Acceptability and strategies for enhancing uptake of human immunodeficiency virus self-testing in Nigeria

BACKGROUND In 2019,the Nigerian Ministry of Health published the first operational guidelines for human immunodeficiency virus self-testing(HIVST)to improve access to human immunodeficiency virus(HIV)testing services among undertested populations in the country.Also,as part of the campaign to increase HIV testing services in Nigeria,the Nigerian Ministry of Health developed standard operating procedures for using HIVST kits.AIM To systematically review the acceptability and strategies for enhancing the uptake of HIVST in Nigeria.METHODS The systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Different databases were searched to get the necessary materials needed for this review.Standardized forms developed by the authors were used for data extraction to minimize the risk of bias and ensure that the articles used for the study were properly screened.Identified articles were first screened using the titles and their abstracts.The full papers were screened,and the similarities of the documents were determined.Qualitative,quantitative,and mixed-method studies were evaluated using the Critical Appraisal Skills Programme and Critical Appraisal Framework criteria.RESULTS All the publications reviewed were published between 2015 and 2022,with 33.3%published in 2021.Most(77.8%)of the studies were cross-sectional,43.3%were conducted in Lagos State,and 26.3%were conducted among young people.The study revealed a high level of acceptability of HIVST.Certain factors,such as gender,sexual activity,and previous testing experience,influence the acceptability of HIV self-testing,with some individuals more likely to opt-out.The cost of the kit was reported as the strongest factor for choosing HIVST services,and this ranged from 200 to 4000 Naira(approximately United States Dollar 0.55-11.07),with the majority willing to pay 500 Naira(approximately United States Dollar 1.38).Privately-owned,registered pharmacies,youthfriendly centres,supermarkets,and online stores were the most cited access locations for HIVST.The least influential attribute was the type of specimen needed for HIVST.Strategies addressing cost and preferred access points and diverse needs for social media promotion,local translation of product use instructions,and HIVST distribution led by key opinion leaders for key populations were found to significantly enhance HIVST uptake and linkage to care.CONCLUSION HIVST acceptability is generally high from an intention-to-use perspective.Targeted strategies are required to improve the acceptability of HIV self-testing,especially among males,sexually active individuals,and first-time testers.Identified and proposed uptake-enhancing strategies need to be investigated in controlled settings and among different populations and distribution models in Nigeria.

Preferences for oral-vs blood-based human immunodeficiency virus self-testing:A scoping review of the literature

BACKGROUND The evidence on preferences for oral-vs blood-based human immunodeficiency virus self-testing(HIVST)has been heterogenous and inconclusive.In addition,most evaluations have relied on hypothetical or stated use cases using discreet choice experiments rather than actual preferences among experienced users,which are more objective and critical for the understanding of product uptake.Direct head-to-head comparison of consumer preferences for oral-versus bloodbased HIVST is lacking.AIM To examine the existing literature on preferences for oral-vs blood-based HIVST,determine the factors that impact these preferences,and assess the potential implications for HIVST programs.METHODS Databases such as PubMed,Medline,Google Scholar,and Web of Science were searched for articles published between January 2011 to October 2022.Articles must address preferences for oral-vs blood-based HIVST.The study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist to ensure the quality of the study.RESULTS The initial search revealed 2424 records,of which 8 studies were finally included in the scoping review.Pooled preference for blood-based HIVST was 48.8%(9%-78.6%),whereas pooled preference for oral HIVST was 59.8%(34.2%-91%)across all studies.However,for male-specific studies,the preference for blood-based HIVST(58%-65.6%)was higher than that for oral(34.2%-41%).The four studies that reported a higher preference for blood-based HIVST were in men.Participants considered blood-based HIVST to be more accurate and rapid,while those with a higher preference for oral HIVST did so because these were considered non-invasive and easy to use.CONCLUSION Consistently in the literature,men preferred blood-based HIVST over oral HIVST due to higher risk perception and desire for a test that provides higher accuracy coupled with rapidity,autonomy,privacy,and confidentiality,whereas those with a higher preference for oral HIVST did so because these were considered non-invasive and easy to use.Misinformation and distrust need to be addressed through promotional messaging to maximize the diversity of this new biomedical technology.

自动协调加载控制及数据采集系统的自检技术研究

自动协调加载控制及数据采集系统是用于结构静强度试验载荷施加的重要设备,其准确程度是保证验证试验准确可靠、成功有效的重要因素。通过对加载系统自检技术的研究,分析并梳理出造成系统故障的原因,并设计了系统自检方案,形成了系统级→组件级的逐级排除故障方法,并将该自检方法应用于现场,证明该自检方法的正确性和适应性,能满足系统的自检要求,可以有效保障试验加载质量和安全。

Web环境下基于项目反应理论的自适应考试系统研究与设计

本文在Web环境下基于项目反应理论(IRT)设计并实现了一种自适应考试系统。通过独创的试题抽取算法,该系统能够根据考生能力动态调整试题难度,从而提高考试的准确性和效率。研究比较了传统考试与基于IRT的自适应考试系统,结果表明后者能够更精确地评估考生能力。此研究不仅引入了新型考试模式,也为教育评估领域的发展提供了新的视角和参考。

吸入用乙酰半胱氨酸溶液自研药非临床安全性评价

目的为吸入用乙酰半胱氨酸溶液自研药的临床安全使用提供依据。方法取18只雄性日本大耳白兔,按体质量分层随机化分组法分为阴性对照组(等体积0.9%氯化钠注射液)、上市品对照组(原研药0.1 mg/mL)和给药组(自研药0.1 mg/mL),各6只。雾化吸入给药35 mg/kg,给药体积均为0.35 mL/kg,各组均给予相应药物,每日上午、下午各1次,连续14 d。记录呼吸道刺激性症状发生及恢复时间。分别于末次给药24 h及14 d后,各组取3只兔处死并解剖,肉眼观察刺激反应,采用苏木素-伊红染色,观察病理形态。取30只Hartley豚鼠,按体质量分层随机化分组法分为阴性对照组(0.9%氯化钠注射液0.8 mL/d)、阳性对照组(0.9%氯化钠注射液0.8 mL/d)、上市品对照组[原研药80 mg/d(0.8 mL/d)]及低剂量组[自研药40 mg/d(0.4 mL/d)]和高剂量组[自研药80 mg/d(0.8 mL/d)],各6只,各组动物隔日致敏(10%卵白蛋白溶液0.6 mL/d)1次,共3次。分别于末次致敏14 d及21 d后,各组取3只豚鼠,按2倍致敏剂量进行激发。根据过敏反应发生率和发生程度综合评价主动全身过敏反应发生情况。结果各组兔的外观、行为、粪便等均正常,给药后无咳嗽等症状;大体解剖均未见明显异常;与阴性对照组和上市品对照组比较,给药组未见药物延迟或蓄积作用。各组豚鼠未出现与给药相关的异常症状,过敏反应均为阴性。结论吸入用乙酰半胱氨酸溶液自研药对日本大耳白兔无明显呼吸道刺激作用,对豚鼠无明显的全身致敏作用。

自愈型电磁式交流接触器的研究

针对传统电磁式交流接触器因触点系统吸合不良或电磁控制机构合闸失效导致企业大容量电动机绕组烧毁、加工原材料直接报废等问题,研制一款由电磁控制机构、触头系统以及自愈电磁控制机构组成的自愈型电磁式交流接触器,在检测到吸合不良或电磁控制机构合闸失效时,立即完成自愈操作,保证供电连续性。

基于PXI总线的综合测试设备设计与实现

综合测试设备在被测控制器产品的生产过程中起着关键作用,可以提供总装后的整机调试、环境适应性试验、交付验收试验以及故障排查等功能。该设备采用PXI主控机箱和专用功能模块作为核心硬件平台,并使用LabVIEW语言开发测试软件。通过系统自检和功能测试,测试设备可以对被测产品进行全面的测试,并生成稳定可靠的测试结果。通过对测试结果的分析和生成综合测试报告,可以确保被测产品达到预期的功能性能要求。

Uptake of HIV Self-testing among Men Who have Sex with Men in Beijing, China： a Cross-sectional Study

Objective To examine HIV self-testing uptake and its determinates among men who have sex with men （MSM） in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participants were users of a popular Chinese gay networking application and had an unknown or negative HIV status. Univariate and multivariate logistic regression analyses were conducted to examine factors associated with HIV self-testing based on adjusted odds ratio （AOR） and 95% confidence interval （CI）. Results Among the 5,996 MSM included in the study, 2,383 （39.7%） reported to have used HIV self-testing kits. Willingness to use an HIV self-test kit in the future was expressed by 92% of the participants. High monthly income （AOR = 1.49; CI = 1.10-2.02; P = 0.010）, large number of male sex partners （≥2： AOR = 1.24; CI = 2.09-1.43; P = 0.002）, sexual activity with commercial male sex partners （〉 2： AOR = 1.94; CI = 1.34 -2.82; P = 0.001）, long-term drug use （AOR = 1.42; CI = 1.23-1.62; P 〈 0.001）, and long-term HIV voluntary counseling and testing （VCT） attendance （AOR = 3.62; CI = 3.11-4.22; P 〈 0.001） were all associated with increased odds of HIV self-testing uptake. Conclusion The nearly 40% rate of HIV self-testing uptake among MSM in our sample was high. In addition, an over 90% willingness to use kits in the future was encouraging. HIV self-testing could be an important solution to help China achieve the global target of having 90% of all people living with HIV diagnosed by 2020.

电力机车分布式校线系统及其应用研究

针对电力机车校线周期长、手动测试难以满足复杂回路测试要求等问题,文章介绍了一套电力机车分布式校线系统,基于该校线系统设计原理提出了自学习线缆测试法及连接器库建立方法。该系统的应用提高了电力机车校线的效率和准确性,同时增加了试验的可追溯性。

新型变电站备自投系统设计与实现

随着电力系统规模的扩大和智能化需求的提升,变电站备自投系统成为保障供电可靠性的关键。文章设计并实现了一种新型变电站备自投系统,系统具备自动检测、快速切换、远程监控以及故障诊断等功能,并对硬件进行了优化设计,确保了高效稳定运行。系统运行测试验证了设计的有效性和实用性,展示了在复杂电网环境下的适应性和稳定性,为构建智慧、绿色、高效的现代电力网络提供了技术支撑。

An Adaptive Ramp Generator for ADC Built-in Self-Test

An adaptive ramp generator based on linear histogram was proposed for the built-in selftest (BIST) of analog to digital convertor (ADC) in CMOS image sensor. By comparing the generated ramp signal to a reference voltage and feeding back a calibration signal, the slope adjustment was implemented, and high linearity and precision of ramp slope were realized. By modulating the pulse width and reference voltage, sweep length varied from microsecond to second and signal swing could reach 3 V with 5.6 mW power consumption. The ramp was used as input to an ideal 10-bit single-slope ADC, and the corresponding DNL and INL were 0.032 LSB and 0.078 LSB, re-spectively.

Robustness self-testing of states and measurements in the prepare-and-measure scenario with 3 → 1 random access code

Recently, Tavakoli et al.proposed a self-testing scheme in the prepare-and-measure scenario, showing that self-testing is not necessarily based on entanglement and violation of a Bell inequality [Phys.Rev.A 98 062307(2018)].They realized the self-testing of preparations and measurements in an N → 1(N ≥ 2) random access code(RAC), and provided robustness bounds in a 2 → 1 RAC.Since all N → 1 RACs with shared randomness are combinations of 2 → 1 and 3 → 1 RACs, the3 → 1 RAC is just as important as the 2 → 1 RAC.In this paper, we find a set of preparations and measurements in the3 → 1 RAC, and use them to complete the robustness self-testing analysis in the prepare-and-measure scenario.The method is robust to small but inevitable experimental errors.

Efficient self-testing system for quantum computations based on permutations

Verification in quantum computations is crucial since quantum systems are extremely vulnerable to the environment.However,verifying directly the output of a quantum computation is difficult since we know that efficiently simulating a large-scale quantum computation on a classical computer is usually thought to be impossible.To overcome this difficulty,we propose a self-testing system for quantum computations,which can be used to verify if a quantum computation is performed correctly by itself.Our basic idea is using some extra ancilla qubits to test the output of the computation.We design two kinds of permutation circuits into the original quantum circuit:one is applied on the ancilla qubits whose output indicates the testing information,the other is applied on all qubits(including ancilla qubits) which is aiming to uniformly permute the positions of all qubits.We show that both permutation circuits are easy to achieve.By this way,we prove that any quantum computation has an efficient self-testing system.In the end,we also discuss the relation between our self-testing system and interactive proof systems,and show that the two systems are equivalent if the verifier is allowed to have some quantum capacity.

Feasibility of a finger prick-based self-testing kit in first- and second-degree relatives of children with coeliac disease

AIM:To assess feasibility of a finger prick-based kit as method for self-testing of first and second-degree relatives of coeliac disease (CD) patients. METHODS:A total number of 379 subjects were invited to participate in this study,consisting of 197 first- degree and 182 second-degree relatives of CD patients. The self-testing kit (BiocardTM) was sent out with included instructions for use. Completed tests were sent back to the study coordinator for assessment. RESULTS:One hundred and ninety-six invited relatives carried out the BiocardTM test at home. Amongst these,70% were children. In 97% of the cases the test was performed correctly. Three tests revealed a positive result,all of which were later confirmed by serology and histology as coeliac disease.CONCLUSION:Our study indicates that BiocardTM test is a reliable,easy to use and well-accepted tool for home testing of first- and second-degree relatives of CD patients.

Assessing the Acceptability and Willingness to Use HIV Self-Testing among Student Nurses in a Private Nursing College, Gauteng Province, South Africa

Globally, there is increasing evidence that HIV self-testing (HIVST) is commonly practiced among health care workers (HCWs). Although HIVST kits are available in South Africa, their distribution and use remain unregulated and its acceptability, undocumented. The aim of the study was to explore the acceptability of HIV self-testing among student nurses, examine their willingness to use self-testing, and evaluate their views on the implementation of a regulated HIV self-testing programme. This was a qualitative explorative study, and six focus group discussions were conducted with 67 student nurses recruited from a private nursing college, in Pretoria, South Africa. Thematic analysis and NVivo10 qualitative software were used for data analysis. The nurses perceived HIVST as an acceptable option for HIV testing and most were willing to self-test. Self-testing will provide confidential and accessible HIV testing services, reduce the stigma associated with the condition, and increase partner testing and disclosure. HIVST is more likely to be practised if self-testing kits are easily accessible and affordable, and there are strategies to educate people before the adoption of HIVST. The lack of pre- and post-test counselling, the risk of inaccurate test results, and lack of strategies for the confirmation of self-testing results were the main arguments against HIVST. The high acceptance of HIVST among nurses suggests that HIVST is a feasible option to increase the uptake of HIV-testing among HCWs. However, pre- and post-test counselling should be considered important components in the implementation of self-testing services. Educational and awareness campaigns should precede the roll-out of the self-testing programs.

Phase-Coding Self-Testing Quantum Random Number Generator

How to estimate the randomness of the measurement outcomes generated by a given device is an important issue in quantum information theory. Recently, Brunner et al. [Phys. Rev. Lett. 112 （2014）140407] proposed a prepare-and-measure quantum random number generation scenario with device-independent assumption, which indicates a method to test the randomness of bit strings according to the generation process rather than the results. Based on this protocol, we implement a quantum random number generator with an intrinsic stable phase-encoded quantum key distribution system. The system has been continuously running for more than 200 h, a stable witness W with the average value of 0.9752 and a standard deviation of 0.0024 are obtained. More than 1 G random bits are generated and the results pass all items of NIST test suite.

HIV Self-Testing Kits Uptake in Mashonaland West Province, Zimbabwe, 2019-2020: A Secondary Data Analysis

Background: Human Immuno-Deficiency Virus Self-Testing (HIVST) is a process where an individual who wants to know their HIV status collects a specimen, performs a test and interprets the result by themselves. HIVST data from the Zimbabwe AIDS and TB Program (ATP) directorate showed that between 2019-2020, only 31% of the target HIVST kits were distributed in the country. Mashonaland West Province was one of the least performing provinces in meeting targets for HIVST kits distribution. Gaps in the implementation of the HIVST in the province ultimately affect the nationwide scaleup of targeted testing, a key enabler in achieving HIV epidemic control. We analyzed HIVST trends in Mashonaland West Province to inform HIV testing services programming. Methods: We conducted a cross-sectional study using HIVST secondary data obtained from the District Health Information Software 2 (DHIS2) electronic database. We conducted regression analysis for trends using Epi Info 7.2 and tables, bar graphs, pie charts and linear graphs were used for data presentation. Results: A total of 31,070 clients accessed HIVST kits in Mashonaland West Province from 2019-2020. A slightly higher proportion (50.4% and 51.7%) of females as compared to males accessed HIVST kits in 2019 and 2020 respectively. Overall, an increase in the trend of HIVST kits uptake was recorded (males R2 = 0.3945, p-value = 0.003 and females R2 = 0.4739, p-value = 0.001). There was generally a decline in the trend of community-based distribution of HIVST kits from the third quarter of 2019 throughout 2020 (R2 = 0.2441, p-value = 0.006). Primary distribution of HIVST kits remained the dominant method of distribution, constituting more than half of the kits distributed in both 2019 (67%) and 2020 (86%). Conclusion: Mashonaland West Province was mainly utilising facility-based distribution model for HIVST over the community-based distribution model. We recommended training more community-based distribution agents to increase community distribution of HIVST kits.

体外诊断试剂自检实验室质量管理体系建设探讨

目的:为注册申请人建立和运行与开展自检工作相适应的实验室质量管理体系提供参考,为注册质量管理体系现场核查注册申请人自检能力提供可操作的检查方法。方法:通过梳理新版《医疗器械监督管理条例》及欧美医疗器械的法规要求,结合检验检测实验室质量管理体系通用要求,分析实验室质量管理体系建立和运行关键要点。结果与结论:体外诊断试剂自检实验室质量管理体系建设的关注要点包括人员、设备和环境设施、样品、质量控制、记录、检验方法等,各关键要素的有效循环与改进,可持续提升实验室检验检测能力。而建立科学、规范的实验室质量管理体系是保证产品检验准确、结果可靠的基础,是深化“放管服”改革的有效探索,有助于激发注册申请人创新发展的活力。

我国医疗器械注册自检工作推进与思考

目的 为促进《医疗器械注册自检管理规定》(以下简称《规定》)的理解和助推医疗器械注册自检工作提供参考。方法 以“医疗器械”“注册管理”“注册检验”“注册自检”为关键词,检索中国知网和万方数据库自建库起至2023年5月的相关文献,通过对相关文献的考证分析,结合《规定》起草过程中行业内反馈的诸多意见,总结我国医疗器械注册检验制度演变、注册自检工作基本要求和注册自检工作对行业的影响。结果与结论 《规定》是为了贯彻落实《医疗器械监督管理条例》要求而制定的。《规定》的实施必将推动我国医疗器械产业创新高质量发展,是我国医疗器械注册管理的重大调整。

3000t加载力盾构机钢结构试验平台设计

为了开发新型盾构机,开发一套满足试验要求的试验平台成为当务之急。本文针对新型盾构机在挖掘过程中的土压力模拟和管片非完全整周拼装问题,设计了一种新型的可周转盾构机试验平台。该平台包括拉杆、环梁、斜梁、腹杆、法兰和柱脚等组成部分,钢材采用Q355钢材。采用SAP2000和MADIS GEN两种软件进行分析和校核。本设计中试验架的荷载工况较多,为此在设计中考虑了前后液压缸的不同工作状态组合;由于该平台自重较大,需要考虑试验平台制作方便及减轻运输单元的重量及试验平台需要周转使用,对试验平台进行适当的结构单元划分;其次,构件的连接是设计中需要考虑的一个重点问题。由于油缸传递到箱形截面杆件上的荷载较大,在设计中考虑了构件内焊接隔板优化杆件整体传递荷载能力及板件抗局部失稳能力。试验平台投入实践开发工作表明,本试验平台系统安全、可靠且受力合理,能够满足盾构机试验的需求。本设计为类似的盾构机试验研究提供了可资参考的案例。