PDF(Pubmed)
Abstract：
People who use drugs (PWUD) are at increased risk for HIV infection. HIV self-testing (HIVST) is a promising method for identifying new infections, but optimal distribution strategies remain understudied.
To characterize PWUD by HIVST distribution strategy (peers vs. mail), we examined data from July 2022 to June 2023 collected from a real-world HIVST program led by the non-profit, Florida Harm Reduction Collective. We used descriptive statistics and Poisson regressions with robust error variance to compare those who received HIVST through peers or via mail by socio-demographics, Ending the HIV Epidemic (EHE) county designation, and HIV testing experience.
Among 728 participants, 78% received HIVST from peers, 47% identified as cisgender female, 48% as heterosexual, and 45% as non-White; 66% resided in an EHE county, and 55% had no HIV testing experience. Compared to those who received an HIV self-test from peers, those who received tests via mail were less likely to be cisgender male (vs. cisgender female; prevalence ratio [PR] = 0.59, 95% confidence interval [CI]: 0.43, 0.81), non-Hispanic Black (vs. non-Hispanic White; PR = 0.57, 95% CI: 0.36, 0.89) or from EHE counties (vs. non-EHE counties; PR = 0.33, 95% CI: 0.25, 0.44). Those who received tests via mail were also more likely to identify their sexual orientation as \"Other/Undisclosed\" (vs. straight/heterosexual; PR = 2.00, 95% CI: 1.51, 2.66).
Our findings support the role of community-based HIVST distribution strategies in increasing HIV testing coverage among PWUD. Additional research could help inform the equitable reach of HIVST.
To characterize PWUD by HIVST distribution strategy (peers vs. mail), we examined data from July 2022 to June 2023 collected from a real-world HIVST program led by the non-profit, Florida Harm Reduction Collective. We used descriptive statistics and Poisson regressions with robust error variance to compare those who received HIVST through peers or via mail by socio-demographics, Ending the HIV Epidemic (EHE) county designation, and HIV testing experience.
Among 728 participants, 78% received HIVST from peers, 47% identified as cisgender female, 48% as heterosexual, and 45% as non-White; 66% resided in an EHE county, and 55% had no HIV testing experience. Compared to those who received an HIV self-test from peers, those who received tests via mail were less likely to be cisgender male (vs. cisgender female; prevalence ratio [PR] = 0.59, 95% confidence interval [CI]: 0.43, 0.81), non-Hispanic Black (vs. non-Hispanic White; PR = 0.57, 95% CI: 0.36, 0.89) or from EHE counties (vs. non-EHE counties; PR = 0.33, 95% CI: 0.25, 0.44). Those who received tests via mail were also more likely to identify their sexual orientation as \"Other/Undisclosed\" (vs. straight/heterosexual; PR = 2.00, 95% CI: 1.51, 2.66).
Our findings support the role of community-based HIVST distribution strategies in increasing HIV testing coverage among PWUD. Additional research could help inform the equitable reach of HIVST.
摘要：
背景：使用药物（PWUD）的人感染HIV的风险增加。艾滋病毒自我检测（HIVST）是一种有前途的方法，用于识别新的感染，但最佳分配策略仍未得到充分研究。
方法：通过HIVST分配策略（同行与邮件)，我们检查了2022年7月至2023年6月从非营利组织领导的真实世界HIVST计划收集的数据，佛罗里达减害集体。我们使用具有稳健误差方差的描述性统计和泊松回归来比较那些通过同龄人或通过社会人口统计学的邮件收到HIVST的人，结束艾滋病毒流行（EHE）县指定，和艾滋病毒检测经验。
结果：在728名参与者中，78%的人从同行那里获得了HIVST，47%被确认为顺性女性，48%是异性恋，45%为非白人；66%居住在EHE县，55%没有艾滋病毒检测经验。与那些接受同龄人艾滋病毒自检的人相比，那些通过邮件接受测试的人不太可能是顺性男性(与顺性女性；患病率[PR]=0.59，95%置信区间[CI]：0.43，0.81)，非西班牙裔黑人(vs.非西班牙裔白人；PR=0.57，95%CI：0.36，0.89）或来自EHE县（与非EHE县；PR=0.33，95%CI：0.25，0.44）。那些通过邮件接受测试的人也更有可能将自己的性取向识别为“其他/未公开”（与直/异性恋；PR=2.00，95%CI：1.51，2.66）。
结论：我们的研究结果支持基于社区的HIVST分布策略在增加PWUD中HIV检测覆盖率方面的作用。更多的研究可能有助于为HIVST的公平覆盖提供信息。
方法：通过HIVST分配策略（同行与邮件)，我们检查了2022年7月至2023年6月从非营利组织领导的真实世界HIVST计划收集的数据，佛罗里达减害集体。我们使用具有稳健误差方差的描述性统计和泊松回归来比较那些通过同龄人或通过社会人口统计学的邮件收到HIVST的人，结束艾滋病毒流行（EHE）县指定，和艾滋病毒检测经验。
结果：在728名参与者中，78%的人从同行那里获得了HIVST，47%被确认为顺性女性，48%是异性恋，45%为非白人；66%居住在EHE县，55%没有艾滋病毒检测经验。与那些接受同龄人艾滋病毒自检的人相比，那些通过邮件接受测试的人不太可能是顺性男性(与顺性女性；患病率[PR]=0.59，95%置信区间[CI]：0.43，0.81)，非西班牙裔黑人(vs.非西班牙裔白人；PR=0.57，95%CI：0.36，0.89）或来自EHE县（与非EHE县；PR=0.33，95%CI：0.25，0.44）。那些通过邮件接受测试的人也更有可能将自己的性取向识别为“其他/未公开”（与直/异性恋；PR=2.00，95%CI：1.51，2.66）。
结论：我们的研究结果支持基于社区的HIVST分布策略在增加PWUD中HIV检测覆盖率方面的作用。更多的研究可能有助于为HIVST的公平覆盖提供信息。
