青少年和年轻人的HIV、肝炎和梅毒自我检测：系统回顾和荟萃分析

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-03-19 DOI:10.1016/j.jiph.2025.102764

Ying Zhang , James Tapa , Cheryl C. Johnson , Tiffany R. Phillips , Christopher K. Fairley , Wole Ameyan , Maeve B. Mello , Eric P.F. Chow , Thato Chidarikire , Jason J. Ong

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引用次数: 0

摘要

青少年和青壮年（AYA）在世界艾滋病毒和其他性传播感染（STI）负担中占很大比例。自我检测可增加检测覆盖率，并加强预防和治疗服务的接受。我们批判性地评价了AYA（10-24岁）中有关HIV、肝炎和梅毒自我检测的文献，并评估了其可用性、可行性和可接受性。方法检索2010年1月~ 2023年10月6个数据库进行系统评价。我们纳入了所有关于艾滋病、肝炎和梅毒自检的研究。我们使用随机效应荟萃分析来汇集三种感染的证据，因为证据被认为足够相似。我们总结了第一次测试者的比例和与护理的联系。定性数据以叙述的方式合成。研究结果：我们确定了89项相关研究。大多数研究在非洲（57/89,64 %）和中低收入国家（34/89,38 %）进行。我们对27项研究（n = 28,787人）的meta分析表明，79 %（95 % CI: 69-87 %,I2 = 99 %）的AYA患者完成了HIV或梅毒自检。5项研究（n = 4117）表明62% %（95 % CI: 53-71 %,I2 = 83 %）为首次测试者。没有研究报告肝炎自检的完成率。总的来说，AYA非常接受自我测试，并且发现它很容易使用。自我检测是一种安全、可接受和有效的方法，可以增加艾滋病、肝炎和梅毒检测的可及性。鉴于自检的这些特点，增加自检使用的政策应能显著改善自检并最大限度地发挥其公共卫生影响。

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HIV, hepatitis, and syphilis self-testing among adolescents and young adults: A systematic review and meta-analysis

Background

Adolescents and young adults (AYA) make up a significant share of the world’s burden of HIV and other sexually transmitted infections (STI). Self-testing can increase testing coverage and strengthen the uptake of prevention and treatment services. We critically appraised the literature regarding HIV, hepatitis, and syphilis self-testing among AYA (age 10–24 years) and assessed its usability, feasibility, and acceptability.

Methods

We conducted a systematic review, searching six databases between January 2010 and October 2023. We included all studies on HIV, hepatitis and syphilis self-testing in AYA. We used a random-effects meta-analysis to pool evidence across the three infections as evidence was deemed sufficiently similar. We summarised the uptake, proportion of first-time testers and linkage to care. Qualitative data were narratively synthesised.

Findings

We identified 89 relevant studies. Most were conducted in Africa (57/89, 64 %) and lower-middle-income countries (34/89, 38 %). Our meta-analysis of 27 studies (n = 28,787 individuals) demonstrated that 79 % (95 % CI: 69–87 %, I² = 99 %) of AYA who were offered HIV or syphilis self-test completed the test. Five studies (n = 4117) demonstrated 62 % (95 % CI: 53–71 %, I² = 83 %) were first-time testers. No studies reported completion rates for hepatitis self-testing. In general, AYA were highly accepting of self-testing and found it easy to use.

Interpretation

Self-testing is a safe, acceptable and effective way to increase access to HIV, hepatitis and syphilis testing in AYA. Given these features of self-testing, policies to increase its use should significantly improve testing and maximise their public health impact.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.