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Acceptability of HIV self-testing among men and women in KwaZulu-Natal, South Africa

机译：南非夸祖鲁 - 纳塔尔的男女艾滋病毒自我测试的可接受性

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摘要

Successful implementation of Universal Test and Treat as a strategy to achieve the 90-90-90 target requires higher HIV testing rates. Currently, uptake of HIV testing is not optimal which has directed research initiatives towards identification of additional HIV testing methods. HIV self-testing (HIVST) has received growing attention as a complementary testing approach as it overcomes barriers that are commonly associated with current HIV testing methods. In sub-Saharan Africa, acceptability rates showed a gendered pattern of men benefitting more than women, with limited evidence to explain this difference. This study assessed whether men or women in KwaZulu-Natal displayed a higher acceptance of HIVST and also explored factors that influenced and motivated their acceptability. Participants were recruited through purposive sampling at two clinical research sites to participate and underwent qualitative assessments. The outcomes from focus group discussions coupled with findings from a scoping review informed the design and data collection instruments for in-depth interviews. A randomised cross-over study design exposed participants to HIV counselling and testing and HIVST, accompanied by before (baseline) and after in-depth interviews. HIVST was acceptable among most participants with acceptability higher in women. Men preferred HIVST due to convenience and efficiency, whilst women favoured HIVST due to its potential to provide autonomy and empowerment. Also, lack of HIV counselling and managing a positive HIV result as well as linkage to care were raised as deterrents of HIVST. As HIVST was acceptable by most participants, future research efforts should be directed towards evaluating the feasibility of its introduction into the public health sector.
机译：成功实施普遍测试和待遇作为实现90-90-90目标的策略需要更高的艾滋病毒检测率。目前，艾滋病毒检测的摄取不是最佳的，这对鉴定额外的艾滋病毒检测方法有针对性的研究举措。 HIV自检（HIVST）作为一种互补的测试方法，由于克服了与当前艾滋病毒检测方法的障碍而受到影响。在撒哈拉以南非洲，可接受性率表现出对妇女的不仅仅是女性的性别模式，有限的证据来解释这种差异。本研究评估了夸祖鲁 - 纳塔尔的男性或女性是否持续接受艾滋病毒，并探索了影响和激发可接受性的因素。参与者在两个临床研究网站上通过有目的采样招募，以参与和接受定性评估。焦点组讨论的结果与范围审查的调查结果通知设计和数据收集仪器进行深入访谈。随机交叉研究设计暴露于艾滋病咨询和测试和艾滋病毒的参与者，伴随着（基线）和深入访谈后。在大多数参与者中，艾滋病毒症是在女性中更高的可接受性的。男性优先考虑艾滋病毒，因为方便和效率，虽然妇女受到艾滋病毒的潜力，但潜力有潜力提供自主权和赋权。此外，缺乏艾滋病毒咨询和管理阳性HIV结果以及为护理的连锁被提出为艾滋病毒的威慑物。由于大多数参与者可接受艾滋病毒，因此将来应该针对评估其引入公共卫生部门的可行性。

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