PDF(Pubmed)
Abstract：
OBJECTIVE: To compare preferences, uptake, and cofactors for unassisted home-based oral self-testing (HB-HIVST) versus clinic-based rapid diagnostic blood tests (CB-RDT) for maternal HIV retesting.
METHODS: Prospective cohort.
METHODS: Between November 2017 and June 2019, HIV-negative pregnant Kenyan women receiving antenatal care were enrolled and given a choice to retest with HB-HIVST or CB-RDT. Women were asked to retest between 36 weeks gestation and 1-week post-delivery if the last HIV test was <24 weeks gestation or at 6 weeks postpartum if ≥24 weeks gestation, and self-report on retesting at a 14-week postpartum.
RESULTS: Overall, 994 women enrolled and 33% (n = 330) selected HB-HIVST. HB-HIVST was selected because it was private (n = 224, 68%), convenient (n = 211, 63%), and offered flexibility in the timing of retesting (n = 207, 63%), whereas CB-RDT was selected due to the trust of providers to administer the test (n = 510, 77%) and convenience of clinic testing (n = 423, 64%). Among 905 women who reported retesting at follow-up, 135 (15%) used HB-HIVST. Most (n = 595, 94%) who selected CB-RDT retested with this strategy, compared to 39% (n = 120) who selected HB-HIVST retesting with HB-HIVST. HB-HIVST retesting was more common among women with higher household income and those who may have been unable to test during pregnancy (both retested postpartum and delivered <37 weeks gestation) and less common among women who were depressed. Most women said they would retest in the future using the test selected at enrollment (99% [n = 133] HB-HIVST; 93% [n = 715] CB-RDT-RDT).
CONCLUSIONS: While most women preferred CB-RDT for maternal retesting, HB-HIVST was acceptable and feasible and could be used to expand HIV retesting options.
METHODS: Prospective cohort.
METHODS: Between November 2017 and June 2019, HIV-negative pregnant Kenyan women receiving antenatal care were enrolled and given a choice to retest with HB-HIVST or CB-RDT. Women were asked to retest between 36 weeks gestation and 1-week post-delivery if the last HIV test was <24 weeks gestation or at 6 weeks postpartum if ≥24 weeks gestation, and self-report on retesting at a 14-week postpartum.
RESULTS: Overall, 994 women enrolled and 33% (n = 330) selected HB-HIVST. HB-HIVST was selected because it was private (n = 224, 68%), convenient (n = 211, 63%), and offered flexibility in the timing of retesting (n = 207, 63%), whereas CB-RDT was selected due to the trust of providers to administer the test (n = 510, 77%) and convenience of clinic testing (n = 423, 64%). Among 905 women who reported retesting at follow-up, 135 (15%) used HB-HIVST. Most (n = 595, 94%) who selected CB-RDT retested with this strategy, compared to 39% (n = 120) who selected HB-HIVST retesting with HB-HIVST. HB-HIVST retesting was more common among women with higher household income and those who may have been unable to test during pregnancy (both retested postpartum and delivered <37 weeks gestation) and less common among women who were depressed. Most women said they would retest in the future using the test selected at enrollment (99% [n = 133] HB-HIVST; 93% [n = 715] CB-RDT-RDT).
CONCLUSIONS: While most women preferred CB-RDT for maternal retesting, HB-HIVST was acceptable and feasible and could be used to expand HIV retesting options.
摘要：
目标：为了比较偏好，摄取，无辅助家庭口服自检（HB-HIVST）与临床快速诊断血液检测（CB-RDT）的辅助因素，用于孕产妇HIV再检测。
方法：前瞻性队列。
方法：在2017年11月至2019年6月之间，接受产前护理的HIV阴性怀孕肯尼亚妇女被纳入研究，并选择使用HB-HIVST或CB-RDT进行重新测试。要求妇女在妊娠36周至分娩后1周之间重新测试，如果最后一次HIV检测<24周妊娠或产后6周，如果妊娠≥24周，以及产后14周的自我报告。
结果：总体而言，994名妇女和33%(n=330)选择了HB-HIVST。选择HB-HIVST是因为它是私有的（n=224，68％），方便(n=211，63%)，并提供了重新测试时间的灵活性(n=207，63%)，而选择CB-RDT是由于提供者对测试的信任(n=510,77%)和临床试验的便利性(n=423,64%).在905名在随访中报告复检的妇女中，135（15%）使用HB-HIVST。大多数(n=595，94%)选择CB-RDT的人都用这种策略进行了重新测试，与选择HB-HIVST复测的39%(n=120)相比。HB-HIVST再检测在家庭收入较高的妇女和在怀孕期间可能无法进行检测的妇女（产后再检测和妊娠<37周）中更为常见，而在抑郁症妇女中不太常见。大多数女性表示，他们将在将来使用注册时选择的测试进行重新测试（99％[n=133]HB-HIVST；93％[n=715]CB-RDT-RDT）。
结论：虽然大多数女性更喜欢CB-RDT用于产妇复检，HB-HIVST是可以接受和可行的，可用于扩大艾滋病毒重新检测方案。
方法：前瞻性队列。
方法：在2017年11月至2019年6月之间，接受产前护理的HIV阴性怀孕肯尼亚妇女被纳入研究，并选择使用HB-HIVST或CB-RDT进行重新测试。要求妇女在妊娠36周至分娩后1周之间重新测试，如果最后一次HIV检测<24周妊娠或产后6周，如果妊娠≥24周，以及产后14周的自我报告。
结果：总体而言，994名妇女和33%(n=330)选择了HB-HIVST。选择HB-HIVST是因为它是私有的（n=224，68％），方便(n=211，63%)，并提供了重新测试时间的灵活性(n=207，63%)，而选择CB-RDT是由于提供者对测试的信任(n=510,77%)和临床试验的便利性(n=423,64%).在905名在随访中报告复检的妇女中，135（15%）使用HB-HIVST。大多数(n=595，94%)选择CB-RDT的人都用这种策略进行了重新测试，与选择HB-HIVST复测的39%(n=120)相比。HB-HIVST再检测在家庭收入较高的妇女和在怀孕期间可能无法进行检测的妇女（产后再检测和妊娠<37周）中更为常见，而在抑郁症妇女中不太常见。大多数女性表示，他们将在将来使用注册时选择的测试进行重新测试（99％[n=133]HB-HIVST；93％[n=715]CB-RDT-RDT）。
结论：虽然大多数女性更喜欢CB-RDT用于产妇复检，HB-HIVST是可以接受和可行的，可用于扩大艾滋病毒重新检测方案。
