首页> 外文期刊>JMIR public health and surveillance. >Acceptability of a Community-Based Outreach HIV-Testing Intervention Using Oral Fluid Collection Devices and Web-Based HIV Test Result Collection Among Sub-Saharan African Migrants: A Mixed-Method Study
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Acceptability of a Community-Based Outreach HIV-Testing Intervention Using Oral Fluid Collection Devices and Web-Based HIV Test Result Collection Among Sub-Saharan African Migrants: A Mixed-Method Study

机译:在撒哈拉以南非洲移民中使用口服液收集设备和基于网络的HIV测试结果收集基于社区的外展HIV测试干预的可接受性:混合方法研究

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Background: Late human immunodeficiency virus (HIV) diagnosis is common among sub-Saharan African migrants. To address their barriers to HIV testing uptake and improve timely HIV diagnoses and linkage to care, the outreach HIV testing intervention, “swab2know,” was developed. It combined a community-based approach with innovative testing methods: oral fluid self-sampling and the choice between Web-based HIV test result collections using a secured website or post-test counseling at a sexual health clinic. The sessions included an informational speech delivered by a physician of sub-Saharan African origin and testimonies by community members living with HIV. Objectives: The objectives of this study were to evaluate the intervention’s acceptability among sub-Saharan African migrants and its potential to reach subgroups at higher risk for HIV infection and to identify facilitators and barriers for HIV testing uptake. Methods: This mixed-method study combined qualitative (participant observations and informal interviews with testers and nontesters) and quantitative data (paper–pencil survey, laboratory data, and result collection files). Data were analyzed using a content analytical approach for qualitative and univariate analysis for quantitative data. Results: A total of 10 testing sessions were organized in sub-Saharan African migrant community venues in the city of Antwerp, Belgium, between December 2012 and June 2013. Overall, 18.2% of all people present (N=780) underwent HIV testing; 29.8% of them tested for HIV for the first time, 22.3% did not have a general practitioner, and 21.5% reported 2 or more sexual partners (last 3 months). Overall, 56.3% of participants chose to collect their HIV test results via the protected website. In total, 78.9% collected their results. The qualitative analysis of 137 participant observation field notes showed that personal needs and Internet literacy determined the choice of result collection method. Generally, the oral fluid collection devices were well accepted mainly because sub-Saharan African migrants dislike blood taking. For some participants, the method raised concerns about HIV transmission via saliva. The combination of information sessions, testimonies, and oral fluid collection devices was perceived as effectively reducing thresholds to participation. Acceptability of the intervention differed between individual participants and settings. Acceptance was higher among women, in churches and settings where community leaders were engaged in HIV awareness raising. Higher preventive outcomes were observed in settings with lower acceptance. The presence of the intervention team visualized the magnitude of the HIV epidemic to the public and promoted HIV testing uptake at large, for example, those who declined indicated they would take up testing later. Conclusions: When accompanied by tailored provision of information, outreach HIV testing interventions adopting a community-based approach and innovative methods such as Web-based result collection and oral fluid collection devices are acceptable and reduce thresholds for HIV testing uptake. The swab2know intervention was able to reach sub-Saharan African migrants at risk of HIV infection, and with limited access to regular HIV testing. Among nontesters, the intervention contributed to awareness raising and therefore has a place in a multipronged HIV test promotion strategy.
机译:背景:晚期人类免疫缺陷病毒(HIV)诊断在撒哈拉以南非洲移民中很常见。为了解决他们接受艾滋病毒检测的障碍并改善艾滋病毒的及时诊断和与护理的联系,开发了外联的艾滋病毒检测干预措施“ swab2know”。它结合了基于社区的方法和创新的测试方法:口服液自我采样以及使用安全网站或性健康诊所的测试后咨询在基于Web的HIV测试结果收集之间进行选择。这些会议包括撒哈拉以南非洲血统的医生发表的信息性演讲,以及感染艾滋病毒的社区成员的证词。目标:这项研究的目的是评估该干预措施在撒哈拉以南非洲移民中的可接受性,以及该干预措施是否可以覆盖艾滋病毒感染风险较高的亚人群,并确定促进艾滋病毒检测的促进因素和障碍。方法:这项混合方法研究将定性(参与者观察和对测试人员和非测试人员的非正式访谈)与定量数据(纸铅笔调查,实验室数据和结果收集文件)相结合。使用内容分析方法对数据进行定量和定性分析。结果:2012年12月至2013年6月之间,在比利时安特卫普市的撒哈拉以南非洲移民社区场所共组织了10次测试。总体而言,在场的所有人中有18.2%(N = 780)接受了HIV测试。其中29.8%的人首次接受了HIV检测,22.3%的人没有全科医生,而21.5%的人报告有2个或更多的性伴侣(最近3个月)。总体而言,有56.3%的参与者选择通过受保护的网站收集其HIV检测结果。总计有78.9%的人收集了他们的结果。定性分析了137个参与者的观察记录,表明个人需求和互联网素养决定了结果收集方法的选择。通常,口服液收集装置被广泛接受,主要是因为撒哈拉以南非洲移民不喜欢采血。对于某些参与者,该方法引起了人们对通过唾液传播艾滋病毒的担忧。信息会议,证词和口腔液体收集设备的结合被认为有效地降低了参与的门槛。干预的可接受性在个体参与者和环境之间有所不同。妇女,社区领袖参与提高艾滋病意识的教堂和环境中的接受程度更高。在接受程度较低的情况下,观察到较高的预防效果。干预小组的在场使公众对HIV流行的程度可视化,并促进了HIV检测的广泛采用,例如,那些拒绝接受调查的人表示他们稍后将接受检测。结论:伴随着量身定制的信息提供,采用基于社区的方法和诸如基于Web的结果收集和口服液收集设备等创新方法的外展HIV检测干预措施是可以接受的,并降低了HIV检测摄入量的门槛。 swab2know干预措施能够覆盖处于艾滋病毒感染风险中的撒哈拉以南非洲移民,并且无法进行常规艾滋病毒检测。在非测试人员中,该干预措施有助于提高意识,因此在多管齐下的HIV测试促进策略中占有一席之地。

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