Secondary Distribution of Dual HIV/Syphilis Self-Testing Among Men Who Have Sex With Men: Pragmatic Randomized Controlled Trial in China
Notice bibliographique
Résumé
BACKGROUND: The World Health Organization recommends dual HIV/syphilis testing, but this approach has not been examined in many low- and middle-income countries. Dual HIV/syphilis self-testing may accelerate secondary distribution of self-test kits. Preliminary studies in Guangdong, China, have demonstrated the feasibility and cost-effectiveness of dual HIV/syphilis self-testing distribution via social media, but evidence comparing dual HIV/syphilis self-testing to single HIV self-testing for secondary distribution within social networks remains limited in resource-limited settings. OBJECTIVE: We aimed to evaluate the effectiveness of secondary distribution of dual HIV/syphilis self-testing kits in promoting HIV testing uptake among men who have sex with men (MSM) in China. METHODS: We conducted a pragmatic 3-arm randomized controlled study in the Guangxi Zhuang Autonomous Region, China. MSM aged 18 years or older who were HIV-negative were enrolled and randomly assigned (1:1:1) to either the site-based HIV testing (SBT) group (110/330, 33.3%), single HIV self-testing (SST) group (110/330, 33.3%), or dual HIV/syphilis self-testing (DST) group (110/330, 33.3%). Participants in the SST and DST groups received free finger-prick-based HIV self-testing or HIV/syphilis self-testing kits at enrollment and during the 12-month follow-up. The primary outcome was the mean number of social network members motivated by the participant and the mean frequency of HIV tests per participant within a 3-month period. The data were analyzed using an intention-to-treat analysis. RESULTS: A total of 330 MSM were recruited, among whom 319 (319/330, 96.7%) completed at least 1 follow-up survey and were subsequently included in the analysis. Among the participants, 245/319 (77%) had a college education or above. Compared to social network members in the SBT group, those in the intervention SST and DST groups were more likely to motivate others for HIV testing over a 3-month average duration. The mean number of motivated individuals was 0.42 in the SST group versus 0.20 in the SBT group, a mean difference (MD) of 0.22 (95% CI 0.12-0.33; P<.001). The mean was 0.51 in the DST group versus 0.20 in the SBT group, with an MD of 0.32 (95% CI 0.20-0.43; P<.001). The mean frequency of total HIV tests per participant in the SST group (1.33) was higher than that in the SBT group (0.87), with an MD of 0.46 (95% CI 0.31-0.62; P<.001) over 3 months. Over a 3-month period, the mean number of HIV tests per participant was higher in the DST group (1.43) than in the SBT group (0.87), with an MD of 0.57 (95% CI 0.41-0.73; P<.001). A total of 4 (1.3%) individuals had a new HIV positive result, while 11 (3.4%) had a new syphilis positive result. All individuals who had positive self-test results underwent laboratory-based confirmation tests. There were no adverse events reported. CONCLUSIONS: Our data demonstrate that the secondary distribution strategy of HIV/syphilis self-testing proves to be an effective means of expanding HIV testing coverage by encouraging the distribution of testing kits within the social networks of MSM. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100050898; https://www.chictr.org.cn/hvshowproject.html?id=158876.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,004 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».