Introduction: 

HIV self-testing (HIVST) is an alternative strategy for reaching population subgroups underserved by available HIV testing services. We assessed individual factors associated with ever HIVST within a community-based program.

Setting: 

Malawi.

Methods: 

We conducted secondary analysis of an end line survey administered under a cluster-randomized trial of community-based distribution of HIVST kits. We estimated prevalence differences and prevalence ratios (PRs) stratified by sex for the outcome: self-reported ever HIVST.

Results: 

Prevalence of ever HIVST was 45.0% (475/1055) among men and 40.1% (584/1456) among women. Age was associated with ever HIVST in both men and women, with evidence of a strong declining trend across categories of age. Compared with adults aged 25–39 years, HIVST was lowest among adults aged 40 years and older for both men [34.4%, 121/352; PR 0.74, 95% confidence interval (CI): 0.62 to 0.88] and women (30.0%, 136/454; PR 0.71, 95% CI: 0.6 to 0.84). Women who were married, had children, had higher levels of education, or were wealthier were more likely to self-test. Men who had condomless sex in the past 3 months (47.9%, 279/582) reported a higher HIVST prevalence compared with men who did not have recent condomless sex (43.1%, 94/218; adjusted PR 1.37, 95% CI: 1.06 to 1.76). Among men and women, the level of previous exposure to HIV testing and household HIVST uptake was associated with HIVST.

Conclusions: 

Community-based HIVST reached men, younger age groups, and some at-risk individuals. HIVST was lowest among older adults and individuals with less previous exposure to HIV testing, suggesting the presence of ongoing barriers to HIV testing.

中文翻译：

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艾滋病毒自我检测会影响谁？马拉维农村社区计划内与自我测试相关的个体因素

介绍： 

艾滋病毒自测（HIVST）是一种替代策略，可以使可用的HIV测验服务无法满足的人群亚群。我们在基于社区的计划中评估了与艾滋病毒/艾滋病相关的个体因素。

设置： 

马拉维。

方法： 

我们对一项以社区为基础的HIVST试剂盒分发的集群随机试验进行的终点调查进行了二级分析。我们估计了按性别分层的患病率和患病率（PR），以得出结果：自我报告过的HIVST。

结果： 

男性曾经感染过艾滋病毒的人数是45.0％（475/1055），女性是40.1％（584/1456）。不论男女，年龄都与艾滋病毒/艾滋病有关，证据表明，各个年龄段的人均呈下降趋势。与25-39岁岁的成人相比，HIVST是40岁及以上的成年人中最低的男人[34.4％，352分之121; PR 0.74，95％置信区间（CI）：0.62至0.88]和女性（30.0％，136/454； PR 0.71，95％CI：0.6至0.84）。已婚，育有子女，受过较高教育或较富有的妇女更有可能进行自我测试。在过去3个月内无安全套性行为的男性（47.9％，279/582）报告说，与男性相比，HIVST患病率更高最近没有无避孕套性生活的人（43.1％，94/218；调整后的PR 1.37，95％CI：1.06至1.76）。在男性和女性中，以前接受艾滋病毒检测和家庭接受艾滋病毒的水平与艾滋病毒相关。

结论： 

以社区为基础的艾滋病毒/艾滋病传播覆盖了男性，较年轻的年龄段以及一些高危人群。在老年人和以前接触HIV检测较少的人群中，HIVST最低，表明存在持续的HIV检测障碍。