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首页> 外文期刊>AIDS care. >Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis
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Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis

机译：同行LED干预的有效性增加与男性发生性关系的男性的HIV测试：系统审查和荟萃分析

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HIV testing constitutes a key step along the continuum of HIV care. Men who have sex with men (MSM) have low HIV testing rates and delayed diagnosis, especially in low-resource settings. Peer-led interventions offer a strategy to increase testing rates in this population. This systematic review and meta-analysis summarizes evidence on the effectiveness of peer-led interventions to increase the uptake of HIV testing among MSM. Using a systematic review protocol that was developed a priori, we searched PubMed, PsycINFO and CINAHL for articles reporting original results of randomized or non-randomized controlled trials (RCTs), quasi-experimental interventions, and pre- and post-intervention studies. Studies were eligible if they targeted MSM and utilized peers to increase HIV testing. We included studies published in or after 1996 to focus on HIV testing during the era of combination antiretroviral therapy. Seven studies encompassing a total of 6205 participants met eligibility criteria, including two quasi-experimental studies, four non-randomized pre- and-post intervention studies, and one cluster randomized trial. Four studies were from high-income countries, two were from Asia and only one from sub-Saharan Africa. We assigned four studies a moderate methodological rigor rating and three a strong rating. Meta-analysis of the seven studies found HIV testing rates were statistically significantly higher in the peer-led intervention groups versus control groups (pooled OR 2.00, 95% CI 1.74-2.31). Among randomized trials, HIV testing rates were significantly higher in the peer-led intervention versus control groups (pooled OR: 2.48, 95% CI 1.99-3.08). Among the non-randomized pre- and post-intervention studies, the overall pooled OR for intervention versus control groups was 1.71 (95% CI 1.42-2.06), with substantial heterogeneity among studies (I-2=70%, p0.02). Overall, peer-led interventions increased HIV testing among MSM but more data from high-quality studies are needed to evaluate effects of peer-led interventions on HIV testing among MSM in low- and middle-income countries.
机译：HIV测试构成沿着艾滋病毒护理连续体的关键步骤。与男性（MSM）发生性关系的男性（MSM）具有低艾滋病毒检测率和延迟诊断，特别是在低资源环境中。同行LED干预措施提供了提高本人的测试率的策略。该系统审查和荟萃分析总结了对同行LED干预措施的有效性的证据，以增加MSM之间的艾滋病毒检测的摄取。使用制定了先验的系统审查协议，我们搜索了PubMed，Psycinfo和Cinahl的文章，报告了随机或非随机对照试验（RCT），准实验干预和预后和后期和干预后研究的原始结果。如果他们针对MSM并利用同行以增加HIV测试，则研究有资格。我们包括1996年或之后发表的研究，专注于组合抗逆转录病毒治疗时代的艾滋病病毒检测。七项研究包括共有6205名参与者达到了资格标准，包括两项准实验研究，四项非随机性介入性研究，以及一组随机试验。四项研究来自高收入国家，两个来自亚洲，只有一个来自撒哈拉以南非洲。我们分配了四项研究，适度的方法学严格额定值和三个强烈的评级。七项研究的Meta分析发现HIV检测率在对等LED干预组与对照组的统计学上显着较高（汇总或2.00,95％CI 1.74-2.31）。在随机试验中，对等LED干预与对照组的HIV检测率显着高（汇集或：2.48,95％CI 1.99-3.08）。在非随机性的前后研究中，汇总或干预与对照组的整体汇总或用于对照组为1.71（95％CI 1.42-2.06），在研究中具有实质性的异质性（I-2 = 70％，P <0.02） 。总体而言，同行LED干预措施增加了MSM之间的HIV测试，但需要更多来自高质量研究的数据来评估同行LED干预在低收入和中等收入国家MSM之间的艾滋病毒检测的影响。

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