两种HIV自我检测模式在促进男男性行为人群HIV检测中的作用

目的评价两种不同HIV自我检测(自检)模式在促进MSM HIV检测中的作用。方法采用两种HIV自检模式,一是以性健康促进网络平台为主体的线上HIV自检模式(常规自检模式);二是鼓励申请者申请多份自检试剂并将其传递给身边朋友的HIV自检模式(自检二次传递模式)。比较两种自检模式中,申请者与受赠者在人口学特征、使用数、阳性率等指标的差异。通过志愿者影响力的调查量表,分析志愿者影响力对派发或使用HIV自检试剂数量的影响。结果常规自检模式、自检二次传递模式的30 d内HIV自检结果回传率分别为94.7%(323/341)和99.2%(1141/1150);自检二次传递模式的受赠者检测比例(45.9%,281/612)明显高于常规自检模式(6.3%,20/318)。自检二次传递模式中,申请者与受赠者人数在年龄、婚姻状况、户籍、自报性取向、最近6个月发生同性肛交、曾经做过HIV检测情况的差异有统计学意义(χ2检验,均P<0.05)。MSM志愿者中有影响力的申请者能够促进HIV自检试剂派发(P<0.05)。结论常规自检模式和自检二次传递模式均能促进MSM的HIV自检、结果回传及HIV感染者发现。在扩大检测及HIV感染者发现方面,自检二次传递模式的优势明显,促进从未检测者参加HIV检测。申请者中有影响力的志愿者,能明显提高MSM的HIV检测率、扩大MSM的HIV检测覆盖面。

The roles of two HIV self-testing models in promoting HIV-testing among men who have sex with men

Objective To evaluate the roles between two different HIV self-testing models in promoting HIV-testing among men who have sex with men (MSM).Methods This paper focuses on two HIV self-testing service models. The first; is the online self-testing model (HIV self-testing conventional model) with the sexual health promotion network platform. The other one is an innovative HIV self-testing model (secondary distribution model), based on the previous program. The two different self-testing models, including the number of indexes and alters, the positive rate, and the demographics of indexes and alters, are compared. The influence of volunteers with or without leadership on the number of HIV self-test kits distributed or self-use is analyzed through the leadership survey scale.Results The return rates of HIV self-testing results in the two models are 94.7%(323/341) and 99.2%(1 141/1 150), respectively, within 30 days. The proportion of alters in the secondary distribution is significantly higher (45.9%,281/612) than the conventional HIV self-testing (6.3%,20/318). In the secondary distribution model, the difference between the number of indexes and alters indicators including age, marital status, residence, sex orientation, anal sex with men in the past six months, and HIV test are statistically significant (χ² test, all P<0.05). The opinion leader of MSM has significantly impacted the promotion of HIV self-testing (P<0.05).Conclusions Both models can promote HIV self-testing, result return, and HIV positive detection among MSM. In terms of expanding the testing and detection of HIV positive, the secondary distribution mode shows more obvious advantages, which significantly promotes a large number of MSM who have never been tested for HIV to undergo HIV testing. Influential indexes have a significant effect on increasing the HIV testing rate and promoting HIV testing among MSM.