男男性行为者HIV自我检测现状及影响因素系统评价

Status and influencing factors of HIV self-testing among men who have sex with men:a systematic review

目的系统评价MSM群体HIV自我检测意愿率、自检率及相关影响因素,以期为扩大MSM群体HIV自检提供参考。方法检索中国生物医学文献数据库、万方数据库、中国期刊全文数据库、PubMed、Embase、PsycINFO、CINAHL、Web of Science,检索时限为建库至2022年8月,纳入评价MSM进行HIV自我检测意愿和/或自我检测经历以及相关的影响因素的横断面研究。采用Revman5.4.1软件对自检意愿率以及自检率进行Meta分析,采用随机效应模型进行数据合并。对影响因素进行描述性分析。结果共纳入17篇文献,涉及24444例MSM。Meta分析结果显示,MSM的自检意愿率为72%(95%CI:0.57~0.88),HIV自检率为48%(95%CI:0.32~0.64)。影响其自检意愿的因素包括文化程度及性行为特征等。实际进行HIV自检受年龄、文化程度、性行为特征等因素影响。结论MSM的HIV自检意愿较高,实际总体自检率处于较低水平。建议相关人员重点关注年龄较大、多性伴及低文化程度等MSM,针对可干预可控因素,制定相应的干预措施进一步提升其HIV检测率。

Objective To systematically describe and analyze the willingness,uptake,and influencing factors of HIV self-testing in order to provide a reference for expanding HIV self-testing among MSM.Methods 8 databases(Chinese Biomedical literature database,Wanfang,CNKI,PubMed,Embase,PsycINFO,CINAHL,and Web of Science)were searched from inception to August 2022,aiming to collect potentially relevant cross-sectional studies.Revman 5.4.1software was used to analyze the willingness and uptake of HIV self-testing with meta-analysis,and random-effect models were used to merge data.Descriptive analysis was used to analyze the influencing factors.Results 17 studies(24,444MSM)were included.The combined rate of willingness and uptake of HIV self-testing was 72%(95%CI:0.57-0.88)and48%(95%CI:0.32-0.64)respectively.The factors influencing MSM’s willingness to self-testing include educational level and sexual behavior characteristics,while the uptake of HIV self-testing was affected by age,educational level,sexual behavior characteristics.Conclusions MSM have a high willingness to conduct HIV self-testing,but the actual proportion of uptake is low.It is suggested that relevant staff focus on MSM with older age,multiple sexual partners,and low-level education and formulate strategies according to the controllable and intervenable factors of MSM self-testing,so as to further expand HIV testing among MSM.