背景:尽管在降低全球艾滋病毒相关死亡率方面取得了进展,艾滋病毒发病率的下降仍然缓慢。因此,艾滋病毒检测对于预防艾滋病毒及其治疗仍然至关重要。
目的:本综述旨在研究由社会心理系统评价产生的证据的可信度和强度,行为,以及与不同的自愿艾滋病毒咨询和检测交付模式相关的流行病学结果。
方法:系统综述。
方法:我们通过搜索PubMed,EMBASE,CINAHL,Cochrane图书馆,WebofScience,ProQuest,Scopus,PsycINFO,以及相关评论的参考清单。考虑了2000年1月1日至2021年2月9日以英文发表的合格评论,以及自愿艾滋病毒咨询和检测的不同报告模式。两名独立审评员评估了审评的方法学质量,采用乔安娜·布里格斯研究所的批判性评估清单进行系统评价和研究综合。来自观察性和介入性研究的荟萃分析的证据被评为结论性的,高度暗示性,暗示,或虚弱。将提取的数据制成表格并进行叙述合成。
结果:共确定了17篇综述论文,其中大部分集中在家庭基础上,以社区为基础,以及基于设施的自愿艾滋病毒咨询和检测。研究最多的流行病学结果包括接受艾滋病毒检测,与护理和获得治疗的联系。最常报告的行为结果是使用避孕药的安全性行为和随意性行为的频率,而研究最多的社会心理结果是社会规范。以社区为基础的自愿艾滋病毒咨询和检测方法实现了高吸收率,与护理的联系,随意性性行为频率降低的行为结果改善,更少的多个性伴侣,通过HIV检测的正常化,用户经历了更少的污名化行为。作为产前护理的一部分,基于机构的自愿艾滋病毒咨询和检测被认为是可以接受的。使用证据分类标准,大多数结局都有提示性证据(III类).
结论:基于设施和基于家庭的自愿艾滋病毒咨询和检测服务的整合可能会增加与护理的联系。然而,在中等高收入国家,我们还可以开展进一步高质量的综述和荟萃分析,以便更深入地了解不同自愿HIV咨询和检测模式对行为和心理社会结局的影响.需要提供这些自愿艾滋病毒咨询和检测模式的组合,以便到2030年实现并超越95-95-95目标。
背景:该方案已在国际前瞻性系统审查注册(PROSPERO)数据库(CRD42020183577)中注册。
BACKGROUND: Despite progress in reducing global HIV-related mortality, the decrease in the rate of HIV incidence remains slow. As such, HIV testing remains crucial to the prevention of HIV and its treatment.
OBJECTIVE: This
review aims to examine the credibility and strength of evidence arising from systematic reviews of psychosocial, behavioral, and epidemiological outcomes associated with different delivery models of voluntary HIV counseling and testing.
METHODS: Overviews of systematic reviews.
METHODS: We conducted the umbrella
review by searching PubMed, EMBASE, CINAHL, the Cochrane Library, Web of Science, ProQuest, Scopus, PsycINFO, and the reference lists of relevant reviews. Eligible reviews published in English between 1 January 2000 and 9 February 2021, and different reported models of voluntary HIV counseling and testing were considered. Two independent reviewers assessed the reviews for methodological quality, employing the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research syntheses. Evidence from meta-analyses of observational and interventional studies were graded as conclusive, highly suggestive, suggestive, or weak. The extracted data were tabulated and narratively synthesized.
RESULTS: A total of 17
review papers were identified, most of which focused on home-based, community-based, and facility-based voluntary HIV counseling and testing. The most studied epidemiological outcomes include uptake of HIV testing, linkage to care and access to treatment. The most frequently reported behavioral outcomes were safe sexual practices of use of contraceptive and frequency of casual sex, while the most studied psychosocial outcome was social norms. Community-based voluntary HIV counseling and testing approaches achieved high uptake rates, linkage to care, improvement in behavioral outcomes of lower frequency of casual sex, fewer multiple sexual partners, and users experienced fewer stigmatizing behavior through the normalization of HIV testing. Facility-based voluntary HIV counseling and testing was found to be acceptable when offered as part of antenatal care. Using the evidence classification criteria, most of the outcomes were presented with suggestive evidence (Class III).
CONCLUSIONS: The integration of facility-based and home-based voluntary HIV counseling and testing services could potentially increase linkage to care. However, there is scope for further high-quality reviews and meta-analyses to provide greater insights into the impacts of different voluntary HIV counseling and testing models on behavioral and psychosocial outcomes in middle-high-income countries. The provision of a combination of these voluntary HIV counseling and testing models is needed to achieve and surpass the 95-95-95 goals by 2030.
BACKGROUND: The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020183577).