网络购买HIV快速检测试剂用于自我检测人群特征

目的了解网络购买艾滋病病毒(HIV)快速检测试剂用于自我检测人群的特征,为进一步扩大基于互联网的HIV检测服务,促进人群主动检测提供依据和参考。方法随机选取网络购买HIV快速检测试剂的1 000人作为调查对象,在邮寄给其的快递盒内放入项目简介卡发布问卷调查信息。利用网络平台,设计、录入网络版"网络购买HIV快速检测试剂用于自我检测调查问卷",调查对象通过QQ,微信在电脑或手机端完成调查问卷。结果共有591人完成网络问卷调查,其中男性512人,女性79人;年龄中位数25岁(15～50岁);未婚占78.7%(465人);大专或本科以上文化占66.2%(391人);自由职业者及大学生人群是主要购买人群,分别占36.0%(213人)及26.2%(155人);月收入在2 000～5 000元之间的占53.0%(313人)。异性恋人群占57.5%(340人),男男同性恋人群占27.2%(161人),双性恋人群占15.2%(90人)。此外,64.7%(220/340)的异性恋人群、69.6%(112/161)的男男同性恋人群及72.2%(65/90)的双性恋人群在最近6个月内发生过无保护性行为。50.9%(301/591)的调查对象在自我检测后会和客服人员联系进行咨询。28.8%(170人)的调查对象在自我检测后,选择去疾病预防控制中心或医院寻求进一步确证及咨询服务。结论网络购买HIV快速检测试剂用于自我检测的人群大部分是未婚年轻男性,他们受教育程度较高,多数为异性恋,且收入属中上等,在最近6个月内发生过无保护性行为,对该人群提供检测后的专业咨询服务非常重要。     

深圳市男男性行为者HIV口腔黏膜渗出液快速检测试剂的使用情况及影响因素

目的 分析深圳市MSM利用口腔黏膜渗出液快速检测（简称口腔自检）试剂进行HIV检测的使用情况及相关影响因素。方法 2019年9月至2021年12月,通过微信网络、同伴动员等方式招募深圳市≥18岁且过去1年内发生过同性口交或肛交性行为的男性,利用在线问卷收集目标人群的社会人口学信息、性行为特征、口腔自检试剂使用情况等信息。结果 共纳入841名研究对象,其中128名（15.22%）曾做过HIV口腔自检。口腔自检试剂获取途径主要为网店购买和社会组织发放,分别占41.41%(53/128)、32.03%(41/128)。多因素Logistic分析结果显示,大专及以上学历（OR=2.51,95%CI:1.06～5.97）、通过网络寻找性伴（OR=3.13,95%CI:1.24～7.92）是MSM使用HIV口腔自检试剂的促进因素。结论 深圳市MSM HIV口腔自检率偏低,文化程度、性伴寻找方式可影响该人群HIV口腔自检试剂的使用。建议开通基于互联网的HIV口腔自检试剂申请渠道,提高HIV口腔自检的覆盖面以期进一步扩大HIV检测。     

艾滋病病毒快速测试用于自我检测的市场和技术前景

艾滋病病毒(HIV)自我检测是HIV检测服务的补充途径,是实现扩大检测的有效方式。截至2018年7月有59个国家有HIV自我检测的支持性政策,其中有28个国家实施了HIV自我检测,14种HIV自我检测试剂通过批准,还有6种HIV自我检测试剂正在开发。我国目前没有批准的用于HIV自我检测的试剂,但有16个厂家在网络上销售HIV快速检测试剂。HIV自我检测试剂或用于自我检测的快速检测试剂在不同的研究中特异性高,但灵敏度有很大差异,不同人群对HIV自我检测的接受度也有很大差异,且在检测操作和结果读取过程中都有可能发生错误从而影响测试结果。当为受试者提供简单的使用说明,视频教程时,结果的准确性明显提高。     

6种艾滋病病毒抗体初筛试剂质量评估

目的评估国内现行使用的部分HIV抗体ELISA试剂质量.方法 5种国产HIV-1/2 ELISA试剂用200份血清样品(其中已知结果血清和未知结果血清各100份)、进口试剂Vironostika(R)HIV Uni-FormⅡ plusO用其中未知结果的100份血清分别进行对比测试,初筛阳性和可疑血清用蛋白印迹(WB)确认.结果 6种试剂的敏感性、功效率和NPV值范围为90.14%～100%、96.5%～100%和94.85%～100%;其中4种试剂的特异性和PPV值均为100%,测试中未发现假阳性;另2种试剂特异性均为97.67%,假阳性率均为2.33%,PPV值分别为95.89 %和95.71%;除进口试剂Vironostika外,5种国产试剂均存在不同程度的HIV抗体阳性漏检,其漏检率分别为9.86%、4.23%、1.41%、7.04%、5.63%.结论 6种被评估试剂中,试剂Vironostika质量居第一,试剂B次之,余4种再次之.     

互联网+自我检测HIV的MSM特征和感染因素

目的了解互联网+自我检测模式下,首次接受艾滋病病毒(HIV)检测的男男性行为者(MSM)的特征及其感染危险因素。方法与北京当地社区组织合作,通过互联网+自我检测模式,为有HIV检测意向的MSM提供免费HIV快速检测试剂。通过快递收到HIV快速检测试剂后,按操作说明要求进行自我检测,并将HIV自我检测结果反馈回HIV自检试剂领取网站。结果 2015-2016年共发放检测试剂5 072份,其中491例未反馈HIV自检结果,未反馈自检结果的比例为9.7%。4 581例反馈结果的网络自检MSM中,680例为既往阳性/重复检测,809例既往进行过HIV检测却不知晓检测结果,3 092例为首次HIV检测者。互联网+自我检测MSM具有受教育程度高、多性伴和肛交行为中未能使用安全套等特点。首次自检MSM的HIV阳性率为7.9%(244/3 092),最近1个月内肛交行为活跃(≥5次)与HIV感染相关[比值比(OR)=1.50,95%可信区间(CI):1.04~2.16],25岁(OR=1.98,95%CI:1.35~2.91)、初中及以下受教育程度(OR=1.47,95%CI:1.06~2.04)和最近一个月未全程使用安全套(OR=1.36,95%CI:1.00~1.85)首次自检者的HIV感染率较高。结论与社区组织合作的互联网+自我检测模式可有效提高HIV检测服务的可及性。     

适合VCT的HIV抗体检测替代策略研究

目的 探求适合在艾滋病自愿咨询检测(VCT)点应用的检测艾滋病病毒(HIV)抗体的替代策略.方法 从河南、安徽和山西省的27个VCT检测点日常工作中采集样品10 310份,离心分离血浆后,全部用HIV快速检测试剂1(RT1)和HIV快速检测试剂2(RT2)进行检测,其中任何一种试剂的检测.结果 为阳性时,分别用酶联免疫吸附试验(ELISA)试剂和免疫印迹试验(WB)试剂复检.当两种快速检测均为阴性时,保留血浆,集中用ELISA试剂复检,复检为阳性者,进一步用WB确认检测.结果 RT1检测为阳性的样品418份,WB确认阳性的样品386份;RT2检测为阳性的样品427份,WB确认阳性的样品388份;RT1和RT2均为阳性的样品391份,WB确认阳性的样品386份.RT1和RT2检测.结果 不一致的样品共63份,57份为ELISA阴性,6份为ELISA阳性.结论 使用任何一种HIV快速检测试剂可以筛查出99%以上的阴性样品;两种HIV快速检测试剂的检测.结果 均为阳性时,可以筛查出98%以上的阳性样品;两种HIV快速检测试剂的检测.结果 不一致时,ELISA复检为阴性的样品可按HIV抗体阴性咨询,ELISA复检为阳性的样品应进一步做WB确认检测.使用RT1 RT2 ELISA策略,可以替代98.54%的WB确认检测,并且与WB确认检测.结果 的符合率为99.94%,因而可以在保证检测.结果 质量的同时,大大减少检测费用,提高检测效率和成本效益.     

对世界银行贷款卫生九项目4个省HIV检测能力和初筛实验室网络建设分析评估

目的　调查了解世界银行贷款卫生九 (卫九 )项目广西、福建、山西、新疆 4个省 (自治区 )艾滋病病毒(HIV)检测能力和实验室网络的现况 ;项目启动以来 ,中国疾病预防控制中心 (CDC)性病艾滋病预防控制中心国家HIV参比实验室举办培训班起的作用 ;根据疫情发展的需要 ,目前是否能满足需求。方法　采用现场调研指导和问卷调查相结合方法进行分析评估。结果　 (1)覆盖面 :37个地区 (州、市 )、5 8个县 (区、市 ) ,占 4个省总人口的35 5 %。 (2 )HIV检测实验室网络建设 :已验收批准 198个HIV初筛实验室 ,比 1999年项目开始前增长 1 75倍。(3) 4个省共 10 3人次参加全国HIV检测专业培训 ,提高了人员的素质 ;积极组织订购仪器设备 ,目前总金额已达 532 9 0 1万元。近 4年合计HIV检测数 4 119935份 ,约为 1987～ 1998年 12年检测数的 1 4 4倍 ;报告阳性 9981例 ,是 1987～ 1998年报告阳性数的 3 0 3倍。 (4 )进口第 3代酶联免疫吸附试验 (ELISA)试剂和国产试剂复测 16 35份HIV抗体初筛阳性标本 ,S/CO均≥ 6者为 14 93份 ,两种试剂S/CO均 <6者为 2 4份 ,一致率为 92 8% (15 17/ 16 35 )。结论　项目启动 3年来 ,提高了省级CDCHIV确认实验室的业务水平和检测能力 ,项目 4个省HIV初筛实验室网络建设取得了明显进展     

不同试剂检测艾滋病抗体结果对照

目的:分析不同试剂检测艾滋病抗体结果对照。方法:从2012年4月~2014年4月采用珠海丽珠试剂股份有限公司与上海科华生物工程股份有限公司所提供的试剂对HIV抗体进行60次检测,并回顾分析其临床资料。结果:不同储存时间HIV抗体S/CO值,都与第1个月比值进行对比,两组试剂在第6个月、第12个月检测结果与第1个月相比较,在HIV抗体稳定性方面无统计学意义(P>0.05)。不同时间两组HIV抗体S/CO值稳定性无统计学意义(P>0.05)。在cv率与HIV抗体检测方面,两种试剂无统计学意义(P>0.05);在S/CO值方面两种试剂检测结果无统计学意义(P>0.05)。随机抽查5组两种试剂检测HIV抗体S/CO值无统计学意义(P>0.05)。第一次检测均匀性与两组试剂HIV抗体检测结果无统计学意义(P>0.05)。结论:采用两种试剂对HIV抗体筛查,临床稳定性、准确度以及灵敏度比较高,可以互相校正,没有明显的差异,有利于HIV抗体阳性的筛查。     

对HIV感染的唾液快速检测试剂OraQuick的评价

通过唾液检测HIV感染的方法简单快速，美国OraSure公司出品的OraQuick HIV1／2快速检测试剂就是一种通过唾液快速检测HIV感染的快速检测试剂。最近，美国出现了一些OraQuick试剂在应用中假阳性高的报道，引起人们对这种HIV感染的唾液快速检测试剂用于常规检测的怀疑。     

艾滋病病毒初筛诊断试剂的临床使用调查及质量评估

目的 了解河南省内市场流通的艾滋病病毒(HIV)抗体初筛试剂[酶联免疫吸附试验(ELISA)]的质量及使用情况。方法 抽检进口或国产6个厂家的HIV ELISA试剂。用已确认(蛋白印迹试验,WB)过的阳性或阴性血清评估试剂的质量。结果 6种试剂的敏感性为97.18％～98.59％,功效率为93.50％～99.00%,阳性预测值为85.36％～98.59％.,阴性预测值为98.36％～99.22％。结论 6种参评试剂在这一批号中均存在不同程度的假阳性,对同一份血清,6种试剂都发生漏检,其漏检率A、C、D、F为0.5％,B、E为1％。根据质量评估统计所获得的数据分析,不同厂家的试剂有差异,同一试剂批号间有差异,说明除试剂质量外,实验操作也有影响。同时认为质量评估是及时发现和纠正试剂质量问题的一项重要措施,也可为HIV初筛实验室在选择使用可靠的试剂提供参考。     

Are women more likely to self-test? A short report from an acceptability study of the HIV self-testing kit in South Africa

This study assessed the acceptability of, as well as the facilitators of and barriers to the HIV self-testing kit in the Gauteng province, South Africa. An exploratory qualitative cross-sectional study was conducted using focus group discussions (FGDs) among a sample of 118 respondents selected from the Braamfontein and Soweto areas of Johannesburg. Sixteen FGDs were conducted in order to assess the acceptability of the HIV self-testing kit. Respondent groups were segmented according to area (Soweto or Braamfontein), gender (male or female), age (20–34 and 35–49 years of age) and HIV testing status (have previously tested for HIV or have never tested for HIV) in order to achieve maximum variability. The main advantage identified was that the self-testing kit allows for privacy and confidentiality with regard to HIV status, and does not require a visit to a health facility – two of the main barriers to current HIV counselling and testing uptake. However, respondents, predominantly males, were concerned about the lack of counselling involved, which they thought could lead to suicide ideation among testers. The HIV self-testing kit was found to be acceptable among the majority of respondents. However, there is still a need for follow-up services for self-testers. The idea of a hotline for telephonic counselling within the self-testing model seemed to be favourable among many respondents and is an alternative to traditional face-to-face counselling, although some respondents felt that this was not sufficient.     

An innovative vending machine-based HIV testing and intervention service in China: anonymous urine collection kits distributed at universities

ABSTRACT

To find more effective test and intervention measures, and to achieve the first 90 of the 90–90–90 target, this study was conducted for the first time to develop and assess an innovative HIV anonymous urine test service-based vending machine and Internet at universities of China. From June to December 2016, 11 vending machines were placed in 7 pilot universities in Beijing, Sichuan, Yunnan and Heilongjiang provinces. A total of 957 HIV urine collection kits were dispensed free and also through vending machines and 378 (39.5%) urine samples were returned and 376 (99.5%) of them were qualified to be tested for HIV antibody in professional laboratories. Participants searched for confidential test results using an ID code online. Only seven (1.86%) urine samples were positive. Monitoring data showed 67.8% (255/376) participants searched for test results online, 72.2% of kits were purchased in dormitory buildings and 27.8% were purchased in teaching buildings and 88.9% were purchased between 21:00 and 24:00. In conclusion, this study analyzes the acceptability, feasibility and effectiveness of HIV testing and intervention service.     

Perceptions and attitudes towards acceptability of HIV self-testing among female sex workers in Selibe Phikwe,Botswana

Background: Sub-Saharan Africa accounts for 71% of the global burden of HIV infection. For the general population of Botswana, the estimated HIV prevalence is 18.5%; for female sex workers it is 61.9%. This study explored and documented female sex workers’ perceptions and attitudes towards the acceptability of HIV self-testing in Selibe Phikwe, north-eastern Botswana.

Methods: Purposive convenience sampling and snowballing approaches were used to recruit 17 participants into the study which was carried out in collaboration with a community-based organisation, the Silence Kills Support Group. Two focus group discussions and five in-depth interviews were conducted. Information was collected on female sex workers’ awareness of HIV self-testing, their willingness to use it, their preferred distribution model, and their preferred test kit. Themes and subthemes that emerged were interpreted based on the Integrated Behavioural Model.

Results: HIV self-testing (HIVST) was not known to most participants. Participants expressed negative attitude towards HIVST due to a lack of knowledge and confidence to carry out self-testing independently. Participants preferred facility-based services and a blood test over HIVST. Inadequate post-test counselling and lack of assisted HIVST were among their major concerns. Raising community awareness of HIVST through education was suggested.

Conclusion: Improving the uptake of HIVST will require community sensitization, the availability of counselling services, close follow-ups, and the introduction of assisted HIVST approaches.     

Correlates of requesting home HIV self-testing kits on online social networks among African-American and Latino men who have sex with men

High levels of HIV stigma are one of the main difficulties in engaging African-American and Latino men who have sex with men (MSM) in HIV testing. The availability of home HIV test and the possibility of self-testing in private may improve uptake and counteract stigma. This paper sought to determine the correlates of requesting home HIV test kits among a sample of MSM social media users. The odds of participants requesting a test kit were significantly associated with using social networks to seek sexual partners (aOR: 2.47, 95% CI: 1.07–6.06) and thinking it is easier to use social networks for seeking sexual partners (1.87, 1.2–3.12), uncertain HIV status (4.29, 1.37–14.4), and having sex under the influence of alcohol (2.46, 1.06–5.77). Participants who had not been tested for more than 6 months were more likely to request a test kit than those who were tested in the past 6 months (2.53, 1.02–6.37). Participants who frequently talked to others about having sex with men online were less likely to request a test kit (0.73, 0.56–0.92). By reaching people over social media and offering them access to test kits, we were able to reach at-risk individuals who were uncertain about their HIV status and had not been regularly tested. The findings of the study will help to inform future HIV testing interventions.     

What happened to home HIV test collection kits? Intent to use kits,actual use,and barriers to use among persons at risk for HIV infection

Through sequential cross-sectional surveys, we examined intent to use home HIV test collection kits, actual use and barriers to use among persons at high risk for HIV infection. Interest in kits was assessed in the 1995-96 HIV Testing Survey (HITS, n=1683). Kit use, knowledge of kits and barriers to use were assessed in the 1998-99 HITS (n=1788), after kits had become widely available. When asked to choose among future testing options, 19% of 1995-96 participants intended to use kits. Untested participants were more likely than previously tested HIV-negative participants to choose kits for their next HIV test (p < 0.001). Among 1998-99 participants, only 24 (1%) had used kits; 46% had never heard of kits. Predictors of not knowing about kits included never having been HIV tested and black or Latino race. Common reasons for not using kits among participants aware of home test kits were concerns about accuracy, lack of in-person counselling and cost. Despite high rates of anticipated use, kits have had minimal impact on the testing behaviour of persons at high risk for HIV infection. Increasing awareness of kits, reducing price and addressing concerns about kit testing procedures may increase kit use, leading to more HIV testing by at-risk individuals.     

Adolescents’ and caregivers’ perceptions of caregiver-provided testing and HIV self-testing using oral mucosal transudate tests in Zimbabwe: a short report

ABSTRACT

Uptake of HIV testing remains lower among children and adolescents compared to adults. This study explored adolescents’ perceptions of HIV self-testing (HIVST) and caregivers’ perceptions of testing their children using an oral mucosal transudate (OMT) rapid HIV test (caregiver-provided testing). We conducted 31 interviews with adolescents aged 16–18 years and caregivers of children aged 2–15 years who received an OMT test. Participants described barriers to HIV testing including lack of privacy and the potential for discrimination by community members towards children and adolescents who received an HIV test. Most participants felt caregiver-provided testing and HIVST could address these barriers through increased privacy. Some participants expressed worry about their ability to correctly perform the OMT and their anxious reactions to a positive result. Counseling and assistance from health care workers were viewed as ways to alleviate concerns. Concerns shaped participants’ preferences for facility-based HIVST and caregiver-provided testing. Findings demonstrate HIVST performed by adolescents and caregiver-provided testing could increase the uptake of HIV testing. Concerns related to being able to test correctly and the availability of post-test counseling must be addressed in any future delivery mechanisms.     

Willingness to distribute free rapid home HIV test kits and to test with social or sexual network associates among men who have sex with men in the United States

Peer-driven HIV prevention strategies can be effective in identifying high-risk persons with undiagnosed infections. Besides individual self-testing, other potential uses of rapid home HIV test kits include distributing them, and testing with others within one's social or sexual networks. We sought to identify factors associated with the willingness to engage in these alternative activities among men who have sex with men (MSM) in the United States. From May to October 2014, we surveyed 828 HIV-negative or unknown status MSM about multiple aspects of rapid home HIV testing. A greater proportion indicated being likely to distribute free oral fluid (OF) tests compared to free finger-stick blood (FSB) tests (91% versus 79%), and almost three-fourths (72%) reported being likely to test with their friends or sex partners in the future. MSM not identifying as homosexual/gay were less willing to distribute OF tests, and those with lower educational attainment were more willing to distribute FSB tests. MSM unaware of their HIV status were less likely to report potentially testing with others using free rapid home HIV tests compared to those who were HIV-negative. Finally, MSM willing to self-test were more likely to report future test kit distribution, and those willing to distribute kits were more likely to report potentially testing with others. Engaging individuals with positive attitudes towards these strategies in prevention efforts could help increase HIV testing levels among MSM. A greater understanding of the potential public health impact of rapid home HIV test kits is necessary.     

A Global Review of HIV Self-testing: Themes and Implications

HIV self-test kits may have the potential to increase testing rates around the globe, and thereby lead to reductions in HIV-related incidence and mortality. However, the effectiveness of these self-test kits and the issues surrounding self-testing have been greatly debated in recent years. We conducted a literature review on the acceptability, feasibility, and effectiveness of HIV self-testing (HST) around the world. Of the 28 articles abstracted, several themes of HST were explored, including behavioral risk compensation, presence of counseling, uses of HST, ability to perform the self-test, sensitivity and specificity, concordance with confirmatory testing, perceptions surrounding HST, instruction and supervision, and cost. Overall, this literature review found that this diverse group of participants generally performed HST correctly with a few exceptions, were accepting of the test if available at a relatively low cost, and preferred the oral-based HST over the blood-based test.     

HIV testing preferences among long distance truck drivers in Kenya: a discrete choice experiment

Providing HIV testing services to truck drivers in Africa is crucial but has proven challenging. The introduction of HIV self-testing promises to provide expanded service delivery options for clients, potentially increasing demand for services and expanding coverage – especially important for high-risk and difficult-to-reach populations. This study examines the preferences regarding HIV testing service delivery models, among long distance truck drivers to identify testing services that would appeal to this population. Using a discrete choice experiment, this study examines the drivers of choice regarding HIV counselling and testing among 305 truck drivers recruited from two roadside wellness clinics along major trucking routes in Kenya. Participants made trade-offs between characteristics of HIV testing service delivery models by making hypothetical choices in a series of paired HIV testing scenarios. Conditional logit models were used to identify the HIV testing characteristics driving the selection of preferred scenarios, as well as determine whether preferences interact with individual characteristics – especially HIV testing history. Participants preferred free, provider-administered HIV testing at a roadside clinic, using a finger-prick test, with in-person counselling, undertaken in the shortest possible time. The strongest driver of choice was the cost of the test. Those who had never tested previously preferred oral testing and telephonic counselling, while those who were not regular testers favoured clinic based – over self-testing. The results of this study indicate that for the majority of participants – most of whom had tested before – the existing services offered at roadside clinics were the preferred service delivery model. The introduction of oral self-testing increases the options available to truck drivers and may even improve testing uptake for some, especially among those who have never tested before. However, these findings suggest the impact on HIV testing uptake of introducing oral self-testing may be limited in this population.