing to control oral anticoagulation, but there are no comprehensive quality assurance (QA) programs to check their performance. We report on the experience with one of such programs applied in a field study where patients on prothrombin time (PT)-international normalized ratio (INR) self-testing were asked to bring their monitors to the anticoagulation clinic for checking.PT-INR testing was performed three times over 3 months with 14 patient's monitors and test strips on three recalcified QA plasmas by an experienced laboratory operator. Each patient was also asked to perform PT-INR self-testing (his/her own capillary blood) which was then compared to the laboratory PT-INR (plasma).Overall, the comparison between the observed and the consensus PT-INR on QA plasmas was acceptable with the majority of measurements lying within ±15% or 20% of the consensus values. The comparison between the PT-INR self-testing and the laboratory method was also acceptable: overall, there was no statistical significant difference between the mean PT-INR values and the majority of paired measurements were less than 15% or 20% apart.In conclusion, our results show that the proposed QA scheme is feasible and may be implemented on a larger scale. Monitors should be recalled periodically to the clinic where they have been prescribed to the patient. During each visit, the clinic may check the monitors and patient self-testing performance as described. Such comprehensive QA system would make monitoring of oral anticoagulant treatment by self-testing safer and more effective.     

开展HIV自我检测的应用性研究，推动我国艾滋病防治目标的全面实现

当前我国艾滋病防治形势依然严峻。虽然我国在扩大HIV检测、促进HIV感染者发现方面取得了长足的进展,但仍有大量的HIV感染者尚未被发现,影响了我国艾滋病总体防治目标的实现。我国需要在开展常规HIV检测的同时进一步推广HIV自我检测（自检）,并将其作为常规检测模式的补充,扩大HIV检测覆盖率和促进HIV感染者发现。本重点号综述了目前全球推广使用HIV自检的总体情况,报告我国MSM 2013-2018年HIV自检的变化情况,比较不同的自检模式在促进重点人群进行HIV/梅毒检测中的作用,以期为我国进一步开展HIV自检的应用性研究提供科学依据,推进我国艾滋病防治总体目标的实现。     

Assessing outcome measures of oral anticoagulation management in children

The complexities of managing oral anticoagulation therapy in children have been well described and various management strategies have been designed to optimise clinical outcomes within this challenging population. To date, outcome measurements used within paediatric studies investigating oral anticoagulant management have focused upon achieving therapeutic range and examining the incidence of medication-related adverse events. Whilst the reporting of such data is a priority, the relatively small number of children participating in clinical studies of oral anticoagulant management and the difficulties associated with conducting multi-centre interventional trials in such populations limit the ability of researchers to measure the significance of interventions made. This review examines current methods of reporting outcomes for paediatric oral anticoagulation management and identifies how the inclusion of quality of life as an outcome measure may strengthen the methodology of research aimed at measuring the impact of management interventions within the field of paediatric oral anticoagulant therapy.     

Over-the-counter human immunodeficiency virus self-test kits: time to explore their use for men who have sex with men in Brazil

Increasing access and frequency of human immunodeficiency virus testing are critical to stemming the epidemic. In Brazil's concentrated epidemic, human immunodeficiency virus prevalence in the men who have sex with men/transgender population far exceeds that in the general population, but testing rates fall below what is needed to ensure early detection and treatment. Over-the-counter human immunodeficiency virus self-testing kits, now available in stores in the U.S., have enormous potential to increase testing access and frequency and to facilitate early detection and treatment. With the advent of human immunodeficiency virus self-testing upon us, it is timely to engage the scientific community, government, and civil society in a dialog around how to best utilize this technology in Brazil. We summarize recent research on over-the-counter testing among men who have sex with men, raise potential questions and challenges to using self-tests, suggest implementation strategies, and outline a research agenda moving forward.     

浙江省2017-2021年青年学生HIV自我检测意愿变化趋势及相关因素分析

目的了解浙江省青年学生HIV自我检测意愿变化趋势及相关因素, 为制定青年学生艾滋病防控措施提供参考依据。方法从2017年开始在浙江省11个城市高等院校开展青年学生艾滋病哨点监测, 每个市选取1所大学或职业技术学院(校)作为监测哨点学校, 每年4-6月在每所学校采用分阶段整群抽样方法进行匿名式问卷调查, 调查对象为≥16岁在读学生, 每所学校样本量为800人。收集调查对象社会人口学、性行为、接受艾滋病宣传和检测服务等信息, 分析青年学生HIV自我检测意愿的变化趋势及相关因素。使用SPSS 23.0软件进行统计学分析。结果 2017-2021年共调查青年学生45 483人, 有HIV自我检测意愿的比例分别为0.4%(35/9 107)、3.7%(334/9 150)、5.2%(475/9 203)、6.3%(563/8 962)和7.4%(674/9 061)(趋势χ2=582.74, P<0.001)。多因素logistic回归分析结果显示, 在有性行为的青年学生中, HIV自我检测意愿较高的相关因素包括医学专业(OR=1.57, 95%CI:1.06～2.33)、通过互联网/交友...     

基于男性社交平台男男性行为人群HIV检测率及HIV自我检测率变化趋势分析

目的了解我国MSM的HIV检测率尤其是HIV自我检测(自检)率的变化趋势,初步评估HIV自检在扩大MSM的HIV检测方面的作用。方法通过Blued男性社交平台在全国范围内招募研究对象,调查内容包括社会人口学特征、性行为、既往HIV检测与自检等,并对历年数据进行趋势性分析。结果2013-2016、2018年,分别招募1342、1424、1173、2105、699名MSM。2013年研究对象年龄(30.6±6.6)岁,之后年份的研究对象年龄较2013年更为年轻化。2013年MSM的HIV检测率为60.0%(805/1342),并于2018年增至77.3%(540/699),2013-2016年与2018年MSM的HIV检测率呈现增长趋势(趋势检验Z=19.3,P<0.001)。2013、2018年MSM的HIV自检率分别为19.3%(259/1342)和58.1%(406/699),2018年是2013年的3倍(χ²=237.5,P<0.001),在HIV检测者中HIV自检比例由2013年的32.2%(259/805)增至2018年的75.2%(406/540)(趋势检验Z=14.3,P<0.001)。结论基于男性社交平台的MSM的HIV检测率、HIV自检率、HIV检测者中HIV自检比例,2013-2016、2018年均呈明显上升趋势。提示HIV自检可提高MSM的HIV检测覆盖面,对我国MSM艾滋病防控有重大公共卫生意义。     

HIV自我检测的应用现状

HIV自我检测(自检)是扩大HIV防治重点人群检测覆盖面的一大重要措施和策略,具有巨大的应用价值,并在重点人群中有很高的接受性。WHO于2016年发布了《HIV自检和性伴通知指南》,支持在HIV检测服务中实施HIV自检,并为各国建立相应公共卫生政策提供具体指导,以改善HIV诊断的可及性和利用程度。在此策略的推动下,HIV自检已在许多国家和地区得到应用并取得了巨大的防治成效。为进一步推动HIV自检,提高重点人群的检测率,本文综述了目前国内外自检政策、干预模式、自检方法、自检试剂的准确性和自检前后的咨询服务方面的应用,旨在为进一步推动我国HIV自检工作提供参考依据。     

At-home HIV self-testing during COVID: implementing the GetaKit project in Ottawa

SettingIn March 2020, COVID-19 shuttered access to many healthcare settings offering HIV testing and there is no licensed HIV self-test in Canada.InterventionA team of nurses at the University of Ottawa and Ottawa Public Health and staff from the Ontario HIV Treatment Network (OHTN) obtained Health Canada’s Special Access approval on April 23, 2020 to distribute bioLytical’s INSTI HIV self-test in Ottawa; we received REB approval on May 15, 2020. As of July 20, 2020, eligible participants (≥18 years old, HIV-negative, not on PrEP, not in an HIV vaccine trial, living in Ottawa, no bleeding disorders) could register via www.GetaKit.ca to order kits.OutcomesIn the first 6 weeks, 637 persons completed our eligibility screener; 43.3% (n = 276) were eligible. Of eligible participants, 203 completed a baseline survey and 182 ordered a test. These 203 participants were an average of 31 years old, 72.3% were white, 60.4% were cis-male, and 55% self-identified as gay. Seventy-one percent (n = 144) belonged to a priority group for HIV testing. We have results for 70.9% (n = 129/182) of participants who ordered a kit: none were positive, 104 were negative, 22 were invalid, and 2 “preferred not to say”; 1 participant reported an unreadiness to test.ImplicationsOur results show that HIV self-testing is a pandemic-friendly strategy to help ensure access to sexual health services among persons who are good candidates for HIV testing. It is unsurprising that no one tested positive for HIV thus far, given the 0.08% positivity rate for HIV testing in Ottawa. As such, we advocate for scale-up of HIV self-testing in Canada.     

通过HIV/梅毒联合自我检测促进男男性行为人群进行梅毒检测的效果研究

目的评估HIV/梅毒联合自我检测(自检)在促进MSM梅毒检测方面的作用。方法2019年7月通过淡蓝网(https://www.danlan.org)招募研究对象,将符合纳入标准的研究对象按照1∶1∶1随机分为3组:HIV/梅毒联合自检组、彩票激励自检组和对照组。对HIV/梅毒联合自检组和彩票激励自检组通过网络邮寄HIV/梅毒联合自检试剂,对照组鼓励其到线下场所进行检测。1个月后随访研究对象,评估3个组梅毒检测比例的差别。结果研究对象145人,其中对照组48人,HIV/梅毒联合自检组49人,彩票激励自检组48人。在随访期间HIV/梅毒联合自检组梅毒检测比例为74.4%(32/43),彩票激励自检组为70.0%(28/40),对照组为36.4%(16/44)。多因素logistic回归分析结果显示,HIV/梅毒联合自检组、彩票激励自检组在随访期间进行梅毒检测的比例分别是对照组的5.38(95%CI:2.06~14.04)倍和4.54(95%CI:1.75~11.74)倍。结论HIV/梅毒联合自检、彩票激励自检均可以提高MSM的梅毒检测比例。HIV/梅毒联合自检具有推广的可行性。