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首页> 外文期刊>AIDS care. >One size does not fit all: HIV testing preferences differ among high-risk groups in Northern Tanzania
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One size does not fit all: HIV testing preferences differ among high-risk groups in Northern Tanzania

机译：一种尺寸并不适合所有人：坦桑尼亚北部高风险人群的HIV检测偏好不同

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摘要

In order to maximize the effectiveness of "Seek, Test, and Treat" strategies for curbing the HIV epidemic, new approaches are needed to increase the uptake of HIV testing services, particularly among high-risk groups. Low HIV testing rates among such groups suggest that current testing services may not align well with the testing preferences of these populations. Female bar workers and male mountain porters have been identified as two important high-risk groups in the Kilimanjaro Region of Tanzania. We used conventional survey methods and a discrete choice experiment (DCE), a preference elicitation method increasingly applied by economists and policy-makers to inform health policy and services, to analyze trade-offs made by individuals and quantify preferences for HIV testing services. Bivariate descriptive statistics were used to analyze differences in survey responses across groups. Compared to 486 randomly selected community members, 162 female bar workers and 194 male Kilimanjaro porters reported 2-3 times as many lifetime sexual partners (p < 0.001), but similar numbers of lifetime HIV tests (median 1-2 across all groups). For the DCE, participants' stated choices across 12,978 hypothetical HIV testing scenarios (422 female and 299 male participants x 9 choice tasks x 2 alternatives) were analyzed using gender-specific mixed logit models. Direct assessments and the DCE data demonstrated that barworkers were less likely to prefer home testing and were more concerned about disclosure issues compared with their community counterparts. Male porters preferred testing in venues where antiretroviral therapy was readily available. Both high-risk groups were less averse to traveling longer distances to test compared to their community counterparts. These results expose systematic differences in HIV testing preferences across high-risk populations compared to their community peers. Tailoring testing options to the preferences of high-risk populations should be evaluated as a means of improving uptake of testing in these populations.
机译：为了最大程度地利用“寻求，测试和治疗”策略来遏制HIV流行，需要新的方法来增加对HIV检测服务的使用，特别是在高风险人群中。在这些人群中，艾滋病毒检测率较低表明，当前的检测服务可能与这些人群的检测偏好不太吻合。在坦桑尼亚的乞力马扎罗地区，女酒吧工人和男山搬运工被确定为两个重要的高风险群体。我们使用了传统的调查方法和离散选择实验（DCE），这是经济学家和政策制定者越来越多地用于告知卫生政策和服务的偏好启发方法，用于分析个人的权衡取舍并量化对HIV检测服务的偏好。使用双变量描述性统计数据来分析各组之间调查反馈的差异。与486个随机选择的社区成员相比，162名女律师和194名乞力马扎罗男搬运工报告说，终生性伴侣的数量是终生伴侣的2-3倍（p <0.001），但终生艾滋病毒检测的数量相似（所有组中位数为1-2）。对于DCE，使用特定于性别的混合logit模型分析了参与者在12978个假设的HIV测试场景中的陈述选择（422位女性和299位男性参与者x 9个选择任务x 2个替代方案）。直接评估和DCE数据表明，与社区同行相比，酒吧工作人员不太可能喜欢家庭测试，并且更关注披露问题。男性搬运工更喜欢在容易获得抗逆转录病毒疗法的场所进行测试。与社区同行相比，这两个高风险人群都不太愿意长途跋涉进行测试。这些结果暴露了与社区同龄人相比，高危人群在艾滋病毒检测偏好方面的系统性差异。应评估针对高风险人群偏好的测试选项，以提高这些人群对测试的接受程度。

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