Acceptability and use of HIV self-testing among young people in sub-Saharan Africa: a mixed methods systematic review.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Eshetu Andarge Zeleke, Jacqueline H Stephens, Hailay Abrha Gesesew, Behailu Merdekios Gello, Anna Ziersch
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引用次数: 0

Abstract

Background: Young people (YP) are disproportionately affected by the HIV pandemic in sub-Saharan Africa (SSA), but testing rates remain low despite global targets of testing 95% of people with HIV infection by 2030. HIV self-testing (HIVST) has been recently introduced to reach high-risk population groups such as these. Thus, synthesis of emerging evidence on the acceptability and use of HIVST among YP in SSA is needed so that comprehensive information can be generated to inform policy and practice.

Methods: We employed a mixed methods systematic review of quantitative and qualitative literature reporting on HIVST among YP involving any design and published in English by 31st of October 2023. The review synthesized quantitative evidence on acceptability and use of HIVST, and qualitative evidence on perspectives of YP about HIVST. We searched databases of published articles (e.g. MEDLINE, CINAHL) and Gray literature sources (e.g. Google, Google Scholar). The concepts for the search included self-testing, HIV/AIDS, and countries in SSA. Two authors independently screened, retrieved full-text, and assessed quality of the studies.

Results: A total of 4150 studies were retrieved and 32 studies were finally included in the review. Acceptability of HIVST computed from a single item asking YP on their preference or willingness or demand for HIVST was moderate (34-67%) to high (≥ 67%) among YP in SSA. Nine of the fourteen studies that reported on acceptability found high acceptability of HIVST. Use of HIVST ranged from 0.8 to 100% while in most studies the use rate was below 50%. Key barriers to HIVST use were coping with a positive test in the absence of counselling and support, physical discomfort, and cost of kits. Perceived enablers included perceptions of HIVST as promoting personal empowerment and autonomy; privacy and confidentiality; and convenience in location, time, and skill.

Conclusions: HIVST was highly accepted but not well utilized among YP in SSA. YP showed diversified needs with mixed preferences for location, and modalities of service provision. Overall, the review identified heterogeneous evidence in terms of methods, population, outcome measures, and results. The review was registered in the International Prospective Registry of Systematic Reviews (PROSPERO: ID = CRD42021278919).

撒哈拉以南非洲年轻人对艾滋病毒自我检测的接受程度和使用情况:混合方法系统综述。
背景:在撒哈拉以南非洲地区(SSA),年轻人受到艾滋病毒大流行的影响尤为严重,尽管全球目标是到 2030 年对 95% 的艾滋病毒感染者进行检测,但检测率仍然很低。最近推出了艾滋病毒自我检测(HIVST),以覆盖这些高危人群。因此,有必要对撒哈拉以南非洲地区青年接受和使用 HIVST 的新证据进行综合分析,以便提供全面的信息,为政策和实践提供依据:我们采用了一种混合方法,对 2023 年 10 月 31 日之前以英文发表的、涉及任何设计的、有关青少年中艾滋病毒检测的定量和定性文献进行了系统综述。综述综合了有关 HIVST 可接受性和使用情况的定量证据,以及有关青少年对 HIVST 的看法的定性证据。我们检索了已发表文章的数据库(如 MEDLINE、CINAHL)和灰色文献来源(如 Google、Google Scholar)。搜索的概念包括自我检测、HIV/AIDS 和 SSA 国家。两位作者独立筛选、检索全文并评估研究质量:结果:共检索到 4150 项研究,最终有 32 项研究被纳入综述。在撒哈拉以南非洲地区,通过询问青年对艾滋病毒检测的偏好、意愿或需求的单个项目计算出的青年对艾滋病毒检测的接受度为中等(34%-67%)到较高(≥ 67%)。在 14 项报告可接受性的研究中,有 9 项发现艾滋病毒检测的可接受性很高。艾滋病毒检测的使用率从 0.8%到 100%不等,而在大多数研究中,使用率低于 50%。使用艾滋病毒检测工具的主要障碍是:在缺乏咨询和支持的情况下如何应对检测结果呈阳性、身体不适以及检测包的费用。所认为的促进因素包括:认为艾滋病毒检测促进个人能力和自主;隐私和保密;地点、时间和技能方面的便利:在撒哈拉以南非洲地区,艾滋病毒检测在青年人群中的接受度很高,但利用率不高。青年患者的需求多种多样,他们对提供服务的地点和方式的偏好也不尽相同。总体而言,综述在方法、人群、结果测量和结果方面发现了不同的证据。该综述已在国际系统综述前瞻性注册中心(PROSPERO:ID = CRD42021278919)注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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